Middle Back Pain Left Side: Causes, Organs, Relief

Middle back pain on your left side can take many diverse forms. It can occur as a sudden sharp stitch or as a throbbing, burning, or stabbing pain that worsens with each day.

This type of pain can occur as a result of many causes, including common injuries such as muscle sprains and strains. It can also happen when you become injured from a traumatic event. While less likely, left-sided middle back pain can also be caused by severe health problems such as a heart attack or cancer.

Left-Sided Middle Back Pain Causes

Common Causes

• Herniated disc: A herniated disc, also known as a slipped or ruptured disc, is a disc that bulges out from between the vertebrae (the 26 bones that make up your spine). In this position, the disc may exert pressure on your spinal nerves, causing middle back pain.
• Myofascial pain: Myofascial pain affects the fascia, the connective tissue in and between the muscles in your back. It is characterized by knotty “trigger points” that hurt when pressed. This type of middle back pain is typically a deep, aching, or throbbing muscle pain that lasts a long time and may worsen.
• Osteoarthritis: Osteoarthritis is caused by the breakdown of cartilage, the flexible tissue that cushions the small facet joints in your spine so they glide over each other.
• Poor posture: Poor posture puts uneven pressure on the tendons, muscles, and ligaments that support your spine. This is a common risk factor among people who sit for long periods and hunch over a keyboard. Sitting with proper posture helps to evenly distribute your weight without placing abnormal pressure on one area of your back and spine.
• Spinal deformity: A severe curve or abnormal development of the thoracic spine can strain the muscles and spinal discs in your middle back, resulting in pain. Examples include scoliosis (curvature of the spine) and kyphosis (curvature of the spine that leads to a round or hunched back).
• Tissue injuries: Tissue injuries, such as sprains or strains, to your spinal muscles, discs, or joints are the most common causes of left-sided middle back pain. They typically occur from impact that occurs during a fall, car accident, or sports injury.
• Vertebral fractures: The bones in your middle spine can become fractured as a result of an injury, fall, or automobile accident. Having osteoporosis (loss of bone mass and bone mineral density) leads to a decrease in bone strength, which increases your risk for vertebral fractures.

Rarer Causes

• Aortic aneurysm: Your aorta is your largest artery. It carries nutrients and oxygenated blood from your heart to other parts of your body. An aneurysm is a bubble that forms in the wall of a weakened, diseased artery. It causes the wall to expand and weaken. An abdominal aortic aneurysm can cause sudden, severe abdominal pain and referred back pain.
• Cauda equina syndrome: Cauda equina syndrome compresses or squeezes the nerves in your lower spine so they become paralyzed. It interferes with the normal motor and sensory functions of your bladder and lower extremities.
• Heart attack: Middle back pain can occur as a symptom of a heart attack, especially in women. This type of left-sided middle back pain may be accompanied by other signs of a heart attack such as tightness or pressure in your chest that radiates to your shoulders and arms, vomiting, dizziness, and/or shortness of breath.
• Pleurisy: Pleurisy is inflammation of the pleura, the lining that surrounds your lungs and chest cavity. The condition causes a sharp chest pain that can radiate to trigger middle back pain.
• Tumor: A benign (noncancerous) or malignant (cancerous) spinal tumor that grows in the middle back can exert pressure on the area. It can impact normal alignment and interfere with areas such as muscles and nerves.

Basic Back Anatomy to Understand Pain Location

Your middle back, or thoracic spine, is the area between your upper back (cervical spine) and lower back (lumbar spine). Your middle back consists of 12 vertebrae labeled T1 through T12. These discs separate the bones from each other and absorb shock, and muscles and ligaments that hold your spine together. Your middle back starts under your shoulder blades and extends to the bottom of your rib cage, down to your last rib.

Muscles, nerves, tendons, and ligaments surround your thoracic spine to help with movement and flexibility. When these sites are damaged or diseased, they can cause middle back pain. Middle back pain on your left side can also be linked to your kidneys. These organs are located on each side of your spine behind your rib cage, so they can be the source of pain in this area when problems such as kidney stones or a pyelonephritis (kidney infection) occur.

Middle back pain can also occur from conditions that affect your pancreas. Chronic pancreatitis can cause pain that starts in the middle or left side of your abdomen and radiates to your back. Pancreatic cancer or colon cancer can also affect your middle back if the disease causes a tumor that presses on your spine.

How to Relieve Minor Middle Back Pain on Your Left Side

Most cases of minor middle back pain on your left side can be managed with conservative home care when symptoms are mild to moderate. These treatments can include:

Medications:

Home Therapies:

• Avoid the tendency to seek bed rest. Instead, limit activities that cause pain and gradually increase physical activity as much as possible.
• Exercise to stretch and strengthen the muscles of your back.
• Maintain a healthy lifestyle with a well-balanced diet, relaxation, and a regular sleep schedule.
• Practice moving your body properly to avoid increasing pain.
• Use cold packs to relieve back pain.
• Use hot packs to increase blood flow and promote healing in damaged back muscles and tissues.

When Left-Sided Middle Back Pain Warrants a Provider Visit

While you may be able to achieve relief from some types of minor middle back pain, certain types of pain warrant a consultation with a healthcare provider. Though a telehealth visit may be appropriate for following up on chronic middle back pain, the assessment of new pain often requires an in-person visit.

To ensure you receive the right care as quickly as possible, ask your healthcare provider what type of visit is appropriate. Start with your primary healthcare provider to rule out causes of left-sided middle back pain that may involve other aspects of your health.

Contact your healthcare provider if your left-sided middle back pain involves any of the following characteristics:

• Accompanied by other abnormal sensations: When middle back pain is accompanied by sensations such as tingling, numbness, or weakness and the pain remains constant despite taking over-the-counter pain relievers, it may be a sign of a pinched nerve or other nerve damage.
• Accompanied by urinary or fecal incontinence: Middle back pain that occurs with the inability to control your bowels or urination, especially if it also involves leg numbness, may indicate a rare condition called cauda equina syndrome. This condition, in which the nerves in your lower spine become paralyzed, requires emergency treatment.
• After a traumatic injury: Middle back pain that occurs after any type of trauma, including a car accident, fall, or other type of injury may be a sign of a fracture or other more serious problem.
• Extends to other body parts: Middle back pain that irradiates to other body parts, such as down the back of the leg, may be a sign of sciatica or a herniated disc.
• Lasts longer than a week: Since back pain caused by minor issues usually subsides within a week, pain that lasts longer may be a sign of a more serious issue.
• With a fever: Middle back pain that occurs with a fever that does not improve with over-the-counter fever-reducing medication may be a sign of an infection.
• With weight loss due to unknown causes: Middle back pain that occurs with sudden and unexplained weight loss may indicate a more severe condition such as a tumor or an infection.
• Worsens at certain times or when you’re in certain positions: Middle back pain that intensifies at night or when you assume certain positions, such as standing or lying down, may be a sign of a more severe problem such as a fracture, infection, nerve compression, or cancer.

Diagnosis

An accurate diagnosis of left-sided middle back pain requires an in-person visit with a healthcare provider. Depending on your symptoms, your healthcare provider may use one or more of the following techniques to determine the cause of your pain:

• Blood tests: These tests may be used to identify infections, inflammation, or other medical disorders that may be causing your pain.
• Bone scan: A bone scan (bone scintigraphy) checks for abnormal areas of damage in your bones. This nuclear imaging technique involves the injection of a tracer (a small amount of radioactive material) into your vein to highlight areas of bone damage or disease.
• Computed tomography (CT) scan: A CT scan uses X-rays to create a three-dimensional image when an X-ray does not provide adequate detail.
• Electromyography (EMG) or nerve conduction velocity testing: An EMG test measures electrical activity within your muscles. A nerve conduction test measures how electrical signals travel down your nerves. These two tests are often performed together.
• Imaging tests: The following imaging tests are used to rule out or determine the cause of your back pain.
• Magnetic resonance imaging (MRI): An MRI uses a strong magnetic field and radio waves to produce two-dimensional (2D) or three-dimensional (3D) images of your spine and other internal structures such as muscles, joints, ligaments, and discs.
• Physical examination: This involves a discussion of your symptoms, medical history, and current health conditions. Your healthcare provider will closely look at your spine, head, neck, and pelvis for signs of misalignment or inflammation that may indicate the cause of your pain. Your reflexes, muscle strength, and sensation will also be tested.
• X-ray: X-rays, or radiography, use a small amount of electromagnetic radiation to create images of your back that can show fractures, misalignment, and changes due to aging.

Treatment

The type of treatment your healthcare provider advises for your left-sided middle back pain depends on the cause of your symptoms. When home remedies do not relieve your pain, one or more of the following prescribed treatments may be used:

• Epidural steroid injections or numbing injections for certain types of back pain, such as middle back pain that travels down your leg due to nerve irritation or compression
• Prescribed drugs called neuromodulatory drugs that change the way your nerves communicate with other nerves to reduce the influence of pain signals
• Prescription pain relievers for severe acute back pain
• Physical therapy to strengthen the muscles that support your back and decrease pain
• Posture training to learn proper movement and standing
• Transcutaneous electrical nerve stimulation (TENS) to send mild electrical pulses to the nerves through a device and electrodes or pads that are placed on your skin
• Bracing
• Therapeutic ultrasound to provide deep heating to soft tissues such as muscles, tendons, joints, and ligaments.

Evidence suggests that complementary and alternative medicine (CAM), such as the following, may also be successful in relieving some types of left-sided middle back pain:

While surgery is not routinely used to treat middle back pain, surgical treatments may be advised if conservative treatments do not provide relief from left-sided middle back pain. These procedures include:

• Vertebroplasty and kyphoplasty: Procedures that treat compression fractures of the spine by using a special cement to stabilize the fractured vertebrae
• Laminectomy: A procedure used to treat spinal stenosis (narrowing of the spinal canal that compresses the spinal cord and/or nerve roots) by removing the bone spurs (bony growths) on the bone walls of the vertebrae to open the spinal column and remove pressure on the nerves
• Discectomy: A procedure that removes a herniated disc and bone spurs compressing the spinal cord and/or surrounding nerve roots that branch off from it
• Spinal fusion: A procedure that corrects deformities caused by degenerative disc disease and spondylolisthesis by fusing two or more vertebrae to increase stability and decrease the motion that may be the source of your pain
• Disc replacement: A procedure that removes a damaged disc and replaces it with an artificial disc that mimics a healthy disc and preserves your spine’s natural ability to move
• Foraminotomy: A procedure to widen the foramina, the openings in the vertebrae where the spinal nerve roots exit from the spinal cord
• Laser surgery: A procedure that uses bursts of laser energy to relieve nerve pressure by reducing the size of a damaged disc
• Radiofrequency lesioning: A procedure that blocks inputs of the pain signals outside the spinal cord from entering the spinal cord
• Spinal cord stimulation: A procedure that uses imperceptible levels of electricity to stimulate your spinal cord to block pain signals from the spinal cord to the brain

How to Stay Ahead of Back Pain Flares

While you may not be able to prevent all types of back pain flares, following these strategies can help reduce your risk of preventable causes and the damage that occurs:

• Establish and maintain a healthy weight. Avoiding excess weight reduces the amount of strain on your back.
• Maintain posture when sitting. This requires sitting up straight, with your back against the back of your chair. Keep your feet flat on the floor and your knees slightly higher than your hips.
• Use the correct lifting technique that concentrates on lifting with your legs, not your back. To do this, squat down at your knees, stand straight up without hunching over, and carry heavy objects close to your body without bending forward.
• Consume the recommended amounts of calcium and vitamin D through diet and supplements to keep your bones strong and prevent osteoporosis.
• Keep your back strong by performing exercises that strengthen and stretch your back muscles at least twice weekly.
• Remain active. Every week, aim for at least 150 minutes of moderate-intensity aerobic activity and at least two days that involve lifting weights or other activities that strengthen your muscles.
• Try a yoga class. This practice can help stretch and strengthen your back muscles and improve your posture.
• Quit smoking. Smoking increases your risk of atherosclerosis (hardening of the arteries), which can cause back pain and degenerative disc disorders.

Summary

Middle back pain on your left side describes pain that occurs below your neck and above the bottom of your rib cage. Also called the thoracic spine, your middle back can hurt as a result of problems that involve injuries, poor posture, or spinal conditions. Less common, pain in the area can also occur as a result of more severe problems such as a heart attack, cancer, or kidney stones.

While most causes of left-side middle back pain resolve with home treatment, more severe problems may need other types of care. Middle back pain on your left side that lasts more than a week should be diagnosed by your healthcare provider. Treatments that range from prescription drugs to surgery may be needed to provide relief. Health conditions must be addressed if they are the cause of the pain.