Neck and Back Pain: Causes and Treatment

If you have neck or back pain — either long-term or acute — you are not alone. In fact, 8 in 10 people will experience back pain and an estimated 7 in 10 will experience neck pain in their lives. At Beaufort Memorial, residents throughout the Lowcountry have access to sophisticated surgical and nonsurgical treatments that offer relief for neck and back pain.

Experiencing neck or back pain? Request an appointment with an orthopedic surgeon or ask your primary care provider for a referral to a board-certified spine specialist.

Understanding Neck and Back Pain

To understand the conditions that cause pain in your neck and back, it helps to know how the bones, nerves, muscles and ligaments in your spine function.

Your spine has 33 vertebrae that run from the bottom of your skull all the way down your back to your tailbone. Your spinal cord runs the length of your spine through small holes in the middle of each vertebra, making up the spinal canal. Pairs of nerves, called nerve roots, exit the spinal canal through spaces in your vertebrae called foramina and send signals to the muscles and ligaments that attach to the spine.

The vertebrae are separated by small cushions called intervertebral discs, which are made of a gel-like material. Each disc has a soft core surrounded by a tougher outer ring. All together, these discs make up 25% of your spine’s length.

Your spine has five sections:

• The cervical spine, which includes the first seven vertebrae
• The thoracic spine, which is in the middle and includes 12 vertebrae
• The lumbar spine, or lower back, which includes five vertebrae
• The sacrum and coccyx (tailbone), which include the last nine vertebrae below your lower back

Any of these structures can get injured, deteriorate or move out of place, causing your nerves to send pain signals that radiate through your arms and legs. The symptoms you experience generally depend on which area of the spine and which vertebrae and discs are affected.

Conditions That Cause Neck and Back Pain

The spine experts with the Beaufort Memorial Advanced Orthopedics and Spine Program have extensive experience in treating many conditions that cause neck, back and nerve pain, including:

• Compression fracture: Compression fractures occur when the bony parts of the spine collapse onto each other, resulting in severe pain. They can happen as a result of trauma, but often, they affect people with osteoporosis. Osteoporosis-related compression fractures are more common in women, but trauma-related compression fractures can affect anyone.
• Herniated disc: A herniated disc is a degenerative disc disease that occurs when the inner part of a spinal disc protrudes its outer layer and moves into the spinal canal, causing pain, numbness or weakness in the back. Herniated discs most often occur in the lower back and affect men more than women. Discs wear down with age in nearly everyone, and as they do, even small stresses can cause them to herniate. You can get a herniated disc through heavy lifting, repeatedly bending or twisting, or prolonged sitting or standing. You’re also at greater risk if you smoke, are overweight or are inactive.
• Radiculopathy: The medical term for a pinched nerve, radiculopathy develops when a nerve root coming off the spinal cord becomes compressed or irritated, causing burning sensations. It’s a type of degenerative disc disease that develops over time, often due to aging, as your intervertebral discs dry out and stiffen. As they degenerate, they lose height, which reduces the space between your vertebrae. In response, your body tries to strengthen the discs by forming bone spurs, which make your spine stiffer and cause narrowing of the foramina through which nerves travel, “pinching” them. You can also develop radiculopathy from a herniated disc, spondylolisthesis, spinal stenosis, trauma, tumors, infections and some vascular conditions.
• Sciatica: Not an official condition, sciatica is the term used to describe pain and other symptoms caused by problems with your sciatic nerve, which is the largest nerve in your body. Often the result of a compressed nerve in your lumbar spine, sciatica causes burning, numbness, a pins-and-needles sensation, tingling and weakness that run the length of your leg. Some people describe sciatica pain as a shooting pain that travels down their leg. The condition commonly occurs in middle age and may develop from a herniated disc, spinal stenosis, a bone spur or arthritis. Sometimes, there is no obvious cause.
• Spinal stenosis: This occurs when the spinal canal narrows, resulting in pain, numbness or weakness in your legs. It can develop in any area of the spine, but it’s most common in the lumbar spine. Spinal stenosis can develop with age or when you have another spine condition, such as arthritis, a compression fracture, a herniated disc, spondylolisthesis or a spinal tumor.
• Spondylolisthesis: Spondylolisthesis, commonly known as a slipped disc, develops when one of your vertebrae shifts forward and no longer lines up with the one below it. In most people, this happens in the lumbar spine, but it can also happen in your neck. It generally only happens in the thoracic spine as a result of trauma. Arthritis is a common cause — the condition generally shows up over time due to wear and tear.

Neck and Back Pain Treatment

The conditions causing your neck or back pain are diagnosed through a physical exam, which may prompt your orthopedic surgeon to order additional imaging tests. Many spine conditions are graded based on severity or degree. If your condition is at a low grade, or early stage, you may benefit from nonsurgical treatments to alleviate symptoms and reduce stress on your vertebrae and discs. As your condition progresses, surgery may become a better treatment option.

Nonsurgical Treatment

To help alleviate neck, back and nerve pain, your provider may recommend nonsurgical treatment, including:

• Physical therapy to strengthen core and back muscles and improve flexibility
• Prescription or over-the-counter anti-inflammatory drugs, which can reduce swelling and inflammation that can aggravate nerves
• Steroid injections, which also reduce inflammation
• A neck or back brace to minimize movement (if you have a compression fracture)

Always discuss nonsurgical treatments with your doctor. Not all treatments are suitable for all spine conditions.

Surgical Treatment

The Beaufort Memorial spine surgeons are specially trained and experienced in the intricacies of spinal care. Our specialists perform many spinal surgeries designed to provide pain relief while sparing healthy muscle tissue, speeding recovery and improving your quality of life.

Three procedures that can address a variety of neck and back conditions are:

• Spinal decompression: Your surgeon removes bones, ligaments, disc materials and tissue that put pressure on your nerves and spinal cord.
• Disc replacement: Your surgeon removes a damaged disc from the lumbar or cervical portion of the spine and replaces it with one made from synthetic materials. The procedure allows for nearly full range of motion and results in less pain and better mobility than spinal fusion.
• Fusion: Your surgeon permanently connects two or more vertebrae to eliminate motion and relieve pain.

Do you have more neck or back pain questions? Speak with our orthopedic care coordinator at 843-522-7435.