General Information

Back or neck pain occurs at some stage in the life of most people.

Pain may be simply due to a muscle strain but, if persistent, usually arises from the discs and/or joints of the spine which are beginning to degenerate (develop “wear and tear”) as a result of normal ageing.

Episodes of pain may be caused simply by loading the spine through normal activities of daily living, or precipitated by injuries (falls, lifting, sport etc).

If pain or tingling extend down the arm or the leg this is usually due to compression of a spinal nerve.

While degeneration (ageing in the discs or joints of the spine) is the most common cause of neck or back pain, less commonly persistent neck or back pain is due to slippage of the spine (spondylolisthesis), fracture (especially in osteoporosis) and very occasionally infections of the spine or cancer of the spine.

Treatment

Painful episodes often resolve within a few days or a few weeks with no treatment, simply the passage of time. Painful episodes can sometimes be shortened by:

• Physical therapy
• Physiotherapy
• Osteopathy
• Chiropractic treatment

Pain management includes:

• Analgesic and anti-inflammatory medication
• Acupuncture
• Massage
• Spinal cortisone injections

Preventative measures:

• Weight reduction
• Improved aerobic fitness (walking, jogging, cycling, swimming etc)
• Core muscle strengthening

For some patients with nerve pain (pain/tingling extended down the arm or the leg) physical therapy may worsen their symptoms. These patients should stop treatment and proceed to imaging tests (e.g. MRI).

My expertise is in diagnosis and surgical management - I do not get involved extensively in non-surgical treatment which can be directed through your General Practitioner.

Surgery is recommended only for selected patients with persistent or recurrent pain causing significant interference with quality of life and after a period of non-operative (physical therapy, pain management) treatment.

For selected patients with severe nerve pain, surgery may be necessary within days or weeks of the onset of symptoms for adequate pain relief.

Surgery is only recommended when the chances of a successful outcome (good or excellent result) are at least 70% to 80% and usually higher.

Surgery for treatment of nerve pain usually achieves 85% to 95% good or excellent results.