Sudden Left Upper Back Pain: When to Seek Medical Advice

Pain in the upper left back?

Last night, while lying down, I suddenly experienced an unexplained soreness in the left side of my back, which felt similar to the soreness after running three kilometers.
The discomfort was so intense that I could hardly sleep through the night.
It is not posture-related, as the soreness persists whether I am lying down or sitting.
This has continued into tonight, making it difficult for me to sleep again.
Occasionally, I feel a bit nauseous, but I'm not sure if it's related.
In the past, I had a similar unexplained soreness, and the doctor at the clinic suggested it might be a deep muscle strain.
I also read online that it could be caused by gastroesophageal reflux (GERD), which I have a history of but hasn't flared up in a while.
I'm wondering if I should first consult a family medicine physician or if I should see a gastroenterologist, pulmonologist, or cardiologist.
Thank you.

Xiao Lin, 30~39 year old female. Ask Date: 2022/10/09

Dr. Liao Yaopan reply Family Medicine

Hello, please consult your family physician for an initial assessment.
If necessary, they may refer you to the appropriate subspecialty.
Please note that online consultations are not equivalent to in-person visits and cannot provide diagnoses or treatment recommendations.
Changhua Hospital cares about you.

Reply Date: 2022/10/09

More Info

When experiencing sudden left upper back pain, especially if it is severe enough to disrupt sleep, it is essential to approach the situation with caution. The symptoms you describe—persistent soreness that feels like muscle fatigue, accompanied by occasional nausea—can arise from various causes, some of which may require immediate medical attention.

1. Musculoskeletal Issues: The most common cause of sudden back pain is musculoskeletal strain. This can occur from overexertion, awkward movements, or even sleeping in an uncomfortable position. If you have a history of similar pain that was attributed to muscle strain, this could be a recurrence. However, if the pain is severe and persistent, it is advisable to consult a healthcare provider to rule out more serious conditions.

2. Gastroesophageal Reflux Disease (GERD): Given your history of GERD, it is possible that the pain could be related to acid reflux. GERD can cause referred pain in the back, particularly if there is significant esophageal irritation. If you notice that the pain correlates with meals or is accompanied by heartburn, this could be a contributing factor.

3. Cardiac Concerns: Although less common, left-sided back pain can sometimes be associated with cardiac issues, particularly in individuals with risk factors such as a history of heart disease, high blood pressure, or diabetes. Symptoms like nausea, sweating, or radiating pain to the arm or jaw should prompt immediate medical evaluation to rule out a heart attack or other serious cardiac conditions.

4. Pulmonary Issues: Conditions affecting the lungs, such as pneumonia or pleuritis, can also present with upper back pain. If you experience shortness of breath, coughing, or fever, it is crucial to seek medical attention promptly.

5. When to Seek Medical Advice: Given the severity of your symptoms and their impact on your sleep, it is advisable to consult a healthcare provider. You can start with your primary care physician, who can perform a thorough evaluation and determine if further testing is necessary. Depending on the findings, they may refer you to a specialist, such as a gastroenterologist for GERD concerns or a cardiologist for potential heart-related issues.

6. Diagnostic Tests: Your doctor may recommend imaging studies, such as X-rays or an MRI, to assess for any structural issues in the spine or surrounding tissues. Blood tests may also be conducted to check for signs of inflammation or other underlying conditions.

In summary, while your symptoms may be related to a benign musculoskeletal issue, the combination of persistent pain and nausea warrants a thorough evaluation. It is always better to err on the side of caution, especially when it comes to potential cardiac or gastrointestinal concerns. Seeking medical advice will help ensure that you receive appropriate care and peace of mind.

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