Published on Sep 12, 2014 and last reviewed on Feb 21, 2019 - 5 min read
Understanding the mechanism of neck or low back pain by both the patient and the treating doctor is essential in establishing an accurate diagnosis and effectively managing the condition.
Pain in the neck or back can severely limit one's ability to function in everyday life and often causes great anxiety that a serious threatening condition may have arrived. Fortunately for the vast majority of those afflicted, no surgery will be necessary usually and there is often a good recovery with conservative measures.
The patient and doctor must work together in understanding the mechanism of the pain affecting the patient to effect the best treatment plan. A detailed history of any event associated with onset, where exactly the pain is located, where does it radiate, what makes it worse or better, any preexisting health problems, and any other constitution symptoms is needed to make an accurate diagnosis. A thorough clinical examination to identify any abnormalities in neurological function or signs of nerve root compression can separate routine benign conditions from those putting the nervous system in peril.
A history of progressive pain unrelieved with rest or worse at night, fever, weight loss, previous diagnosis of cancer, immune compromise, tuberculosis, bacterial infection, trauma, osteoporosis, advanced age, weakness or numbness, loss of bladder or bowel control, and/or loss of erection are among the symptoms that may immediately point to a serious condition needing imaging investigation and other testing.
The intensity or severity of the pain itself is not often a useful indicator of the diagnosis.
Generally speaking, there are three different types of pain associated with spine pain. They are:
Mechanical Spine Pain:
Radiculopathy and Myelopathy:
Following a thorough history and physical examination, which does not elucidate any warning signs or neurological involvement most adult patients can safely be treated conservatively for at least a month before undergoing expensive imaging such as an MRI. However, it should be noted that in regions where tuberculosis is endemic it may be wise to go for an x-ray of the spine and an ESR (Erythrocyte Sedimentation Rate), which together approach a 90 percent effective low-cost screening for tuberculosis of the spine.
Patients with warning signs in the history or clinical evidence of neurological compromise can consult a neurosurgeon online --> https://www.icliniq.com/ask-a-doctor-online/neuro-surgeon
Query: Hi doctor, My mother who is 63 years old, suffering from back pain. She is not able to walk even 100 meters. After walking a short distance, she feels numb in her foot and needs to sit for some time to proceed further. While sleeping, she feels needle pricking like effect in either side of her back... Read Full »
Answer: Hi, Welcome to icliniq.com. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. Thank you for uploading the lab reports (attachment removed t... Read Full »
Query: Hi doctor, I am a 26 year old male, and I get severe pain in the backbone and the surrounding area. What could it be? Read Full »
Answer: Hi, Welcome to icliniq.com. I need to know the following things: Since when are you having pain in your back? Is it radiating to your legs? Does it aggravate or relieve on movement and lying down? Is there any history of trauma? Revert to an orthopaedician online with the details, the pai... Read Full »
Query: Hi doctor, I had cervical polypectomy and was told to expect brown discharge. Now experiencing cramping, minor bleeding, vinegar smell, and severe back pain, to the point that I am dizzy and nauseous. A couple of days earlier had a bunch of discharge that looked like dark reddish and orangish skin.... Read Full »
Answer: Hello, Welcome to icliniq.com. It is normal to experience reddish brown discharge for 4-5 days post cervical polypectomy, but it should not cause any back pain per se unless there has been a secondary infection or vaginitis or bacterial vaginosis which is quite likely with vinegar smell. Flagyl (Met... Read Full »
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