Introduction
Back and neck pain are very common - almost everyone has experienced some pain in the back and neck at some point in their lives. Figures indicate that three million people in Australia have back problems and up to 4 in 10 people have neck pain in any one year.
Both the back and the neck are susceptible to injury due to the complex interaction of bones, joints, ligaments, muscles and nerves.
Causes
Back and neck pain have many potential causes, and in many cases, the precise cause of the pain is not fully understood.
Typical causes of back and neck pain include…
- Nerve compression.
- Injury to a disc (the tissue between each vertebral bone which acts as a form of shock absorber), e.g. a ruptured or ‘slipped’ disc, or disc prolapse / protrusion.
- Strain of the back or neck muscles.
- Injury to bones, ligaments, joints.
- Other conditions e.g. ankylosing spondylitis, arthritis, osteoporosis, scoliosis, spinal stenosis.
- Obesity (causing greater stress on the spine).
Other causes of neck pain may include...
- Infection.
- Cancer (very uncommon and may be due to metastasis).
These are the direct causes of back and neck pain, which in turn may frequently be caused by bad posture, repetitive manual work (e.g. heavy lifting) and a sedentary lifestyle with insufficient physical exercise.
Symptoms
Symptoms may indicate the cause of the pain. The symptoms listed below can be caused by the following conditions...
- Musculoskeletal ('mechanical') pain - this can be a result of muscle or ligament strain, or in some cases may be caused degenerative disease affecting the joints.
- Severe back pain – this can be caused by a herniated disc, i.e. a disc that has been pushed out from its normal position between vertebrae and may be pressing on one or more nerves; and may be due to a tear in the membrane surrounding the disc (annular tear).
- Pain in the buttocks, rear thigh and lower leg (Lumbar radiculopathy) - When there is compression of the nerves that travel from the back to the leg, such as from disc herniation or degenerative conditions, this can result in pain, weakness or numbness in the legs. Although this is often referred to as ‘sciatica’ because the sciatic nerve is commonly involved, leg pain can be due to compression any nerves in the lumbar spine.
- Pain worse when walking or standing (Spinal claudication) - this may be caused by spinal stenosis, where the spinal canal which carries the nerves, narrows.
- Weakness, pain or a tingling sensation in neck and arm (Cervical radiculopathy) - this may be caused by compression affecting the roots of the nerves in the neck as they travel due to the arm and fingers.
Tests / Diagnosis
Diagnosis of the cause of neck or back pain generally involves a review of medical history and an assessment of sensory and motor functions. Further tests may include x-rays or MRI (magnetic resonance imaging) or CT (computed tomography) scans, and other tests such as EMG (electromyography), a myelogram / myleography (a type of radiography of the spinal cord) or occasionally a lumbar discogram / discography.
Related Information
Lumbar laminectomy and microdiscectomyCervical laminectomy and foraminotomy