<s>[INST] I have had pain in upper back area to my left side of spine for over 3 hours. I have taken 1 extra strength tylenol and since added 400 mg ibuprofen. It is not improving. Blood pressure is up a bit but is OK. I have put pressure on the area, vibrated, rubbed the area on a post. It might be moving towards left shoulder area. Should I be worried or take more pain killers? [/INST] Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.Firstly, I would like to rule out a myocardial infarction since the pain is on the left side. Sometimes, it presents like this. So, I suggest you to go immediately to the ER and do ECG and blood test for enzymes to exclude that emergency. If the heart is okay then doctors can investigate other options and give proper treatment.Wish you quick recovery.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani </s>