Left middle back pain experienced during breathing can be a concerning symptom. This discomfort, located in the thoracic spine, can range from a dull ache to a sharp, intense sensation that limits movement and respiration. While often benign, it can sometimes signal underlying health conditions requiring medical attention. Understanding potential causes and when to seek professional guidance is important.
Understanding Potential Causes
Pain in the left middle back that intensifies with breathing often stems from issues affecting respiratory structures. The thoracic spine, ribs, and surrounding muscles coordinate for lung expansion, making this area susceptible to pain from inflammation or injury. Conditions triggering this discomfort broadly fall into musculoskeletal issues, respiratory conditions, and less commonly, referred pain.
Musculoskeletal Issues
Muscle strains, from overuse, sudden movements, or poor posture, can cause sharp pain worsening with deep breaths or movement. The intercostal muscles, located between the ribs, are vulnerable to strain or inflammation, directly impacting breathing comfort. Rib injuries, such as fractures or bruising, also lead to severe pain during respiration.
Conditions like costochondritis, an inflammation of cartilage connecting ribs to the breastbone, may cause pain radiating to the back with breathing. Spinal conditions such as scoliosis, an abnormal spinal curvature, can place pressure on muscles and nerves, restricting rib cage expansion and leading to pain. Herniated discs in the thoracic spine can similarly press on nerves, intensifying discomfort with respiratory movements.
Respiratory Conditions
Respiratory conditions can also cause left middle back pain when breathing. Pleurisy, inflammation of the pleura (the double-layered membrane surrounding the lungs), is a common cause, producing sharp, stabbing pain that worsens with inhalation. This inflammation can result from infections like the flu or pneumonia.
Pneumonia, a lung infection filling air sacs with fluid, can lead to chest, abdominal, or back pain that increases with breathing or coughing. Bronchitis or asthma can also cause referred back pain due to airway inflammation or irritation, with persistent coughing sometimes straining back muscles. More serious lung issues, including a collapsed lung or lung cancer, can also present with back pain, especially if a tumor presses on spinal nerves.
Referred Pain
Referred pain, though less common for isolated left middle back pain related to breathing, can be a factor. While heart conditions typically present with chest pain, a heart attack can sometimes cause pain to radiate to the back, potentially with shortness of breath. A pulmonary embolism, a blood clot in the lungs, can cause sudden, sharp pain in the chest or upper back that worsens with deep breaths, alongside shortness of breath. Digestive issues like gastroesophageal reflux disease (GERD) or ulcers are generally less likely to cause middle back pain specifically aggravated by breathing, but pain from such conditions can sometimes be felt in the back.
When to Seek Medical Attention
While many instances of left middle back pain with breathing are minor and resolve on their own, certain “red flag” symptoms indicate a need for prompt medical evaluation. Recognizing these signs ensures timely diagnosis and treatment of potentially serious underlying conditions.
Seek immediate medical assistance if back pain is accompanied by severe, sudden onset, or worsening pain. Symptoms such as shortness of breath, difficulty breathing, or gasping for air warrant urgent attention. Chest pain, especially if it feels like pressure or fullness, or radiates to one or both arms or the jaw, could signal a heart attack. Coughing up blood also necessitates immediate medical care.
Other concerning signs include dizziness, lightheadedness, or loss of consciousness. If pain is accompanied by fever, chills, or unexplained weight loss, it could indicate an infection or other systemic issue. Numbness or tingling in the hands, feet, or extremities, or weakness in the legs, may suggest nerve involvement or spinal issues requiring prompt assessment. Loss of bladder or bowel control is a critical red flag symptom requiring emergency medical attention, as it can indicate severe nerve compression. Pain that does not improve with rest, persists for several weeks, or is severe enough to disrupt sleep also warrants a medical consultation.
The Diagnostic Process
When experiencing left middle back pain with breathing, a medical professional typically begins with a comprehensive evaluation. This process often starts with a detailed medical history, where the provider asks about the pain’s nature, onset, what makes it better or worse, and any associated symptoms. Questions about previous injuries, medical conditions, medications, and lifestyle factors like smoking or activity levels are also common.
Following the history, a physical examination is performed. This usually includes observing posture and movement, palpating the back for tenderness or muscle spasm, and assessing range of motion. The doctor may also listen to the lungs and heart for abnormalities, and conduct neurological tests to evaluate nerve function, sensation, and reflexes. These initial steps help narrow down potential causes and guide further diagnostic tests.
Depending on history and physical exam findings, various diagnostic tests may be ordered. Imaging tests like X-rays can reveal fractures, spinal curvature (e.g., scoliosis), or signs of arthritis. MRI or CT scans provide detailed images of soft tissues, allowing for detection of herniated discs, tumors, or other conditions affecting the spinal cord, muscles, or nerves. Blood tests might check for signs of infection, inflammation, or other systemic conditions contributing to the pain. In some cases, nerve studies like electromyography (EMG) may assess nerve function.
Initial Steps for Relief
While awaiting a diagnosis or for mild, non-concerning pain, several initial steps can help manage left middle back discomfort associated with breathing. These measures are for temporary relief and are not a substitute for professional medical advice, especially if red flag symptoms are present.
Rest is often recommended, allowing affected muscles and tissues time to recover, though prolonged inactivity should be avoided. Applying heat or cold therapy can provide relief; ice packs may reduce inflammation, while heat can soothe muscle stiffness and spasms. Over-the-counter pain relievers, such as NSAIDs like ibuprofen, can help reduce pain and inflammation. Use these medications cautiously and consult a doctor if unsure, particularly if other health conditions exist.
Gentle stretching exercises can improve flexibility and reduce muscle tightness in the back and chest, potentially easing pain with breathing. Examples include seated twists or yoga poses like Child’s Pose, which can help elongate the spine. Maintaining proper posture, both sitting and standing, can alleviate strain on back muscles and support the rib cage’s natural movement during breathing. Mindful breathing exercises, such as diaphragmatic breathing, can also help relax muscles and calm the nervous system, which may reduce pain perception.