Back Pain and Neck Pain

Approximately $20 billion is lost each year in employee productivity due to back pain. That’s second only to the common cold and it affects 65%-85% of Americans at some point in their lives.

Neck pain is the second most common disorder after low back pain. Among the approximately 20 million American workers with non-work related neck pain, 70% say that it influences their job performance while two-thirds say that it influences their morale while working.

What causes this pain? Where does it come from? It helps to understand back pain and neck pain by first understanding the fundamental makeup of the back and neck.

Where Back Pain Begins Cervical Radiculopathy Facet Joint Syndrome Post Laminectomy Syndrome
Where Back
Pain Begins
Cervical
Radiculopathy
Facet Joint
Syndrome
Post Laminectomy
Syndrome
Lumbar Radiculopathy Sacroiliac Joint Steroid Injection Fluoroscopic Guided Piriformis Injection
Lumbar
Radiculopathy
Sacroiliac Joint
Steroid Injection
Fluoroscopic Guided
Piriformis Injection

Your Spine

Serving as the very foundation of your back and neck is your spine, a miraculous assemblage of 32 or 33 bones. The first 24 or 25 are circular and called vertebrae, generally consisting of large, flat, round bone sections toward the front, with two thinner bones (the lamina) at the back that form a triangular shape. At the center of the triangle is a passageway. With the vertebrae stacked on top of each other, the passageway in the triangle combine to form the vertebral canal, which serves to contain and protect your spinal cord. Cushioning your entire spine are gel-filled discs located between the circular sections of each vertebra.

Small openings exist along the right and left sides of the spine at each lamina. Called neural foramen, they allow nerves that control the body to exit and enter the spinal column.

The central nervous system consists of the spinal cord and brain. The peripheral nervous system consists of all the nerves coming and going from the spinal column. The spinal column itself has five regions including the cervical spine, the thoracic spine, the lumbar spine, the sacrum and coccyx.

It would be amazing enough if your spine was rigid and simply protected the spine while allowing nerves to run from the body to the spinal cord and on to the brain. But the spine is not rigid. Each vertebra interacts with its neighbor above and below to allow the spine to articulate via facet joints, located on the left and right side of each vertebra. It is the carefully orchestrated interaction of the vertebrae, the discs between each, the facet joints on each side and countless nerves and muscles that give your spine the flexibility to allow you to walk, jump, run, bend and even lift.

Pain

Pain is a symptom, not a diagnosis. Its purpose is to let us know there is a problem. Typically, back pain or neck pain is caused by one of the following:

  • Bone and joint problems such as degeneration, arthritis or fracture
  • Muscle and soft tissue problems such as sprain, strain, spasm, or fibromyalgia
  • Disc problems such as a herniated disc (“ruptured disc”)
  • Nerve problems such as compression or entrapment of a nerve

Common causes of injuries include:

  • Work injury
  • Improper lifting technique
  • Poor posture
  • Trauma, such as whiplash
  • Degeneration due to aging or disease such as spinal stenosis and compression fractures

Regardless of the cause, neck pain or back pain either can be a temporary nuisance or severely debilitating. Either way it can impact your quality of life. Neck pain and back pain sometimes resolve with little or no treatment. Sometimes the pain is ongoing and requires treatment to relieve or tolerate the pain, and decrease recovery time.

Neck Pain

Neck pain is commonly caused by muscle strain, tension or facet joint disorders. If the neck pain source involves a nerve, the pain can radiate to the shoulder and down the arm.

Back Pain

Back pain frequently results from herniated (bulging) discs associated with trauma or injury that causes the disc to protrude, placing pressure on the spinal cord or canal or irritating one of the nerves leading from the spinal cord to the body. In this case it is common to feel pain radiating down your leg.

Spinal Stenosis

Spinal Stenosis refers to a narrowing of the vertebral canal. Some individuals may be born with this condition but the majority of cases develop over time. Along with the wear and tear that occurs over time, bone spurs build up on the joints where one vertebra meets another (facet joint). These bone spurs can push into the vertebral canal and pinch the nerve roots that exit/enter the spinal cord. In combination with, or independent of, the bone spurs, a degenerated disc can cause the narrowing and pressure on the spinal cord and/or nerve roots. Although spinal stenosis can affect the entire spine, including the cervical, thoracic or lumbar regions, it is predominately found in the lumbar region

The pressure these problems can cause on the spinal cord and/or nerve root can cause pain, sometimes severe, and/or difficulty standing or walking for distances. Patients sometimes describe the sensation as having very “heavy” legs.

There are many treatment options of spinal stenosis including medications, blocks/injections, physical therapy or surgery.

Spinal Compression Fractures

A spinal compression fracture occurs when an injury to, or weakness of, a vertebra causes it to fracture (break) and collapse (compress). Weakness of the vertebra is commonly caused by osteoporosis. Compression fractures occur in more than 700,000 Americans annually. More frequent than hip fractures these compression fractures often result in prolonged disability.

Until recently, doctors were limited in how they could treat osteoporosis-related spine fractures. Pain medications, bed rest, bracing and invasive spinal surgery were the only options available. Today, epidural steroid injections can help with the majority of the pain. There are two helpful therapeutic treatments for compression fractures – vertebroplasty and kyphoplasty. They are performed by interventional spine specialists, usually in a hospital.

Treatments of the Spine

Treatment options include:

  • Epidural steroid injections
  • Nerve blocks
  • Medications
  • Acupuncture
  • Physical therapy
  • Chiropractic
  • Massage
  • Braces/support
  • Heat/rest
  • Surgery

Advancements in medicine and technology have increased the number of less-invasive treatments for back and neck pain. The ultimate goal with any treatment is to alleviate the symptoms, correct underlying problems when possible and improve quality of life.

Disabling pain or pain accompanied by numbness, weakness, lack of balance, and/or loss of control of bowels/bladder should be reported to your healthcare provider immediately.

The pressure these problems can cause on the spinal cord and/or nerve root can cause pain, sometimes severe, and/or difficulty standing or walking for distances. Patients sometimes describe the sensation as having very “heavy” legs.

There are many treatment options of spinal stenosis including medications, blocks/injections, physical therapy or surgery.