Know when to get spine treatment for back and neck pain

07/31/2023

By Scott Sanderson, MD, Chief of Neurosurgery, Danbury Hospital, part of Nuvance Health

When is back or neck pain serious?

If you have back or neck pain, it is usually good to see your primary care provider for an initial evaluation when:

• The back or neck pain is new and stays localized in that area.
• You do not have pain radiating down your arms, back, buttocks or legs.

This type of spine pain can happen for various reasons, including disc irritation or a pinched nerve. Many people describe it by saying “I threw my back out.”

Speaking from personal experience, this type of pain can feel catastrophic and you may be inclined to go to the emergency department. However, it usually gets better with a course of strong anti-inflammatory medication or muscle relaxants and local treatment, such as heat or ice.

See a spine specialist for a back or neck injury if:

• The pain does not go away within two weeks.
• The pain worsens.
• You have pain radiating down one or both arms or legs or your back or buttocks.
• You have arm or leg numbness or weakness.
• You are unsteady when you stand or walk.
• You have new bladder or bowel incontinence.

You may need urgent medical attention if you have spine pain after a traumatic event where you hit your head, neck or back.

Call 9-1-1 if you have an accident that causes bad head, neck or back pain with the following serious symptoms:

• Your body, in particular your head or neck, are twisted or bent in an unusual position.
• You have numbness, tingling and weakness in your neck or back and cannot move your arms or legs.
• You lost consciousness.

How a spine specialist can help when you have back or neck pain

If you tried self-care with medication, heat or ice and your back or neck pain is not improving after a couple weeks, you may benefit from seeing a spine specialist.

Look for a spine specialist who takes a conservative approach to recommending surgery. There are several reasonable treatment options to try before surgery, including physical therapy and interventional pain management. Your doctor should exercise caution, consider all your options, and guide you through the process to get better.

Your spine specialist should also make a personalized care plan for you based on a thorough examination, medical history, and imaging such as X-rays, CT scans and MRIs. It is also important for your doctor to develop a care plan that supports your lifestyle goals so you not only feel better but can maintain your quality of life.

During the initial exam, your spine specialist should accurately determine the source of your symptoms. For example, many people with a cervical spine (neck) injury have pain in the shoulder blade. They understandably think it is a shoulder or upper back problem and first see an orthopedist, physiatrist, physical therapist or pain management specialist before a spine specialist.

Speaking of these specialties, back and neck surgeons collaborate with many talented specialists because spine care is a team sport. After a diagnosis, we connect patients with appropriate, well-rounded care options.

Spine injury treatment options

Non-surgical spine treatment

The good news is there are many non-surgical ways to manage spine injuries ranging from oral or injectable steroids to reduce inflammation and pain, physical therapy, spinal cord stimulation, chiropractic care, acupuncture, massage and more.

Spine surgery

Your spine specialist may recommend surgery if they are worried about nerve damage, or if you tried several other non-surgical options without improvement. Also good news: there are more innovative and less aggressive options for spine surgery now than ever before. These include minimally invasive procedures like robotic-guided spinal fusion.

Minimally invasive spine surgery

Robotic technology is a great option for people who need spinal fusion to treat a herniated disc or spinal instability. Benefits from robotic technology compared to traditional, open spinal fusion include:

• Shorter hospital stay after surgery
• Less post-operative pain
• Faster recovery

Minimally invasive procedures may also be a safe option for people who are not candidates for traditional, open surgery due to their age or other medical conditions.

Artificial disc replacement is also an alternative to spinal fusion for people who meet criteria, which can result in having more mobility in the spine post-surgery.

The bottom line: Back and neck pain is very common; if you have it, you are not alone. Rest assured there are many options to help you feel better. Seeing a primary care provider for isolated spine pain is a great first step. Be aware of red flag symptoms to know when to see a spine specialist who will discuss your options, connect you to care and resources, and support you on your road to recovery.