Back & Neck Pain

The symptoms of neck pain will vary depending on the cause. The most common conditions are listed here:

1. Cervical or Neck Sprain/Strain

Injury to the muscles, ligaments and/or tendons located in the neck is called a cervical sprain or strain which is sometimes also commonly referred to as “pulled neck muscles” or as “having a kink in the neck.” Sprain/strain is the most common cause of neck pain. It occurs due to trauma, over-activity, lifting, poor posture, sudden movement, or overuse.

Symptoms may include:

• Neck pain, cramping and/or spasms that may or may not radiate to the shoulders
• Neck pain that is worse with certain movements
• Neck pain that may start 24-48 hours after the initial injury

2. Cervical Radiculopathy

This is also referred to as “radiculitis” or is commonly called a “pinched nerve” in the neck. It occurs when the nerves or nerve roots in the neck become compressed due to a bone spur, cervical disc herniation, and/or inflammation of tissues in the vicinity.

The cervical disc exists between the spinal bones in the neck. The function of the disc is to act as a shock absorber and cushion the individual spinal bones (vertebrae) and allow for neck mobility. The disc consists of a tough outer layer and an inner jelly like layer. A cervical disc herniation can occur when there is wear and tear of the tough outer layer allowing the inner jelly like substance to slip or herniate through the outer layer potentially irritating spinal nerves or the spinal cord.

Symptoms may include:

• Neck pain that may be associated with a muscle spasm and radiate down one or both arms
• Numbness and/or tingling (the feeling of “pins and needles”) in the hands or fingers
• Weakness of the arm, shoulder, or hand

3. Cervical spondylosis

Cervical spondylosis (otherwise known and degenerative osteoarthritis or “wear and tear” arthritis of the cervical spine) is very common and worsens with age. It is the result of wear and tear on the bones, discs and ligaments of the neck. Cervical spondylosis may result in cervical radiculopathy/radiculitis (described above), or myelopathy (a compression of the cervical spinal cord).

Symptoms may include:

• Neck pain and stiffness
• Cracking and popping sounds with movement of the neck
• Headache
• Decreased range of motion of the neck
• Pain in shoulder or arms

Symptoms of cervical spondylosis with myelopathy may include:

• Numbness, tingling, and/or weakness in your arms, hands, legs, or feet
• Decreased range of motion of the neck
• Difficulty walking or balancing
• Spasms in muscles
• Loss of bladder or bowel control

4. Inflammatory arthritis

Examples of inflammatory neck pain include Rheumatoid Arthritis, Ankylosing Spondylitis and Polymyalgia Rheumatica

Symptoms may include:

• Constant deep aching pain
• Prolonged morning stiffness
• Stiffness and pain that improves with activity and worsens with rest

Common Causes and Symptoms of Back Pain

The symptoms of back pain will vary depending on the cause. The most common conditions are listed here:

1. Sprain/Strain:

An injury to a muscle and/or tendon is called a “strain” or more commonly referred to as a “pulled back muscle.” An injury to a ligament is called a “sprain.” These are the most common causes of low back pain and may occur due to trauma, over-activity, lifting heavy objects, faulty posture, and sudden movement.

Symptoms include:

• Muscle cramping and/or spasms
• Back pain that is worse with certain movements
• Decreased function and/or range of motion
• Back pain that may start 24-48 hours after the initial injury

2. Radiculopathy:

This is also referred to as “radiculitis” or is commonly called a “pinched nerve” in the back. It occurs when the nerves or nerve roots become compressed due to a bone spur, degenerative disc disease and disc herniation, and/or inflammation of tissues in the vicinity.

Sciatica is term used to describe a specific compression of the large sciatic nerve that runs from the back through the buttock and down the back of the leg to the foot. The nerve can be compressed at the level of the spine as well as the buttock region by tight muscles especially the piriformis muscle.

The disc exists between the spinal bones (vertebrae) and functions as a shock absorber and allows for back mobility. The disc consists of a tough outer layer and an inner jelly like layer. A disc herniation can occur when there is wear and tear of the tough outer layer of the disc allowing the inner jelly like substance to slip or herniate through the outer layer potentially irritating spinal nerves or the spinal cord.

Symptoms may include:

• Local back pain
• Muscle spasm
• Pain, numbness, tingling, and/or weakness that can radiate down one or both legs and occasionally to the feet

3. Spondylosis:

Spondylosis is also known as degenerative or osteoarthritis of the spine and can affect any region of the spine. This condition generally occurs due to age and wear and tear of the spine over time and is typically characterized by bony overgrowths and degenerating intervertebral discs (degenerative disc disease).

Symptoms may include:

• Majority of the time, no symptoms are present
• Local back pain
• Muscle spasm
• Back pain after sitting or standing for extended periods of time
• Symptoms of radiculopathy may be present

4. Spinal stenosis:

Spinal stenosis is a term used to describe a narrowing of the spinal canal with a resultant compression of the spinal cord and spinal nerves. This most commonly occurs in the lower lumbar spine, but can involve any level of the spine. Spinal stenosis can have many causes including a congenital narrowing of the spinal canal, but it most often results from a degenerative process that results in herniated discs, bone spurs, and/or thickened ligaments.

Symptoms may include include:

• Back pain
• Leg pain and cramping that worsens with walking or standing for prolonged periods and improves with rest and leaning forward
• Numbness or tingling in the buttocks or legs
• Weakness in the legs or foot
• In rare instances loss of bowel or bladder control may also occur which is a sign of a rare but serious medical condition called cauda equina syndrome that requires immediate medical attention

5. Inflammatory arthritis:

Several inflammatory arthritis conditions can be associated back pain such as: ankylosing spondylitis, psoriatic arthritis, reactive arthritis, arthritis related to inflammatory bowel disease, and rheumatoid arthritis.

Symptoms may include:

• Local back pain
• Prolonged stiffness in the back that worsens with rest and improves with activity

6. Scoliosis:

Scoliosis is an abnormal lateral or sideways curvature of the spine. It is a very common problem with many causes including degenerative scoliosis which is the most common form in adults. Idiopathic scoliosis, which is the most common cause of scoliosis in children, has no specific identifiable cause.

Symptoms may include:

• Local back pain
• Muscle spasm
• Physical deformity such as an uneven waist, one shoulder being higher than the other or one shoulder blade sticking out more than the other, and uneven hips
• In severe cases, it can cause heart and lung problems making it more difficult to breath and harder for the heart to pump

7. Compression fracture:

Compression fractures are most often related to osteoporosis or brittle bone disease which is discussed in detail elsewhere, but may also be due to trauma. When the vertebrae or bones of the spine become weak from osteoporosis they can collapse. This is referred to as a compression fracture of the spine.

Symptoms may include:

• Local back pain
• Loss of height
• Poor posture ie “hunchback” shape