Diagnosis can be made after thorough history taking and physical examination. Recent history of fall, accidents injuries and stings may suggest the cause of upper left back pain. Presence of fever is assessed to rule out possibility of infections. Blood investigations help to detect infections, inflammation and other possible conditions. X-rays, bones scans and MRI may be performed to find bone, muscle, ligament and soft tissue damage as well as diseases of lung and abdominal organs. Nerve conduction studies, ECG and other cardiac related investigations may be performed, if appropriate.
Posture when sitting: A good seat for working should have good back support, arm rests and a swivel base. When sitting, try to keep your knees and hips level and keep your feet flat on the floor, or use a footstool. You should ideally be able to sit upright with support in the small of your back. If you are using a keyboard, make sure your elbows are at right-angles and that your forearms are horizontal.
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Rest. If your back hurts a lot, take a break. But try not to let too much time pass before you get moving again. Instead, return to your activities slowly, and avoid things that make your pain worse. Studies show that bed rest doesn't relieve back pain better than staying active. And bed rest of more than a couple of days can make your back pain worse and lead to other problems, such as stiff joints and muscle weakness.
Treatment options include physical therapy, back exercises, weight reduction, steroid injections (epidural steroids), nonsteroidal anti-inflammatory medications, rehabilitation and limited activity. All of these treatment options are aimed at relieving the inflammation in the back and irritation of nerve roots. Physicians usually recommend four to six weeks of conservative therapy before considering surgery.
Activity: Bed rest should be limited. Individuals should begin stretching exercises and resume normal daily activities as soon as possible, while avoiding movements that aggravate pain. Strong evidence shows that persons who continue their activities without bed rest following onset of low back pain appeared to have better back flexibility than those who rested in bed for a week. Other studies suggest that bed rest alone may make back pain worse and can lead to secondary complications such as depression, decreased muscle tone, and blood clots in the legs.
How can disc desiccation be treated? The bones in the back have sponge-like discs between them. These discs can become dehydrated and lose flexibility, often as people age, resulting in desiccation. Treatment, that can include at-home therapy, depends on the severity of the desiccation, which can cause stiffness in the back and pain. Learn more here. Read now
Cat-cow: Start on all fours, with palms and knees on the ground. Slowly arch your back, tilt your butt up and look up at the ceiling so you make a C curve with your torso. Return to the neutral starting position, then tilt your pelvis down and gaze at the floor near your feet, so your body reverses the C curve the other way. Return to neutral and repeat the series three times.

Emerging technologies such as X-rays gave physicians new diagnostic tools, revealing the intervertebral disc as a source for back pain in some cases. In 1938, orthopedic surgeon Joseph S. Barr reported on cases of disc-related sciatica improved or cured with back surgery.[100] As a result of this work, in the 1940s, the vertebral disc model of low back pain took over,[99] dominating the literature through the 1980s, aiding further by the rise of new imaging technologies such as CT and MRI.[100] The discussion subsided as research showed disc problems to be a relatively uncommon cause of the pain. Since then, physicians have come to realize that it is unlikely that a specific cause for low back pain can be identified in many cases and question the need to find one at all as most of the time symptoms resolve within 6 to 12 weeks regardless of treatment.[99]
In all other cases, you can safely read this tutorial first. For instance, even if you have severe pain or numbness and tingling down your leg, you can safely read this first. Or, even if you have an obviously severe muscle tear from trying to lift your car or something, you can safely start here — rest and read. Your back is not as fragile as you probably think, and understanding why is a great starting place for healing in nearly all cases of low back pain.
Please note that none of the above given tips or recommendations substitute medical advice. Important: consult a health professional in case of an injury or if you suspect overuse of joints or a medical condition such as a fracture. A physician should be consulted in those acute cases when the condition is accompanied by reddening, swelling or hyperthermia of joints, ongoing joint trouble or severe pain and/or are associated with neurological symptoms

Exercise may offer relief if you suffer from middle and upper back pain in pregnancy. It’s advisable to get some advice from an antenatal exercise specialist who can tailor your exercise programme for your specific needs to support and help strengthen your back. You should avoid sleeping on your back.Try to sleep on your left side, and use a support pillow under your knees. A support belt under your abdomen may also help and make sure you get plenty of rest.
Low back pain can be caused by tumors, either benign or malignant, that originate in the bone of the spine or pelvis and spinal cord (primary tumors) and those which originate elsewhere and spread to these areas (metastatic tumors). Symptoms range from localized pain to radiating severe pain and loss of nerve and muscle function (even incontinence of urine and stool) depending on whether or not the tumors affect the nervous tissue. Tumors of these areas are detected using imaging tests, such as plain X-rays, nuclear bone scanning, and CAT and MRI scanning.
Most acute low back pain fades steadily — up to 90% of it, for uncomplicated cases.10 And so does a lot of so-called “chronic” low back pain!11 But when you don’t recover, many of the therapeutic options — things like surgery for a herniated disc — cause anxiety that is unnecessary and harmful. The purpose of this tutorial is to review and expand the options.

Some people suffer from spinal stenosis. With this condition, the spinal canal itself narrows. This happens from age-related wear-and-tear, especially if you work in a physical job. The symptoms of this condition are pretty obvious. You’ll feel pain in the neck and back, especially when you stand straight. It’s often relieved when you bend over. Other more serious symptoms include:


On any matter relating to your health or well-being, please check with an appropriate health professional. No statement herein is to be construed as a diagnosis, treatment, preventative, or cure for any disease, disorder or abnormal physical state. The statements herein have not been evaluated by the Foods and Drugs Administration or Health Canada. Dr. Marchione and the doctors on the Bel Marra Health Editorial Team are compensated by Bel Marra Health for their work in creating content, consulting along with formulating and endorsing products.


Everything you need to know osteopenia: Causes, treatments, and prevention In this MNT Knowledge article, learn about osteopenia, in which bones have low bone density, a common sign of aging that is less serious than osteoporosis but does not generally show symptoms. How does it differ from osteoporosis, what causes it, and how can a person prevent and treat osteopenia? Find out here. Read now
Have you ever noticed how your muscles tense up when you’re stressing about something? Well, there’s a reason for that: Stress is considered part of the inherent “fight or flight” response that all humans have. If you’re stressed out, your body perceives those feelings as a response to some sort of threat, and that might trigger pain as a protective mechanism, says Zachary Rethorn, board-certified orthopedic physical therapist and clinical faculty member at the University of Tennessee at Chattanooga.
There are many causes of back pain, including blood vessels, internal organs, infections, mechanical, and autoimmune causes.[10] Approximately 90 percent of people with back pain are diagnosed with nonspecific acute back pain in which there is no serious underlying pathology.[11] In approximately 10 percent of people, cause can be identified through diagnostic imaging.[11] Less than 2 percent are attributed to secondary factors, with metastatic cancers and serious infections, such as spinal osteomyelitis and epidural abscesses, accounting for around 1 percent.[12]
The management of low back pain often includes medications for the duration that they are beneficial. With the first episode of low back pain the hope is a complete cure; however, if the problem becomes chronic, the goals may change to pain management and the recovery of as much function as possible. As pain medications are only somewhat effective, expectations regarding their benefit may differ from reality, and this can lead to decreased satisfaction.[13]
Shingles (herpes zoster) is an acute infection of the nerves that supply sensation to the skin, generally at one or several spinal levels and on one side of the body (right or left). Patients with shingles usually have had chickenpox earlier in life. The herpes virus that causes chickenpox is believed to exist in a dormant state within the spinal nerve roots long after the chickenpox resolves. In people with shingles, this virus reactivates to cause infection along the sensory nerve, leading to nerve pain and usually an outbreak of shingles (tiny blisters on the same side of the body and at the same nerve level). The back pain in patients with shingles of the lumbar area can precede the skin rash by days. Successive crops of tiny blisters can appear for several days and clear with crusty inflammation in one to two weeks. Patients occasionally are left with a more chronic nerve pain (postherpetic neuralgia). Treatment can involve symptomatic relief with lotions, such as calamine, or medications, such as acyclovir (Zovirax), for the infection and pregabalin (Lyrica) or lidocaine (Lidoderm) patches for the pain.
An uncomfortable position or uncomfortable bed while sleeping / at night could lead to upper and middle back pain or exacerbate the pain you’re experiencing. Try to find a comfortable sleeping position and use pillows to maintain this position whilst you’re asleep if needed. A relatively firm mattress may also be beneficial as a soft mattress doesn’t give your back proper support. According to the Sleep Council a mattress should be changed every 7 years³.
If you are experiencing true numbness14 around the groin and buttocks and/or failure of bladder or bowel control, please consider it a serious emergency — do not wait to see if it goes away. These symptoms indicate spinal cord injury or compression15 and require immediate medical attention. (Few people will have symptoms like this without having already decided it’s an emergency, but I have to cover all the bases here.)
Nonsteroidal anti-inflammatory drugs (NSAIDS) relieve pain and inflammation and include OTC formulations (ibuprofen, ketoprofen, and naproxen sodium). Several others, including a type of NSAID called COX-2 inhibitors, are available only by prescription. Long-term use of NSAIDs has been associated with stomach irritation, ulcers, heartburn, diarrhea, fluid retention, and in rare cases, kidney dysfunction and cardiovascular disease. The longer a person uses NSAIDs the more likely they are to develop side effects. Many other drugs cannot be taken at the same time a person is treated with NSAIDs because they alter the way the body processes or eliminates other medications.

The thoracic spine starts beneath the neck and is comprised of 12 vertebrae, labeled T1 through T12, which go down the back of the torso (Figure 1). Unlike the cervical spine and lumbar spine, the thoracic spine is relatively immobile because each of its vertebrae are connected to a pair of ribs (one on each side), which along with the sternum at the front of the chest combine to form the rib cage.
Gallbladder ailments. Even though your gallbladder is not located near your upper back, conditions affecting it, such as gallstones, can make your upper right back hurt. This is known as referred pain. Cholecystitis (inflammation of the gallbladder), is a potentially serious condition that can also cause pain in this area. When not treated, cholecystitis may make your gallbladder rupture.
^ Machado, GC; Maher, CG; Ferreira, PH; Pinheiro, MB; Lin, CW; Day, RO; McLachlan, AJ; Ferreira, ML (31 March 2015). "Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials". BMJ (Clinical Research Ed.). 350: h1225. doi:10.1136/bmj.h1225. PMC 4381278. PMID 25828856.
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.
Doctors lack the skills and knowledge needed to care for most common aches, pains, and injury problems, especially the chronic cases, and even the best are poor substitutes for physical therapists. This has been proven in a number of studies, like Stockard et al, who found that 82% of medical graduates “failed to demonstrate basic competency in musculoskeletal medicine.” It’s just not their thing, and people with joint or meaty body pain should take their family doctor’s advice with a grain of salt. See The Medical Blind Spot for Aches, Pains & Injuries: Most physicians are unqualified to care for many common pain and injury problems, especially the more stubborn and tricky ones.

“Red flags” are signs or symptoms that something medically ominous may be going on. Red flags are not reliable, and their presence is not a diagnosis. When you have some red flags, it only indicates a need to look more closely. Sometimes red flags are missing there really is something serious going on … and sometimes they are a false alarm.18 Check off all that apply … hopefully none or few or only the least alarming of them!


An odd-shaped spine, such as with scoliosis or kyphosis. This can make your back hurt. When you look at a normal spine from the back, it is usually straight. But when a person has scoliosis, the spine curves from side to side, often in an S or C shape. It may also be twisted. When a person has kyphosis, the upper spine is rounded and looks like a hump. In bad cases of scoliosis or kyphosis, a person may have a hard time breathing.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Scoliosis is a condition in which the spine curves and twists, like the letter "S" or letter "C." It usually develops in childhood or during adolescence. In most cases, the cause of scoliosis is unknown, although it may be related to an injury or birth defect. In some instances, multiple family members will have scoliosis, suggesting a potential genetic component.
^ Jump up to: a b c d e f Qaseem, A; Wilt, TJ; McLean, RM; Forciea, MA; Clinical Guidelines Committee of the American College of, Physicians. (4 April 2017). "Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians". Annals of Internal Medicine. 166 (7): 514–530. doi:10.7326/M16-2367. PMID 28192789.
This book-length tutorial explores the nature of the beast and reviews all popular back pain treatments. It is not a sales pitch for a miracle cure or guaranteed treatment method — there is no such thing — but I do offer some surprising ideas about underestimated factors and under-rated treatment strategies. I won’t claim that all back pain comes from a single cause or has one cure (exactly the opposite). It’s just a thorough tour of the topic, the myths and misconceptions, and the best (and worst) low back pain treatment ideas available.

Using the wrong form or overexerting yourself can strain muscles or tendons in your back, or sprain one of your ligaments, according to the Cleveland Clinic. That essentially means those components have been twisted, stretched, or torn. These kinds of injuries can present as abrupt pain that worsens with activity, muscles cramps or spasms, and stiffness or limited movement.

Conventional treatment consists of surgical removal of the appendix. This is called an appendectomy, and it can be done via minimally invasive laparoscopic surgery in uncomplicated cases. In some cases, it may be possible to treat appendicitis with antibiotics alone, meaning you may not need surgery. In one study, nearly three quarters of people who received antibiotics for their appendicitis did not require a later appendectomy.
Massage therapy does not appear to provide much benefit for acute low back pain.[1] A 2015 Cochrane review found that for acute low back pain massage therapy was better than no treatment for pain only in the short-term.[89] There was no effect for improving function.[89] For chronic low back pain massage therapy was no better than no treatment for both pain and function, though only in the short-term.[89] The overall quality of the evidence was low and the authors conclude that massage therapy is generally not an effective treatment for low back pain.[89]
Liver problems. Pain related to the liver may be caused by inflammation (hepatitis), an abscess, liver scarring (cirrhosis), or an enlarged or failing liver. Symptoms of liver problems include pain in the upper right abdomen and/or back, fatigue, nausea or lack of appetite, and jaundice. Liver problems are relatively rare in persons not already at risk.
Nachemson says, “Rarely are diagnoses scientifically valid … .” And Deyo: “There are wide variations in care, a fact that suggests there is professional uncertainty about the optimal approach.” Many other researchers have made this point, but Sarno states it most eloquently: “There is probably no other medical condition which is treated in so many different ways and by such a variety of practitioners as back pain. Though the conclusion may be uncomfortable, the medical community must bear the responsibility for this, for it has been distressingly narrow in its approach to the problem. It has been trapped by a diagnostic bias of ancient vintage and, most uncharacteristically, has uncritically accepted an unproven concept, that structural abnormalities are the cause of back pain” (p111). BACK TO TEXT

Lower right back pain is commonly caused by damage or injury to the spinal structures, such as the lower right back muscles, the lumbar intervertebral discs, or the facet joints. While problems with these structures are more likely to cause centralized pain around the spine, it is possible that pain is felt primarily or entirely on one side of the spine.


Age: The first attack of low back pain typically occurs between the ages of 30 and 50, and back pain becomes more common with advancing age. As people grow older, loss of bone strength from osteoporosis can lead to fractures, and at the same time, muscle elasticity and tone decrease. The intervertebral discs begin to lose fluid and flexibility with age, which decreases their ability to cushion the vertebrae. The risk of spinal stenosis also increases with age.
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