Upper Left Back Pain: When to Seek Medical Advice - Family Medicine

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Upper left back pain, particularly when it is localized near the spine and associated with discomfort in the side ribs, can be concerning and warrants a thorough evaluation. Given your symptoms, it is essential to consider various potential causes, including musculoskeletal issues, referred pain from internal organs, or even nerve-related problems.

Since you have already consulted with a gastroenterologist and a urologist, and have undergone a gastroscopy and abdominal ultrasound without significant findings, it is prudent to explore other avenues. The recommendation to see a pulmonologist (胸腔科) may be appropriate if there is a suspicion of lung-related issues, especially if you experience any respiratory symptoms or if the pain worsens with breathing.

However, before proceeding to a pulmonologist, I would suggest considering a visit to an orthopedic specialist or a physical medicine and rehabilitation (PM&R) physician. These specialists can assess for any musculoskeletal conditions, such as muscle strain, ligament injuries, or spinal issues that could be contributing to your pain. Conditions like thoracic outlet syndrome, herniated discs, or even referred pain from the cervical spine can manifest as upper back pain and may require imaging studies like an MRI or CT scan for a definitive diagnosis.

In addition, if you have any neurological symptoms, such as numbness, tingling, or weakness in your arms or legs, it would be wise to consult a neurologist. They can evaluate for any nerve compression or other neurological conditions that might be causing your symptoms.

It is also important to consider lifestyle factors that could be contributing to your discomfort. Poor posture, prolonged sitting, or repetitive movements can lead to muscle imbalances and pain. Engaging in physical therapy may provide relief through targeted exercises, stretching, and manual therapy techniques that can help alleviate muscle tension and improve mobility.

In summary, while it is essential to rule out serious conditions related to your internal organs, the next logical step would be to consult with an orthopedic specialist or a PM&R physician. They can perform a comprehensive evaluation and determine if further imaging or treatment is necessary. If musculoskeletal issues are ruled out, then pursuing a pulmonologist or neurologist may be warranted based on the findings. Always listen to your body, and do not hesitate to seek medical advice if your symptoms persist or worsen.