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What Causes Neck and Low Back Pain?

Written by
Dr. Tony Magana
and medically reviewed by iCliniq medical review team.

Published on Sep 12, 2014 and last reviewed on Feb 21, 2019   -  5 min read

Abstract

Abstract

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.

What Causes Neck and Low Back Pain?

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:

Pseudoradiculopathy:

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

 

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Last reviewed at:
21 Feb 2019  -  5 min read

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Dr. Tony Magana

Dr. Tony Magana

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