Upper Left Back Pain: Gastrointestinal or Musculoskeletal Issues? - Pulmonology

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Left upper back pain?


Hello Doctor, I would like to ask some questions.
I have had gastrointestinal issues for a long time, experiencing gastroenteritis at least a dozen times since childhood.
Last April, I felt unwell, and the examination revealed that my dizziness was caused by inner ear imbalance.
After taking Meclizine for over two months, I mostly recovered.
However, in August, I visited a doctor again due to stomach discomfort.
I underwent an endoscopy, which showed gastroesophageal reflux disease (GERD) but was otherwise normal.
After taking Pantoprazole for two months, I gradually improved, but I still occasionally feel nauseous and lack appetite, although I have not actually vomited.
Recently, I have occasionally felt strange sensations in my heart and consulted a traditional Chinese medicine practitioner.
He believes it is related to my stomach issues.
After taking his medication for a while, the frequency of these sensations decreased.
However, recently I have been experiencing pain in the upper left back, just below the scapula, for about a week (I have had similar pain before).

Could this be related to my stomach issues, or is it more likely due to exercise-related injuries from weight training or poor posture in daily life? If it is one of those causes, that would be fine, but I am most concerned about whether there could be a problem with my lungs (I have been smoking for several years, but I do not have a cough and have not lost weight).
Should I go to the hospital for an examination, or should I rest for a while and see if it improves? I have an upcoming graduate school exam, and my entire routine has been disrupted.
I hope you can provide me with some advice.
Thank you.

Ellis, 20~29 year old female. Ask Date: 2017/01/05

Dr. Jian Shuntian reply Pulmonology


Hello: It is recommended to have a chest X-ray and then consult a pulmonologist for further advice.

Reply Date: 2017/01/05

More Info


Upper left back pain can be a complex issue, often stemming from a variety of causes, including gastrointestinal problems, musculoskeletal issues, or even referred pain from other organs. Given your history of gastrointestinal problems, including recurrent gastritis and gastroesophageal reflux disease (GERD), it is reasonable to consider whether your current symptoms might be related to these conditions.

Firstly, it is important to understand that the body’s anatomy allows for pain to be referred from one area to another. For instance, issues with the stomach or esophagus can sometimes manifest as pain in the back, particularly in the upper left quadrant. This is due to the shared nerve pathways that innervate these areas. In your case, the discomfort you feel in your upper left back could potentially be linked to your ongoing gastrointestinal issues. The sensation of nausea and lack of appetite you mentioned could also be indicative of an underlying gastrointestinal disturbance that might be contributing to your discomfort.

On the other hand, your symptoms could also be attributed to musculoskeletal issues, especially considering your engagement in weight training. Activities like heavy lifting or improper form during exercises can lead to muscle strain or injury, particularly in the back and shoulder areas. The pain you describe near the scapula could be a result of muscle tension or strain, which is common among individuals who participate in physical training without proper warm-up or recovery practices. Poor posture during daily activities, such as sitting for extended periods while studying, can exacerbate these musculoskeletal issues, leading to discomfort in the upper back.

Given your concern about potential lung issues, it is worth noting that while smoking can lead to various pulmonary problems, the absence of cough or weight loss is a positive sign. However, if you are experiencing persistent pain that does not improve with rest or over-the-counter pain relief, it would be prudent to consult a healthcare professional. They may recommend imaging studies, such as an X-ray or MRI, to rule out any serious underlying conditions, including issues with the lungs or spine.

In the meantime, here are some recommendations to help manage your symptoms:
1. Rest and Recovery: Allow your body to recover from any potential strain. Avoid heavy lifting or strenuous activities until the pain subsides.

2. Posture Correction: Pay attention to your posture, especially while studying or working at a desk. Ensure that your workspace is ergonomically friendly to reduce strain on your back.

3. Gentle Stretching and Strengthening: Incorporate gentle stretching exercises for your back and shoulders. Strengthening your core muscles can also provide better support for your spine.

4. Heat Therapy: Applying a warm compress or heating pad to the affected area can help alleviate muscle tension and pain.

5. Hydration and Nutrition: Maintain good hydration and a balanced diet to support your overall health, particularly your gastrointestinal function.

6. Consult a Professional: If your symptoms persist or worsen, seek medical advice. A healthcare provider can perform a thorough evaluation and may refer you to a specialist if necessary.

In conclusion, while your upper left back pain could be related to your gastrointestinal history, it is essential to consider musculoskeletal factors as well. Monitoring your symptoms and seeking medical advice when necessary will help ensure that you address any underlying issues effectively.

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