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HOW COMMON IS NECK AND BACK PAIN?

Neck and/or back pain can be commonly experienced in a person’s lifetime and have a serious impact on quality of life. It has been estimated that up to 66% of the adult UK population experience neck pain every year, and that 84% will have back pain at some point during their lives, with 1 in 15 people seeing their GP regarding their back pain.

WHAT CAUSES NECK AND BACK PAIN?

The neck and back are made up of a series of bones called ‘vertebrae’ which are separated by discs and joined up like a chain (this is the spine). The vertebrae are surrounded by supportive ligaments and muscles for movement.

The most common cause of neck and back pain is known as ‘musculoskeletal pain’. This means that muscles around the neck and back can become strained, overstretched or damaged, causing pain around the spine.

It can get worse through degeneration (wear and tear of the joints) within the spine: this is known as ‘arthritis’ and can occur as our bodies age. General arthritic conditions such as osteoarthritis and rheumatoid arthritis can increase pain and discomfort.

Other common causes of neck and back pain include conditions that cause generalised long-term pain (such as fibromyalgia), problems with the discs of the spine (including bulging or degeneration), and conditions affecting the joints of the spine such as spinal stenosis (where the narrow spinal canal gets compressed and causes pinching of the nerves, causing pain, cramping, weakness or numbness).

WHAT ARE THE SYMPTOMS OF LOWER BACK AND NECK PAIN?

Pain in the neck and back can vary between individuals and depends on the underlying cause. People can experience different intensities, types and durations of pain.

Some people might experience a dull, aching pain while others experience much sharper pain.

In addition to pain around the neck and lower back, there are a number of other symptoms associated with lower back and neck pain:

Neck pain can be accompanied by neck stiffness, headaches, tingling or shooting pain in the arms and hands, and weakness in the arms and hands.

Lower back pain can result in pain radiating down the back of the leg (known as ‘sciatica’); this is caused by a pinching or irritation of the sciatic nerve in the spine as it travels down the buttocks and legs.

Patients with lower back pain can also experience pain that affects the legs on walking for a fixed distance (known as spinal claudication). When they reach that distance, they start to get pain and have to stop walking for the pain to subside each time.

Rarely, if leg weakness or loss of sensation in the legs occurs, or if there is any associated bladder or bowel problems, then immediate medical attention should be sought.

Investigating and treating back pain at The London Clinic involves multi-disciplinary teams of neurologists and spinal specialists. Our facilities and expertise for investigating and diagnosing back pain include:

  • Diagnostic imaging: X-rays, CT scanning and MRI scanning
  • Discography
  • Myelography

Many patients can benefit from physiotherapy, carefully selected exercises, muscle strengthening and pain relief. Rehabilitation can be used as a first line treatment or as an aid to recovery after spinal surgery.

Injections into the spine

There are several types of spinal injection that can help relieve neck pain and back pain:

  • A facet joint injection. One approach for back pain is to inject a local anaesthetic and a corticosteroid into the spinal tissue.
  • A nerve block. This type of injection is made directly into the nerve that is causing the back pain.
  • An infraorbital nerve block. For neck problems causing facial pain, injections can be done higher into the spine or even directly into the nerves of the face.

A spinal injection is a specialised procedure that needs to be done by a highly trained and very experienced orthopaedic surgeon. The surgeon locates the exact point for the injection by visualising the spine using X-rays. Such treatments can be very effective. The anaesthetic acts to numb the pain, while the corticosteroid reduces inflammation in the damaged tissues. After just three to four injections, more than eight out of 10 patients with neck pain or back pain experience significant pain relief.

Spinal surgery techniques

  • Microdiscectomy: surgery to treat sciatica
  • Spinal canal stenosis treatments including non-surgical treatments, insertion of interspinous spacers, spinal stabilisation and laminectomy
  • Lumbar spinal fusion: fusing one vertebra to another using a bone graft technique
  • Replacement of a vertebral disc with a disc prosthesis, commonly used to treat degenerative disc disease
  • Stabilising the lumbar spine, an alternative to spinal fusion that retains spinal flexibility
  • Kyphoplasty: surgery to treat vertebral compression fractures

HOW IS NECK PAIN, BACK PAIN (WITH AND WITHOUT SCIATICA) DIAGNOSED?

A doctor will be able to diagnose neck and back pain disorders by asking about the symptoms and doing a thorough clinical examination of the spine. They may ask about how the pain started, the duration and pattern of the pain, the severity of pain and anything that makes it better or worse.

The clinical examination of the spine will involve the doctor feeling down the neck and back for any points of pain. The patient will be asking to perform several movements whilst the doctor is doing this. For specific symptoms, such as sciatica, special examinations will be required during the assessment.

Further investigations may be needed to confirm the diagnosis. These may include blood tests, imaging such as an X-ray or MRI scan, or neurological investigations, including special ‘conduction studies’ (where specific nerves are stimulated to assess how well they are working).

WHAT TREATMENTS ARE AVAILABLE FOR NECK AND BACK PAIN? 

The mainstay of treatment for the commonest causes of neck and back pain include a combination of painkillers and appropriate physiotherapy to relieve symptoms and help patients return to their normal daily activities.

Some specific causes of neck and back pain may require more targeted treatments such as injections to reduce inflammation, or surgery to repair discs or trapped nerves.

A referral to the chronic pain team may be required to manage cases of pain that are more difficult to treat. Our specialist experts in pain management are on hand to support the treatment of neck and back pain using the latest in treatment innovations.

Treatment cost

The London Clinic offers affordable, competitive self-pay packages for certain treatments. An All-Inclusive Package for this treatment is available from £1,720.

Patients have the option to spread the cost of treatment with Chrysalis Finance.

Please call +44 (0)20 3613 7502 to speak to our helpful team to find out more and to book an appointment.

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