Common causes
Neck and back pain can start suddenly after a lift, fall, or car accident, or build gradually over years. Frequent sources include:
- Disc problems — a bulging or herniated disc can irritate nearby nerves and send pain into an arm or leg.
- Facet joint arthritis — wear in the small joints at the back of the spine often causes aching that is worse with twisting or leaning back.
- Spinal stenosis — narrowing around the spinal cord or nerves, often causing leg pain with standing and walking.
- Sacroiliac (SI) joint pain — pain low in the back or buttock where the spine meets the pelvis.
- Vertebral endplate changes — a source of chronic low back pain called vertebrogenic pain.
- Compression fractures — often related to osteoporosis.
- Muscle strain and myofascial pain — tight, tender knots in the neck, shoulders, or back.
How we evaluate your pain
Your first visit includes a detailed conversation about your symptoms and history, a physical and neurological exam, and a review of any X-rays, MRI, or CT scans you already have. If more information is needed, we may recommend imaging or other tests.
Treatment options
Most people do best with a combination of approaches. Depending on your diagnosis, your plan may include home exercise or physical therapy, medication adjustments, and image-guided procedures such as:
- Epidural steroid injections for pain that travels into an arm or leg
- Facet injections and medial branch blocks
- Radiofrequency ablation for longer-lasting relief of joint-related spine pain
- Intracept for vertebrogenic low back pain
- MILD and minimally invasive interspinous fusion (Minuteman, ZIP) for lumbar spinal stenosis
- Spinal cord stimulation for chronic pain that has not responded to other care
- Trigger point injections for muscle-related pain
Exercises you can do at home
Staying active is an important part of most pain treatment plans. See our low back (lumbar) exercises and neck (cervical) exercises for gentle stretches and strengthening options in lying, seated, and standing positions. Please ask your provider before starting, especially after a procedure.
This page is for general education and is not a substitute for an evaluation by a medical professional. Results vary, and no treatment works for everyone. Your provider will discuss whether this option is appropriate for you, along with its benefits, risks, and alternatives. Insurance coverage varies by plan — please call to verify.