DenverSpine - Causes of Back and Neck Pain

Muscle strain

Some research studies note that 80 percent of back and neck pain is caused by muscle strain. Unlike leg muscles, which are long and resistant to spasms, the back is composed of short extensor muscles that bridge from vertebra to vertebra.

Because these muscles are shorter, they are more prone to spasm. A muscle spasm occurs when muscle fibers in the back tighten and convulse involuntarily.

Muscle strain can also be a result of spinal ligaments near the vertebral bodies or tendons that become painful due to inflammation. Ultimately, a muscle spasm is an alert to the body that it has been pushed beyond its limits. When a muscle spasm occurs, it is a good idea to gently stretch the injured area to increase circulation. The more circulation to the area, the sooner the pain will subside.
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Herniated and bulging discs

The spine is composed of many vertebrae stacked on top of each other. Between these bones are discs, which act as shock absorbers. The shock-absorbing discs resemble jelly donuts, each having a jelly-like center. As we age, the discs naturally become less flexible and more brittle.

In the event of a fall or heavy strain, these discs can rupture, causing the nucleus to break through the wall of the disc and place pressure on the nerves that branch out from the spinal cord. This results in a herniated disc, accompanied by back or neck pain.

As the nucleus escapes through the wall, the tissue either remains connected with the disc, or it can break from the nucleus and travel away from the disc. Discs can herniate in any direction—forward, centrally, or most commonly, backwards and sideways in the direction of the spinal nerves.

Sometimes, people mistake excruciating pain for a herniated disc, when the pain might actually be the signal of a muscle strain. The most common indicator of a herniated disc is when pain radiates down into the leg or arm. Sitting down for a while, and then lifting a heavy object can cause a disc to herniate. Often, back pain without leg pain can be a result of partial herniation of the disc or an internal disc disruption.

Special extension exercises can help relieve pain from a herniated disc. Exercise can work like a vacuum to suck the center of the disc back into place, helping release pressure on the nerve. Although someone suffering an attack of back pain may find it hard to believe, it has been proven that specific exercises can help relieve their pain.

The good news is that a herniated disc does not necessarily mean a person needs surgery. In some cases, symptoms from a minor herniation can subside, and, with care, pain recurrences can be minimized.

A bulging disc forms when the wall of the disc is deformed but not necessarily herniated. The nucleus is still contained in the wall. You NEVER need surgery to treat a bulging disc.

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Spondylolisthesis and spondylolysis

Spondylolisthesis and spondylolysis are caused by joint instability in the low back. When a person experiences low back pain that does not subside after a few weeks, a spine doctor will scan for this instability by taking X-rays or performing other diagnostic tests.

As you may recall, the rear section of the spinal vertebrae have facet joints that act as hinges, which allow our spines to twist and bend. Sometimes, however, this posterior element can crack. Factors such as heredity and stress can cause part of the posterior element, called the pars interarticularis (PARS), to crack. Spondylolisthesis occurs when the cracked PARS causes the vertebra to slide forward out of its correct position.

Gymnasts who perform routines that bend and arch the back are often victims of spondylolysis or spondylolisthesis. If left untreated, spondylolysis can lead to spondylolisthesis. Many victims of spondylolisthesis don’t experience symptoms and may not know they have it.

While ligaments and muscles help hold vertebrae in place, over time, it may be necessary to install surgical instrumentation or bone grafts that lock vertebrae in place in order to prevent them from sliding out of position and damaging the spinal nerves.

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Scoliosis

Scoliosis is a disease characterized by an abnormal curvature to the spine, in which the vertebrae twist like a bent corkscrew. In less severe cases, scoliosis may cause the bones to twist slightly, making the hips or ribs appear uneven. When this occurs, the problem is more cosmetic and less of a health risk.

Scoliosis does present a health risk if bones are so severely twisted that they compress vital organs, or if the spinal deformity is so severe that spine health and posture is threatened. If this happens, surgery may be necessary. If left untreated, severe cases of scoliosis can shorten a person's life span.

The exact cause of scoliosis is unknown. Only 1-4 percent of the population has this condition. It is more common in women than men and most often affects adolescents between the ages of 10 and 18. A child's likelihood to develop scoliosis is much higher if their parent or a sibling has it. Scoliosis can also develop over time in mid- to late childhood, usually before puberty. In other cases, the disease is congenital, meaning a person is born with a vertebral abnormality that causes it.

Sometimes, the symptoms of scoliosis are visible. For instance, the child may have uneven shoulders, chest, hips, shoulder blades, waist, or a child may have a tendency to lean to one side. In other cases, there are no visible symptoms. To diagnose a child with scoliosis, have them can touch their toes. If either one or both shoulder blades are prominent, the waist is shifted or ribs are uneven, scoliosis may be present. For a child or teenager, your pediatrician often screens for scoliosis. There are school screening programs as well.

Surgery may be required in order to correct the spinal curve. Surgery is usually only recommended for large, progressive curves or in those patients who have nerve pain that steadily worsens. These surgeries can be extremely complicated, and a person should invest a great deal of time in selecting a spine surgeon who subspecializes in using the most current (fourth generation) corrective techniques. As with any spine surgery, finding a doctor with experience in this specific type of surgery is key.

Learn more about scolioisis through the Scoliosis Research Society.

Click here to read patient testimonials.

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Kyphosis

Kyphosis and lordosis are types of spinal deformities. Lordosis occurs when the spine curves too far inward in the low back. Kyphosis occurs when the spine in the shoulder blade area curves forward more than normal. Individuals with kyphosis may have visible humps in their back.
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Coccygeal pain

In rare cases, back pain originates in the coccyx, the small section of fused bones at the base of the spine. This pain typically results from a direct fall onto the buttocks or from too much sitting.
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Neck pain

Neck pain can be muscle-related, caused by holding the head in the same place for too long. Other cases of neck strain can result from an injury involving a sudden jerk of the neck, such as a car accident. Just as in the low back, a disc may herniate, which places pressure on nerves branching out from the spinal cord.
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Spinal tumors

The presence of a tumor in the spinal area is extremely serious. These tumors may or may not be painful, which is why it is important to see a spine specialist when back or neck pain persists for more than a week. A tumor can place pressure on nearby nerve roots, which will cause pain. Spine tumors can be benign or malignant.
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Bone spur

A bone spur is an excess growth of bone around a vertebral body. If bone spurs grow too much, they can impinge on nerve roots.

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Degenerative disc disease

Degenerative disc disease commonly occurs with age. Discs become more brittle, less resilient and more prone to herniation. In many cases, the space between vertebrae narrow, which can be painful.

Osteoporosis can be a contributing factor to disc degeneration. As bones weaken, a person becomes increasingly at risk for vertebral fractures. Since osteoporosis typically does not have noticeable symptoms, those at risk, particularly older women, should undergo a bone density scan in order to detect osteoporosis in its early stages. Dietary supplements or medications may be recommended to treat degenerative disc disease.
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Spinal stenosis

Spinal stenosis occurs when there is not enough room in the spinal canal for the spinal nerves. This condition resembles placing a ring on your finger. If the finger becomes injured or inflamed, the ring constricts and causes pain. The pain caused by stenosis is usually focused in the low back area and can shoot down the legs and flare up after walking or exercising.

Relief from spinal stenosis can be found by leaning forward or sitting. Pain typically increases when the person bends backward. Stenosis can be treated nonsurgically, but some cases require surgery in order to create more space around the nerves.
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Learn more about back pain causes and prevention methods through the North American Spine Society.

Need more information on back and neck pain?
Click here to view resource books on spine problems, what causes back pain, what causes neck pain and when to see the doctor.