There are several causes of back pain: 1. Myofasciitis of the thoracic back. When myofasciitis of the thoracic back occurs, there will be long-term pain in the back of the shoulder, which can be accompanied by numbness and weakness of the ipsilateral upper limb, especially at night when the pain is heavier in bed, commonly after excessive exertion or wind or cold. 2. When there is cholecystitis or gallbladder stones, there will be involved pain in the right side of the back, especially after eating greasy food or drinking alcohol and the back pain is severe. If there is a heart attack or angina pectoris, reflex pain in the left side of the back may also occur. If the long-term back pain is not due to the above reasons, it may also be due to pancreatic diseases, such as pancreatic tumors or pancreatitis, which can also occur. 4. Tumors, tuberculosis, rheumatoid diseases or ankylosing spondylitis in the spine may also cause pain in the middle of the back. MRI and related laboratory tests will be performed to further confirm the diagnosis.