Back and Neck Pain

Overview

Back pain can range from a mild, dull, annoying ache, to persistent, severe, disabling pain. Pain in your back can restrict mobility and interfere with normal functioning and quality of life. You should always consult your health care provider if you have persistent pain.

Neck pain occurs in the area of the cervical vertebrae in your neck. Because of its location and range of motion, your neck is often left unprotected and subject to injury.

Pain in your back or neck area can be acute. That means it comes on suddenly and intensely. Chronic pain lasts for weeks, months, or even years. The pain can be continuous or intermittent.

What causes back and neck pain?

Even with today's technology, the exact cause of back and neck pain is difficult to determine. In most cases, back and neck pain may have many different causes, including any of the following:

• Overuse, strenuous activity, or improper use, such as repetitive or heavy lifting
• Trauma, injury, or fractures
• Degeneration of vertebrae, often caused by stresses on the muscles and ligaments that support your spine, or the effects of aging
• Infection
• Abnormal growth, such as a tumor or bone spur
• Obesity, which places increased weight on your spine, and pressure on your discs
• Poor muscle tone
• Muscle tension or spasm
• Sprain or strain
• Ligament or muscle tears
• Joint problems, such as arthritis
• Smoking
• Protruding or herniated (slipped) disk and pinched nerve
• Osteoporosis and compression fractures
• Congenital (present at birth) abnormalities of your vertebrae and bones
• Abdominal problems, such as an aortic aneurysm

What are the symptoms of back and neck pain?

Symptoms associated with back pain may include:

• Dull, burning, or sharp pain in your back. The pain can be confined to a single spot or cover a large area
• Leg numbness or tingling above or below your knee
• Stiffness or achiness that occurs anywhere along your spine (from your neck to your tailbone)
• Sharp, shooting pain that radiates from your low back to your buttocks, down the back of your thigh, and into your calf and toes
• Consistent ache in the middle or lower part of your back, especially after standing or sitting for an extended period

Loss of bladder and bowel control, with weakness in both legs, are symptoms of a serious condition that requires immediate medical attention.

Symptoms associated with neck pain can be:

• Arm numbness or tingling
• Headaches
• Shoulder pain
• Sharp shooting pains or a dull aches in your neck

Pain that occurs suddenly in your back or neck, due to an injury, is considered to be acute pain. Acute pain comes on quickly and may leave sooner than chronic back or neck pain. This type of pain should not last more than 6 weeks.

Pain that may come on quickly or slowly and lingers for weeks, 3 months or greater, is considered to be chronic pain. Chronic pain is less common than acute pain.

How are back and neck pain diagnosed?

If you experience neck or back pain, you should see your health care provider for a medical and physical exam. He or she may also do X-rays of the affected areas, as well as magnetic resonance imaging (MRI). This allows a more complete view. The MRI produces pictures of soft tissues as well, such as ligaments, tendons, and blood vessels. The MRI could lead to a diagnosis of infection, tumor, inflammation, or pressure on your nerve. Sometimes a blood test may help diagnose arthritis, a condition that can cause back and neck pain.

If you experience acute back or neck pain, it may simply improve with some rest. Over-the-counter medicines, such as acetaminophen or ibuprofen, may also help with the discomfort. You should try to move gently during this period, so that you will not become stiff and lose mobility.

If you have chronic pain of your back and neck, you should try several remedies that may be helpful, before seeking surgical options. These include:

• Hot or cold packs (under your health care provider’s instructions)
• Specific exercises to strengthen muscles and ease pain, such as stretching and flexing. Your health care provider can provide and demonstrate these exercises.
• Aerobic exercise may be permitted and can help with your overall fitness and strength
• Certain anti-inflammatory medications or muscle relaxants may be used, with your health care provider’s supervision
• Braces or corsets for extra support
• Injections for pain relief in the area
• Nerve block, which decreases pain signals from the affected nerve
• Acupuncture

How are back and neck pain managed?

Acute back pain usually gets better without special treatment. Using acetaminophen or ibuprofen will decrease pain and help you rest. Surgery and special exercises are generally not used with acute pain.

For severe, disabling, or chronic back and neck pain, rehabilitation programs can be designed to meet your needs. The type of program will depend on the type and severity of your pain, injury, or disease. Active involvement of the patient and family is vital to the success of rehabilitation programs.

The goal of back and neck rehabilitation is to help you manage disabling pain, return to your highest level of functioning and independence possible, while improving your overall quality of life. The focus of rehabilitation is on relieving pain and improving mobility (movement).

To help reach these goals, back and neck rehabilitation programs may include the following:

• Exercise programs to improve range of motion, increase muscle strength, improve flexibility and mobility, and increase endurance
• Help with obtaining assistive devices that promote independence
• Patient and family education and counseling
• Pain management techniques
• Smoking cessation counseling
• Gait (walking) and movement retraining
• Stress management
• Nutritional counseling
• Ergonomic assessments and work-related injury prevention programs
• Vocational counseling

What are the complications of neck and back pain?

• Loss or productivity: Back pain is the most common reason for disability in working adults.
• Nerve damage: If your back pain is from a herniated disc, pressure on the spinal nerves may cause a variety of problems, such as weakness, numbness, or severe shooting pain that travels from the back to the leg.
• Depression: Back or neck pain can disrupt all aspects of a person’s life: work, physical exercise, social activities, and sleep. The anxiety and stress caused by the change in mobility and pain can lead to depression.
• Weight gain: Loss of mobility and inability to exercise can lead to weight gain and the loss of muscle strength.

It is a good idea to see a health care provider if you have numbness or tingling, or if your pain is severe and does not improve with medication and rest. If you have difficulty urinating, weakness, pain, or numbness in your legs, fever, or unintentional weight loss, you should call your health care provider right away.

Leg Pain

Leg pain can be constant or intermittent, develop suddenly or gradually, and affect your entire leg or a localized area, such as your shin or your knee. It can take a number of forms — stabbing, sharp, dull, aching or tingling.

Some leg pain is simply annoying, but more-severe leg pain can affect your ability to walk or to bear weight on your leg.

Causes

Most leg pain results from wear and tear, overuse, or injuries in joints or bones or in muscles, ligaments, tendons or other soft tissues. Some types of leg pain can be traced to problems in your lower spine. Leg pain can also be caused by blood clots, varicose veins or poor circulation.

Some common causes of leg pain include:

• Achilles tendinitis
• Achilles tendon rupture
• ACL injury (tearing of the anterior cruciate ligament in your knee)
• Ankylosing spondylitis
• Baker cyst
• Bone cancer
• Broken leg
• Bursitis (joint inflammation)
• Chronic exertional compartment syndrome
• Claudication
• Deep vein thrombosis (DVT)
• Gout (arthritis related to excess uric acid)
• Growing pains
• Growth plate fractures