Back and Neck Pain When Is It More Than Just a Strain?

By Justin Park, MD

Bay Area Orthopaedics & Sports Medicine

. http://www.bayareaorthopaedics.com

More Special Articles

Back and Neck Pain When Is It More Than Just a Strain?

Dealing with spine pain can be a very painful and debilitating problem. In fact millions of Americans a year will visit their primary care physicians for symptoms relatable to back and neck pain. As a patient we often wonder, “When is back and neck pain more than just a simple strain?”

Spinal stenosis is a common condition that affects men and women over 50 years old. Arthritis can affect the mobile joints in the aging spine similar to the hip and knee. Bone spurs, ligament overgrowth, and disc degeneration can all cause a narrowing of the spinal canal that subsequently leads to pinching and irritation of the spinal nerves. This often leads to severe back pain and associated pain, numbness, and tingling down one or both lower extremities. The pain can feel like a heaviness or throbbing in the thigh and calf region or present with a sciatic type of sharp pain running down one leg.

Cervical myelopathyis caused by spinal stenosis in the neck leading to pinching of the spinal cord. Patients may start dropping car keys or have trouble holding and turning objects. Pain and numbness running down both arms and hands is common. In severe cases walking ability can be affected.

Disc herniations are more common in patients between the ages of 20-50. Symptoms can sometimes be attributed to an inciting event that causes a tear in the disc allowing the disc contents to bulge out. The herniated disc then causes nerve root compression causing radiculopathy. Radiculopathy is a medical term used to describe the dysfunction of a nerve root that can occur from pressure on the nerves, such as pain, numbness, or weakness in the affected extremity. Lumbar disc herniations present with severe back/buttock pain with radiating symptoms into the legs. Cervical disc herniations cause neck pain and radiculopathy into the shoulder, arm, wrist or hand.

Consultation with a spine surgeon is paramount whenever there is concern for any of the above-mentioned spinal conditions. A history and physical exam along with an X-ray and MRI can usually lead to a correct and timely diagnosis. Initial treatment includes medications, physical therapy, and epidural steroid injections. The vast majority of patients get better without surgery. Patients that have extreme weakness in their legs or arms or experience problems with bowel/bladder function should seek consultation with a spine surgeon immediately.