Neck and Back Pain

Neck and back pain are among the most common complaints people experience. While most cases improve with time and simple care, persistent or severe pain can interfere with daily activities and quality of life. This page explains what causes neck and back pain, when it is important to seek medical attention, how it is diagnosed, and what treatments are available. It is for education only and does not replace advice from your own doctor.

Understanding Neck and Back Pain

Neck and back pain affects approximately 80% of adults at some point in their lives. Most people experience mild to moderate discomfort that resolves on its own within a few weeks. However, some develop persistent pain that significantly impacts their ability to work, exercise, or enjoy daily activities.

It is important to understand that not all neck and back pain is the same. Pain can originate from muscles, ligaments, bones, joints, or nerves. When pain comes from muscles and ligaments, it is usually mechanical pain that improves with rest and movement. When pain comes from nerves being pinched or compressed, it is neuropathic pain that often radiates into the arms or legs and may feel like burning, tingling, or numbness.

Understanding the source of your pain helps your doctor recommend the right treatment. Simple muscle strain feels different from a pinched nerve, and each needs a different approach.

Common Causes of Neck Pain

Poor posture is one of the most common causes of neck pain, especially in today’s world where many people spend hours hunched over computers or looking down at phones. Sleeping with too many pillows, sudden jerking movements, muscle tension from stress, and prolonged use of a computer can all trigger neck pain.

More serious causes include wear and tear in the bones of the neck (cervical spondylosis), herniated discs that press on nerves, or pinched nerves. Some people develop neck pain from previous injuries, arthritis, or infections. In rare cases, neck pain can be a symptom of something more serious that needs urgent attention.

When a nerve is pinched or compressed in the neck, it is called cervical radiculopathy or a “pinched nerve.” The compressed nerve can cause pain, numbness, tingling, or weakness in the neck, shoulders, arms, or hands. This type of nerve pain often radiates down one arm and can significantly interfere with your ability to work or perform daily tasks.

Common Causes of Back Pain

Back pain can result from muscle strain caused by overexertion, improper lifting of heavy objects, sudden movements, or excessive activity. For many people, simple muscle strain from a bad movement or weekend activity is the cause. This type of pain usually improves within days to weeks with rest and over-the-counter pain relief.

More serious causes include herniated discs where the soft inner part of a disc pushes through the outer layer and presses on nerves, spinal stenosis where the spinal canal narrows and compresses nerves, and arthritis causing degenerative changes in the spine. Other causes include osteoporosis that weakens bones and increases fracture risk, poor posture and sedentary lifestyle, and in rare cases, infections or tumours.

One of the most common neurological causes of back and leg pain is sciatica, where the sciatic nerve becomes compressed. The sciatic nerve is the largest nerve in the body and runs down the back of each leg. When compressed, it causes burning, tingling pain that radiates from the lower back through the buttocks and down one or both legs.

When to Seek Medical Attention

Most people can manage mild neck or back pain at home with rest, ice or heat, and over-the-counter pain relievers. However, you should seek medical attention if your pain is severe, lasts more than a few weeks, or is accompanied by other symptoms.

See your doctor promptly if your back or neck pain lasts more than two weeks and keeps you from participating in normal daily activities. See a doctor sooner if the pain is severe. Additionally, if your pain is causing radiating symptoms like numbness, tingling, or weakness in your arms or legs, this suggests nerve involvement and requires medical evaluation.

Seek immediate medical attention if you experience fever with your back or neck pain, have recent injury or trauma to your neck or back, experience loss of bladder or bowel control, notice unexplained weakness in your arms or legs, have unexplained weight loss accompanying your pain, or have a history of cancer or immune system problems combined with new back pain. These symptoms could indicate spinal infection, fracture, tumours, or other serious conditions that require urgent care.

How Neck and Back Pain Are Diagnosed

When you visit a doctor for neck or back pain, they follow a systematic approach to understand what is causing your discomfort. Your doctor will first ask detailed questions about when the pain started, exactly where it hurts, whether you were in an accident, what activities make it worse or better, and whether physical strain or mental stress might be contributing.

Next, your doctor performs a physical examination. They will feel your neck or back with their hands, checking how well you can move your head or spine, and testing your reflexes and muscle strength in your arms, shoulders, legs, and feet. This examination helps identify if muscles are tight or tender, if there is a limited range of motion, or if nerve function is affected.

If your doctor suspects nerve involvement, they may order imaging tests such as X-rays, MRI scans, or CT scans to visualize the bones, discs, and soft tissues. An MRI is particularly useful for showing disc problems and nerve compression. Your doctor may also order blood tests to check for infections or inflammatory conditions if indicated.

In some cases, your doctor may recommend an EMG (electromyography) test that measures electrical activity in muscles and nerves, or specific nerve block injections that help identify which nerve is causing your pain.

Understanding Nerve-Related Neck and Back Pain

Not all neck and back pain is simply muscular. When pain involves nerves being compressed or pinched, it can be more complex and may require specialist evaluation. The spine and spinal cord are part of the central nervous system, and nerves exit the spine to provide sensory and motor functions to the entire body. When these nerves are irritated or compressed, the resulting pain can be severe and disabling.

In the neck, nerve compression causes a condition called cervical radiculopathy where the pain radiates from the neck down the arm. Symptoms include arm pain, numbness, tingling, and weakness. The severity depends on how much the nerve is compressed and which nerve root is affected.

In the lower back, sciatica is a common neurological condition where the sciatic nerve is compressed, causing pain, numbness, tingling, and weakness that radiates from the lower back down one or both legs. Patients may feel burning pain, sharp shooting sensations, or a sensation of pins and needles. The symptoms can be very disruptive to daily life and may limit walking, sitting, or standing ability.

Understanding whether your pain is muscular or nerve-related is crucial because treatments differ significantly between the two types.

Treatment Options for Neck and Back Pain

Treatment depends on the cause and severity of your pain. For simple muscle strain, initial treatment typically includes over-the-counter pain relievers, ice in the first 48 hours followed by heat, rest, and gentle movement. Maintaining good posture and avoiding movements that aggravate pain helps recovery.

For persistent pain, your doctor may recommend physical therapy, which includes exercises to strengthen muscles that support the spine, improve flexibility, and correct posture. Physical therapists teach techniques to prevent future injury and often provide significant pain relief without medication.

If you have nerve-related pain, treatment becomes more targeted. Your doctor may prescribe medications specifically designed for nerve pain, such as muscle relaxants to reduce spasm or medications that calm nerve irritation. In some cases, epidural steroid injections near the compressed nerve can provide significant relief by reducing inflammation around the nerve.

For severe, persistent nerve pain that does not respond to conservative treatment, your doctor may discuss more advanced options such as spinal decompression surgery to relieve nerve pressure. However, surgery is usually considered only after other treatments have been tried.

Why You Should See a Neurologist

While many cases of neck and back pain can be managed by your primary care doctor, a neurologist specializes in disorders of the nervous system and is best equipped to diagnose and manage nerve-related pain. You should see a neurologist if you have numbness, tingling, or weakness in your arms or legs, if pain radiates from your neck or back down your limbs, if you have symptoms of nerve compression that are worsening, or if conservative treatments are not providing relief.

A neurologist can confirm whether your pain is coming from nerve compression, order appropriate nerve tests, prescribe targeted nerve medications, and discuss advanced treatment options including potential surgery. They understand how the spine and nerves interact and can create a comprehensive treatment plan tailored to your specific condition.

Prevention and Self-Care

Many cases of neck and back pain can be prevented through simple lifestyle changes. Maintaining good posture when sitting at a computer, using an ergonomic chair and desk setup, taking regular breaks to stretch, and avoiding prolonged sitting all help prevent pain. When lifting heavy objects, bend at your knees and keep your back straight rather than bending at the waist.

Keeping a strong core through regular exercise supports your spine and helps prevent injury. Simple activities like walking, swimming, or yoga strengthen core muscles. Sleeping on a supportive mattress with an appropriate pillow helps maintain proper spinal alignment during sleep.

Managing stress is also important because stress often causes muscle tension in the neck and shoulders. Regular exercise, meditation, deep breathing, and relaxation techniques all help reduce stress-related pain.

Living With Chronic Neck or Back Pain

For people with chronic pain, learning to manage symptoms and adapt activities is essential. Even with ongoing pain, many people successfully maintain work and enjoy physical activities by understanding their limits, using proper techniques, and following their doctor’s recommendations.

Regular physical therapy, maintaining core strength through appropriate exercise, using supportive devices when needed, and following a comprehensive pain management plan all help improve quality of life. Many people find that a combination of approaches—medication, physical therapy, lifestyle changes, and when appropriate, specialist consultation—provides the best results.