Column: Interpreting back, neck pain


Commentary by Dr. Shashank Dave

With summer on the horizon, your neck and back pain could be holding you back from fully enjoying the warmer weather. It’s important to understand what could be causing your back and neck pain as well as your treatment options.

Understanding pain

Back and neck pain can originate from a variety of causes, including sprains and fractures, dislocations, stress from overuse, obesity and infections. Back and neck pain can cause mild to debilitating discomfort that impacts your ability to function.

What causes the pain?

Your spine has five sections of vertebrae: the neck or cervical spine, the mid-back or thoracic spine, the lower back or lumbar spine, the base of the spine or sacrum, and the tailbone or coccyx. Pain generated from each area can have different causes. Some of the conditions that cause pain in these areas include muscle or ligament strain, disc herniation (slipped disk or ruptured disk) and degenerative disc disease, sciatica, spinal stenosis, scoliosis, ankylosing spondylitis, brain tumors, spinal tumors, torticollis or whiplash.

How is it treated?

To treat your back and neck pain, your physician must first determine the cause. Your physician may use a combination of medical history, physical examination, diagnostic testing and imaging. They may also decide to conduct more advanced tests to better understand your condition. These can include an electromyogram to study nerve and muscle function, an MRI to study your spinal cord and an arthroscopy to investigate internal joint function.

Once your physician determines the origin of your pain, they can work with you to develop the best treatment plan to address your specific condition and pain. There are a variety of treatment options, such as medications to reduce pain and inflammation as well as physical therapy to potentially fix your pain.

If these do not work, your doctor could prescribe advanced pain management techniques. These more advanced techniques may include epidural injections, which can help with pain and inflammation, radiofrequency ablations, which deadens nerves thereby blocking pain, and nerve stimulation (either peripheral or central), which is a wire implanted that stimulates nerves and can also block pain. Another option includes surgery, which is done to relieve pressure on nerves or your spinal cord.

Dr. Shashank Dave is an IU Health physical medicine and rehabilitation physician at Methodist Medical Plaza North. For more information on back and neck pain, visit