<s>[INST] i have pain under my left rib cage. it hurts sometimes to take a deep breath or even to pull on something that would strain it. lately i noticed ive been very tired and some days iam so dizzy that i have to stay in laying down postion to releve some of the dizziness. i also have pain in my back it is very sharp and feels worse than a muscle cramp. if i try to bend my left arm to go to my back i cant do it cause the pain is to bad. i dont think ive pulled a muscle, and i also have very bad heartburn. do u think i should see my doctor right away or maybe i just strained my left side and dont remember doing it [/INST] Hi, Thank-you for providing the brief history of you. A thorough neuromuscular assessment is advised. As the pain is limited to under the rib cage and behind of it, you can get a chest x-ray done. Either the pain can be due to any Cochin Chat Doctor.  Since you have not mentioned breathing difficulties like breathlessness it can not be related to something serious. Still an x-ray can help assist. Performing breathing exercises will help reduce the pain and also there are various types of breathing exercises which when performed you should keep hand over the painful area to avoid pain. In case the pain doesn't come down with this, then an abdominal ultrasound scan is advised to see any abdominal pathology. Post that the treatment will be directed accordingly.regards Jay In </s>