Back and Neck Pain

What is back and neck pain?

Back pain can range from a mild, dull, annoying ache to persistent, severe, disabling pain. Pain in your back can limit your ability to move. It can interfere with normal functioning and quality of life. Always talk with your healthcare provider if you have persistent pain.

Neck pain occurs in the area of the cervical vertebrae in your neck. Because of its location and range of motion, your neck is often left unprotected and at risk for injury.

Pain in your back or neck area can come on suddenly and intensely. Chronic pain lasts for weeks, months, or even years. The pain can be constant or come and go.

What causes back and neck pain?

Even with today's technology, the exact cause of back and neck pain is hard to find. In most cases, back and neck pain may have many different causes. They include:

• Overuse, strenuous activity, or incorrect use, such as repetitive twisting or heavy lifting

• Trauma, injury, or fractures

• Breakdown of vertebrae, often caused by stresses on the muscles and ligaments that support your spine, or the effects of aging

• Infection

• Abnormal growth, such as a tumor or bone spur

• Obesity, which puts extra weight on your spine and pressure on your disks

• Poor muscle tone or muscle weakness in the back and belly (abdomen)

• Muscle tension or spasm

• Sprain or strain

• Ligament or muscle tears

• Joint problems, such as arthritis

• Smoking

• Slipped disk (protruding or herniated disk) and pinched nerve

• Osteoporosis and compression fractures

• Problems of your vertebrae and bones that you were born with (congenital)

• Abdominal problems, such as an aortic aneurysm

What are the symptoms of back and neck pain?

Symptoms linked to back pain may include:

• Dull, burning, or sharp pain in your back. The pain can be limited to a single spot or cover a large area.

• Leg numbness or tingling above or below your knee

• Stiffness or aching that occurs anywhere along your spine from your neck to your tailbone

• Sharp, shooting pain that spreads from your low back to your buttocks, down the back of your thigh, and into your calf and toes

• Consistent ache in the middle or lower part of your back, especially after standing or sitting for a long period

Loss of bladder and bowel control with weakness in both legs are symptoms of a serious condition that needs medical attention right away.

Symptoms linked to neck pain can be:

• Arm numbness or tingling

• Headaches

• Shoulder pain

• Sharp shooting pain or a dull ache in your neck

Pain that occurs suddenly in your back or neck from an injury is acute pain. Acute pain comes on quickly and may leave sooner than chronic back or neck pain. This type of pain should not last more than 6 weeks.

Pain that may come on quickly or slowly and lingers for 3 months or more is chronic pain. Chronic pain is less common than acute pain.

How are back and neck pain diagnosed?

Your healthcare provider will ask about your health history and do a physical exam. They may also do X-rays of the affected areas, as well as an MRI. This allows a more complete view. The MRI also makes pictures of soft tissues such as ligaments, tendons, and blood vessels. The MRI can help spot infection, tumor, inflammation, or pressure on your nerve. Sometimes a blood test may help diagnose arthritis, a condition that can cause back and neck pain.

How are back and neck pain treated?

In many cases, acute back or neck pain may simply improve with some rest. Over-the-counter medicines, such as acetaminophen or ibuprofen, may also help with the discomfort. Try to move gently during this period, so that you won't become stiff and lose mobility.

If you have chronic pain of your back and neck, try several remedies before considering surgery. These include:

• Hot or cold packs as advised by your healthcare provider

• Certain exercises to strengthen back and belly muscles and ease pain, such as stretching and flexing. Your healthcare provider can show you these exercises. Physical therapy can also help you find the correct exercises.

• Aerobic exercise may help with your overall fitness and strength.

• Certain anti-inflammatory medicines or muscle relaxants may be used, as advised by your provider.

• Sometimes your provider may suggest a brace or corset for extra support.

• Shots (injections) for pain relief in the area

• Nerve block. This eases pain signals from the affected nerve.

• Acupuncture

• Osteopathic manipulation

How are back and neck pain managed?

Acute back pain usually gets better without special treatment. Using acetaminophen or ibuprofen as directed will decrease pain and help you rest. Surgery and special exercises are generally not used with acute pain.

For severe, disabling, or chronic back and neck pain, rehabilitation programs can be designed to meet your needs. The type of program will depend on the cause and the type and severity of your pain, injury, or disease. Your active involvement is key to the success of rehab programs.

The goal of back and neck rehab is to help you manage disabling pain. It's also important to return you to your highest level of functioning and independence and improve your quality of life. The focus of rehab is on easing pain, improving movement. It also focuses on limiting any additional damage and increasing your functional ability.

To help reach these goals, back and neck rehab programs may include:

• Exercise programs to improve range of motion, increase muscle strength, improve flexibility and mobility, and increase endurance

• Help with assistive devices that keep you independent

• Education and counseling

• Pain management methods

• Help to quit smoking

• Gait (walking) and movement retraining

• Stress management

• Nutritional counseling

• Ergonomic assessments and work-related injury prevention programs

• Job counseling

What are possible complications of neck and back pain?

Complications of back and neck pain may include: 

• Loss of productivity. Back pain is the most common reason for disability in working adults.

• Nerve damage. If your back pain is from a herniated disk, pressure on the spinal nerves may cause a variety of problems, such as weakness, numbness, or severe shooting pain that travels from the back to the leg.

• Depression. Back or neck pain can disrupt all aspects of life. This includes work, physical exercise, social activities, and sleep. The anxiety and stress caused by the change in movement and pain can lead to depression.

• Weight gain. Loss of movement and inability to exercise can lead to weight gain and the loss of muscle strength.

It is a good idea to see a healthcare provider if you have numbness or tingling, or if your pain is severe and does not get better with medicine and rest. If you have trouble urinating, weakness, pain, or numbness in your legs, fever, or unintentional weight loss, call your healthcare provider right away.

Can I prevent neck and back pain?

The following may help to prevent back and neck pain:

• Practice correct lifting methods. Don't lift heavy items. When you do lift something, bend your legs, keep your back straight, and then slowly lift your body and the object.

• Wear a seat belt in motor vehicles in case of a collision.

• Use telephones, computers, and other equipment correctly.

• Maintain correct posture while sitting, standing, and sleeping.

• Exercise regularly. Learn back-strengthening exercises to keep your back and belly muscles strong. Warm up with stretching exercises before doing exercises.

• Do exercises that improve your balance.

• Don't smoke.

• Stay at a healthy weight.

• Reduce emotional stress that may cause muscle tension.

• Get enough vitamin D and calcium in your diet.

When should I call my healthcare provider?

See your healthcare provider if you have:

• Loss of bladder or bowel control with weakness in either leg. These symptoms need attention right away.

• Severe back or neck pain that does not decrease with medicine and rest

• Pain after an injury or a fall

• Weakness, numbness, or tingling in your legs or arms

• Fever of 100.4°F (38°C) or higher, or as advised by your healthcare provider

• Unintentional weight loss

Key points about back and neck pain

• Back and neck problems range from minor aches to severe, disabling pain.

• Often, the reason for your pain can't be found.

• See a healthcare provider if you have numbness or tingling, severe pain that does not improve with medicine and rest, trouble urinating, weakness, pain, or numbness in your legs, fever, unintentional weight loss, or pain after a fall.

• Often, back and neck pain will improve over time. See your healthcare provider if your pain is not decreasing.

• Use prevention strategies to keep yourself healthy and injury-free.

• For severe, disabling, or chronic back pain, consider an individualized rehabilitation program.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.