Spine Conditions Causing Back Pain and Neck Pain
It is estimated that 80% of Americans will suffer from back or neck pain at some time in their lives. In most cases, spine pain either improves on its own or can be treated conservatively, without surgery. Spine pain can be caused by a variety of different conditions that affect the lower, middle or upper part of the spine. The Denver spine surgeons at Neurosurgery One (formerly South Denver Neurosurgery) are committed to accurately diagnosing the cause of your back pain or neck pain and offering you complete information on your treatment options. With a personalized approach to care, our spine surgeons always choose to treat spine conditions conservatively without surgery whenever possible, never recommending surgery unless it is absolutely necessary.
Read on to learn more about the conditions that commonly cause back pain and neck pain, or click on one of these links to go directly to the information you are interested in:
- Overview of Spine Pain
- Overview of the Spine Structure
- Common Spine Conditions that Cause Spine Pain:
- Diagnosing the Cause of Back Pain
- Treatment Plans to Relieve Back and Neck Pain
- Treating Back Pain Without Surgery
- When to Consider Spine Surgery
- Spine Condition Resources
Spine pain is one of the most common reasons people seek medical treatment, or practice self-care at home. While back pain often can be treated conservatively, one third of people who experience back pain will have a recurrence within a year.
Back pain or neck pain can be caused by many things, such as improper lifting, an injury, arthritis, or spine conditions which affect the vertebrae, discs, or nerves in the spine. Things like improper lifting, accidents or injuries tend to cause acute, or short term, spine pain. Arthritis and issues with the spinal vertebrae, discs or nerves tend to cause chronic, or long term, spine pain. On this page, we will provide an overview of the common spine conditions that cause back pain as a result of a spinal condition or an identifiable structural cause.
The spine is composed of 24 vertebrae, or bones of the spine, separated by gel-like discs, both of which surround the spinal cord. Nerves branch off of the spinal cord between the vertebrae and continue down into the arms and legs. Spine pain is usually classified by the part of the spine in which it occurs:
- Cervical spine: the neck, composed of seven vertebrae numbered C1 to C7
- Thoracic spine: the upper and mid back, where your ribs attach to the spinal column, including twelve vertebrae numbered T1 to T12
- Lumbar spine: the lower back, composed of five vertebrae numbered L1 to L5
[Find appropriate image of spine; add alt image tag]
Many of the spine conditions that cause pain can occur in any area of the spine. Pain can occur due to problems with the vertebrae (bones), the discs between the vertebrae, or the spinal nerves. We have divided these common spine conditions into five categories:
- Spinal deformity
Conditions that commonly cause back pain are outlined below. For some conditions, there is more detailed information on the condition and treatments – click on the links to read the details.
Degenerative spine conditions result in a “breakdown” of function and normal structure of the spine over a period of time, which may result in back pain and neck pain. These conditions are most often caused by aging. Tumors, infections, or arthritis also can lead to some of these conditions. Common degenerative spine conditions are listed below. We also offer a comprehensive section on the causes, diagnosis, and treatment specific to neck pain.
Degenerative disc disease – A common source of lower back pain, degenerative disc disease evolves gradually as the discs lose flexibility, elasticity, and shock-absorbing characteristics through normal wear and tear in the process of aging.
Bulging discs – Bulging discs are sometimes called disc protrusions or disc herniation. They may cause symptoms such as pain in the arms/legs, numbness, tingling, and weakness of the arms and/or legs if they press on an adjacent nerve root or the spinal cord.
Sacroiliac (SI) joint dysfunction – SI joints are located where the pelvis and lower spine connect. When the SI joint becomes inflamed or the cartilage wears down, SI joint dysfunction occurs, causing up to 25% percent of all lower back pain. SI joint dysfunction is often misdiagnosed, leading to improper treatment that doesn’t relieve the pain.
Herniated discs (also called disc herniation or slipped disc) – A herniated disc is similar to a bulging disc, but in addition to the disc protruding, the soft inside of the disc breaks through the outer covering. It often can compress nearby nerves, resulting in pain, numbness, tingling or weakness in an arm or leg. Disc herniation is often the result of degenerative disc disease caused by aging, but it can also occur with events such as trauma or even improper lifting.
Radiculopathy – Radiculopathy occurs when a nerve in the spine is compressed and nerve inflammation occurs. It most commonly occurs in the lower back and the neck. It can result from a number of other spine conditions, including disc herniation and degenerative disc disease. Symptoms of radiculopathy include pain, tingling, numbness or weakness in the arms and legs. Most initial treatment options for radiculopathy are non-invasive and may include medications, injections, and physical therapy.
Spinal stenosis – Most often occurring in the neck or lower back, spinal stenosis is created when the spinal column narrows, which can be caused by a series of issues including overgrown bone, herniated disks, tumors, and spinal injuries. This puts pressure on the spinal cord and the nerves that travel through the spine. The pressure can cause pain, numbness, tingling, balance dysfunction, and in rare cases: muscle weakness, incontinence, and problems with bowel function.
Spondylolisthesis – Spondylolisthesis occurs when one vertebra slips forward relative to another vertebra. Spondylolisthesis can occur in the neck or low back and symptoms can include lower back pain, leg pain, weakness, numbness and/or tingling in the legs.
Myelopathy – Myelopathy is a condition in the neck or mid back in which the spinal cord is irritated or injured. Symptoms include numbness and tingling, weakness in the arms and legs, changes in balance, fine motor function and in severe cases bowel and bladder dysfunction.
Synovial cyst – A fluid-filled sac in the joints of the spine, usually in the lumbar area, that has developed as a result of arthritis and may compress nerves like a herniated disc. Symptoms of a synovial cyst are similar to spinal stenosis and typically include pain in the lower back that radiates down one or both legs.
Facet arthropathy – A type of arthritis that affects the joints that connect the vertebrae, facet arthropathy can occur when the protective cushioning between the facet joints breaks down and becomes thinner. This allows the bones of the facet joint to rub together, causing pain that often shows up as back or neck pain.
Scoliosis – Adult onset scoliosis or degenerative scoliosis can occur slowly over time as a person ages. This side-to-side curvature of the spine is caused by degeneration of the facet joints and intervertebral discs. In rare cases, the spine develops a curvature to compensate for the wear and tear that has occurred.
Most often, degenerative spine conditions require conservative treatment and may improve through simple exercises and strengthening. If conservative treatments fail, surgery may be recommended.
Spine conditions that are related to trauma can occur from a series of events, including car accidents, sports injuries, and falls. Trauma-related spine conditions typically result in sprains, fractures, and bone dislocations in the spine. Depending on the number of vertebrae involved, certain injuries can cause compression or wedge fractures and may lead to a spinal deformity, such as kyphosis. Treatments for traumatic spine conditions vary depending on the severity of the injury and may include immediate surgery.
The spine surgeons at Neurosurgery One are trained trauma specialists and provide on-call coverage to St. Anthony Hospital in Denver, a Level I Trauma Center, and Littleton Adventist Hospital, a Level II Trauma Center.
Spinal infections can occur following a surgery or can spread from an infection in a different part of the body. Certain risk factors increase the chances of contracting an infection in the spine, including poor nutrition, immune suppression, diabetes, and certain cancers. Spine conditions that are caused by infection include:
- Vertebral osteomyelitis
- Spinal epidural abscess
Most cases of infectious spine conditions can be treated with antibiotics and may require hospitalization. In rare cases, surgery may be necessary if there is severe impact to a bone, neurological structure, or if the condition is not responsive to antibiotics.
Neoplastic spine conditions involve tumors (benign or cancerous) located in the spinal region, most commonly the vertebrae and spinal cord. In some cases, the tumor causes spinal cord compression and can damage nerves located near the area of the tumor, causing neurological problems and possible paralysis. Progression of such tumors depends on the specific type of tumor. Treatment for neoplastic spine conditions may include spine surgery, radiation therapy, and chemotherapy. Recent studies show that patients tend to have better functional outcomes with surgery and radiation than with radiation alone.
Spinal deformity conditions occur when there is a curvature in the spine. Most spinal deformities are non-progressive but can cause persistent pain that can become debilitating. Spinal deformities include:
- Spondylolisthesis – Spondylolisthesis occurs when one vertebra slips forward on the vertebra below and is most common in the lower back. Spondylolisthesis usually occurs when the top vertebra has a defect, commonly known as spondylolysis. Symptoms can include lower back pain, leg pain, and numbness and/or tingling in the leg.
- Scoliosis – Can be a condition that occurs in childhood or may occur later in life as a result of aging or degenerative spinal structure.
- Kyphosis – Kyphosis is a forward rounding of the back that commonly occurs in older patients with osteoporosis. It may cause pain or compression fractures of the spine.
- Lordosis – Sometimes called swayback, lordosis is a significant inward curve in the lower back.
Many treatment options are available based on the severity of the condition. Options include bracing to correct spine curvature, physical therapy, and spine surgery.
While some back pain and neck pain is caused by improper lifting, injury, or strains and resolves on its own, persistent or recurring back or neck pain can be a symptom of an underlying condition. To determine the exact origins of your pain, your primary care physician or spine specialist at NeurosurgeryOne will take your medical history, ask you about the location, frequency, and duration of your pain and perform a specialized physical exam. Depending on your symptoms, your doctor may choose to confirm a diagnosis with an imaging test or scan, including:
- Spine X-ray is used to identify degenerative disease, fractures, or even tumors.
- CT scans of the spine produce detailed, cross-sectional images of the spine, which can help detect subtle changes in bones.
- Spine MRI shows both tissue and bone and is useful in diagnosing a bulging, protruding, or herniated disc, or pinching of the nerves or spinal cord.
- Myelogram uses a special dye that is injected into the area around the spinal column, to allow better viewing of the spinal canal and discs, and the condition of nerves in and around the spine; it is used primarily when patients have had multiple prior surgeries.
- Electrodiagnostic testing studies the electrical activity of nerves in your arms and legs.
- Bone scans identify abnormalities of the bone, such as tumors or inflammation.
Read more about testing and diagnosis of neck pain conditions here.
Once a cause of your spine pain is identified, your spine surgeon will develop a treatment plan for you. If you are diagnosed with certain traumatic or neoplastic spine conditions, or you have a spinal deformity, spine surgery may be the recommended treatment. But for many spine conditions, conservative treatments will most likely be recommended as a starting point. Our spine specialists at Denver’s NeurosurgeryONE always begin with conservative treatments if possible and appropriate. We work hard to ensure that you understand your condition, and all treatment options available to you. We can provide you with the medical research backing our recommendations, and partner with you to make a personalized treatment plan that is tailored to you and your spine condition.
The most common first-line treatments for back pain that our spine specialists recommend include:
- Medications including nonsteroidal anti-inflammatory drugs (ibuprofen), muscle relaxants, antidepressants, and anti-seizure drugs.
- Steroid injections that can reduce inflammation and relieve pain and pressure. The number of injections a patient can receive are limited and are not meant to be used long term due to the side effects of the steroids. Learn more about the nonsurgical pain procedures offered at Neurosurgery One.
- Physical therapy, combining exercise, ice, heat, and ultrasound to reduce pain and muscle spasms. Our Denver spine specialists have found physical therapy—and exercise in general—to be one of the most effective treatments for back pain and we work closely with trained physiatrists as well as physical therapists and other providers of specialized spine care to develop treatment plans.
- Alternative medicine such as acupuncture, to help alleviate pain in some patients.
No matter which conservative treatment is recommended, it’s important to note that you may not experience immediate relief. It may take several months or more before you start to feel better. Patients should not assume these treatments are ineffective until some time has passed to allow the treatment to start working. Our spinal neurosurgeons will monitor your progress and discuss when to discontinue conservative treatment and begin to consider surgery.
Read more about conservative treatments for back pain and neck pain.
While the vast majority of people with back pain or neck pain will improve over time without medical treatment or with non-surgical treatments, a portion of patients may need spine surgery. Typically, a person with back pain or neck pain is a candidate for spine surgery if they meet these criteria:
- A structural problem has been diagnosed and confirmed through imaging (such as an X-ray or MRI)
- Conservative treatments, such as physical therapy or medications, have failed to provide adequate pain relief
- Back pain or neck pain is debilitating, meaning it is preventing you from participating in daily activities or physical activity
- Back pain or neck pain is negatively impacting your physical or emotional health
- There is a reasonable expectation that you will benefit from spine surgery
- If the patient’s neurological system is being affected, and
- Your general health and age supports spine surgery without creating an undue health risk
Our Denver spine surgeons will help you understand if spine surgery will benefit you, the right time to consider spine surgery, and the best type of spine surgery for your condition—and for you.
To learn more about spine surgery and whether it is the right choice for you, go to our online Spine Surgery Guide where you can learn more about:
- Am I a candidate for spine surgery?
- Appropriate conditions for spine surgery
- Spine Surgery to Decompress or Stabilize the Spine
- Spine Surgery Techniques: From Traditional to Minimally Invasive
- Minimally Invasive Spine Surgery vs. Laser Spine Surgery
- Choosing a Spine Surgeon
- Preparing for spine surgery
- Day of surgery
- Recovery after spine surgery
- Pain management after spine surgery
- Spine surgery resources
To review additional information on common spine conditions, please click on the links below:
Downloadable guide: Spine Surgery 101
Downloadable guide: Lumbar Spinal Fusion Surgery
Downloadable guide: Cervical Disc Fusion vs Disc Replacement
Video: Spondylolisthesis Treatment
Video: Cervical Spine Fusion vs Disc Replacement
Video: Minimally Invasive Spine Surgery
Video: Treatment for Bulging Discs
South Denver Neurosurgery's four spine experts can help you find the treatment that will work best for your condition. To make an appointment, complete the form to the right and one of our schedulers will call you.