Understanding Back & Neck Pain
Not all spine pain is the same. Understanding the type and source of your pain is crucial for determining the most effective treatment approach.
Three Main Types of Spine Pain
Originates from discs, facet joints, muscles, or ligaments. Usually felt in the neck or back area, often worse with movement or certain positions.
Sharp, shooting pain that travels down the arm or leg following specific nerve pathways. Often accompanied by numbness or weakness.
Coordination problems, balance issues, hand clumsiness, or gait changes from spinal cord compression. Requires urgent evaluation.
Detailed Pain Patterns
Characteristics
- • Aching, stiff, or burning sensation
- • Located in neck or lower back
- • Worse with movement or prolonged positions
- • Better with rest or position changes
- • May radiate to shoulders or buttocks
Common Causes
- • Degenerative disc disease
- • Facet joint arthritis
- • Muscle strain or spasm
- • Ligament inflammation
- • Poor posture or alignment
Cervical Radiculopathy
- • Sharp pain down the arm
- • Follows specific nerve patterns
- • Numbness in fingers or hand
- • Weakness in specific muscles
- • Worse with neck movement
Lumbar Radiculopathy (Sciatica)
- • Sharp pain down the leg
- • May reach foot or toes
- • Numbness or tingling
- • Weakness in leg or foot
- • Worse with sitting or coughing
Cervical Myelopathy Signs
- • Hand clumsiness (difficulty with buttons, writing)
- • Balance problems or unsteady gait
- • Weakness in arms or legs
- • Electric shock sensations
- • Bowel or bladder changes (severe cases)
Why It's Urgent
- • Spinal cord damage can be permanent
- • Early treatment prevents progression
- • Function may not fully recover if delayed
- • Quality of life significantly affected
- • Decompression often required
Imaging is a Map, Not the Territory
What Imaging Shows
- • Structure: Disc height, bone changes, alignment
- • Compression: Nerve or spinal cord pressure
- • Degeneration: Wear patterns and arthritis
- • Stability: Movement between vertebrae
What Imaging Doesn't Show
- • Pain level: Severe changes may not hurt
- • Function: How well you move or work
- • Quality of life: Impact on daily activities
- • Treatment urgency: Symptoms guide timing
Common MRI Findings Explained
Disc Dehydration
Dark discs on MRI indicate water loss. Common with aging, may or may not cause pain.
Disc Height Loss
Collapsed discs can stress facet joints and narrow nerve openings.
Disc Bulge/Herniation
Disc material extending beyond normal boundaries, may compress nerves.
Facet Arthritis
Joint degeneration that can cause mechanical pain and limit motion preservation options.
Spinal Stenosis
Narrowing of spaces where nerves travel, can cause radicular pain or myelopathy.
Bone Marrow Changes
Modic changes indicate bone stress and inflammation, may affect treatment planning.
How Pain Type Guides Treatment
Treatment Options
- • ADR for disc-related pain
- • Fusion for instability
- • Conservative care first
- • Activity modification
Key Factors
- • Facet joint health
- • Alignment quality
- • Activity demands
- • Bone quality
Treatment Options
- • Decompression surgery
- • ADR with decompression
- • Fusion with decompression
- • Conservative care trial
Key Factors
- • Severity of compression
- • Neurological deficits
- • Response to conservative care
- • Underlying disc health
Treatment Approach
- • Urgent decompression
- • Fusion often required
- • ADR in select cases
- • Alignment correction
Key Factors
- • Severity of cord compression
- • Stability requirements
- • Alignment problems
- • Timing of intervention
- • Progressive weakness in arms or legs
- • Loss of bowel or bladder control
- • Severe pain with fever
- • Rapidly worsening neurological symptoms
- • Balance problems or frequent falls
Understanding Your Specific Pain
Now that you understand different pain types, explore treatment decision guides or start your evaluation to learn more about your specific situation and options.