Neck and Low Back Pain

Neck pain and back pain are one of the most common reasons for physician visits. Although the traumatic injures are the common cause of pain other pathologies must be considered carefully in the absence of traumatic history. Most neck and back pain is caused by disorders of the spine. However extra spinal disorders such as Fibromyalgia vascular, GI, or GU disorders may present as neck or back pain. Some more serious causes of spinal and extra spinal disorders include infection processes and cancer. The frequent causes are mechanical and degenerative changes of the joints or supporting structures of the spine that can be confirmed by various diagnostic studies.

These include:
  • Disk herniation
  • Compression fracture
  • Lumbar spinal stenosis
  • Osteoarthritis
  • Spondylolisthesis
  • Some of the causes that can not be demonstrated by diagnostic studies include muscle strain, ligament sprain, spasm, or a combination.

Etiology of back pain, particularly if mechanical, is often multi factorial, with an underlying disorder exacerbated by fatigue, physical reconditioning, and sometimes psychosocial stress or psychiatric abnormality. Thus, identifying a single cause is often difficult or impossible. Although the back pathology is more common than the compressive neck disorders, the impact of cord compression in the neck is more serious.

In presence of neurological impairment or persistent pain more than 4 to 6 weeks, diagnostic test with MRI is recommended Treatment options include anti-inflammatory medication, muscle relaxants, oral steroids, pain medication, and proper exercises. If all fail or in presence of neurological impairment and supporting diagnostic studies, surgical treatment may become necessary.

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