Back and Spine Pain

It may be sharp or stabbing. It can be dull, achy, or feel like a "charley horse" type cramp. The type of pain you have will depend on the underlying cause of your back pain.

People with low back pain often find their pain worsening when:

• Bending and lifting
• Sitting
• Standing and walking

They may also experience:

• Back pain that comes and goes, and often follows an up-and-down course, with good days and bad days.
• Pain that extends from the back into the buttock or outer hip area, but not down the leg.
• Sciatica. This includes buttock and leg pain, and even numbness, tingling, or weakness that extends down to the foot. Although sciatica is commonly associated with a herniated disk, it is possible to have sciatica without back pain.

Regardless of your age or symptoms, if your back pain does not get better within a few weeks or is associated with fever, chills, or unexpected weight loss, you should call your doctor. Other red flag symptoms include weakness in your legs and loss of bladder and bowel control.

Your spine, or backbone, protects your spinal cord and allows you to stand and bend. Spinal stenosis (or narrowing) is a common condition that occurs when the small spinal canal, which contains the nerve roots and spinal cord, becomes compressed. This narrowing can cause a “pinching” sensation of the spinal cord and/or nerve roots, leading to pain, discomfort, cramping, weakness or numbness, and at its worst, can affect how your bladder and bowel work.

Spinal stenosis or lumbar spinal stenosis doesn’t happen at once, but over time. 

What Causes Spinal Stenosis?

There are many causes of spinal stenosis, including aging, herniated discs, trauma, Paget’s disease, osteoarthritis, scoliosis, thickening ligaments and more.

Spinal Stenosis Symptoms

In the neck:

• Numbness, pain, or tingling in a hand, arm, foot or leg
• Weakness in a hand, arm, foot or leg
• Problems with walking and balance
• Neck pain
• In severe cases, bowel or bladder dysfunction (urinary retention and incontinence)

In the lower back:

• Numbness, pain, or tingling in a foot or leg
• Weakness in a foot or leg
• Pain or cramping in one or both legs when you stand for long periods of time or when you walk, which usually eases when you bend forward or sit
• Back pain

Degenerative disc disease refers to the symptoms of back or neck pain caused by wear and tear on a spinal disc. It is one of the most common causes of low back and neck pain, and in some cases, can cause weakness, numbness, and hot, shooting pains in the arms or legs. Despite the use of the term “disease,” degenerative disc disease is not a disease, but a condition caused by natural, age-related wear and tear on a spinal disc.

Symptoms of Degenerative Disc Disease

The most common symptom of degenerative disc disease is a low-grade, continuous pain around the degenerating disc that can occasionally flare up into more severe and potentially disabling pain. These flare-ups can be the result of recent activity or abnormal stress on the spine, or can occur with no apparent cause. 

Other common symptoms include increased pain with activities that involve bending or twisting the spine or lifting something heavy, a “giving out” sensation, muscle tension or spasms, radiating pain in various parts of the body that feels sharp, stabbing, or hot, increased pain when holding certain positions such as sitting, standing, or looking down at something, reduced pain when changing positions frequently, and decreased pain with certain positions such as sitting in a reclining position or lying down with a pillow under the knees.

Treatment for Degenerative Disc Disease

If the pain from degenerative disc disease is severe and non-surgical treatments such as pain medication or physical therapy are ineffective, then surgery may be used to address it. A spinal fusion, where two adjacent vertebrae are grafted together, is the most common procedure used for degenerative disc disease, but artificial disc replacement has recently become another frequently used option.

Neurological back pain refers to pain originating from issues affecting the nerves within the spine. Unlike general back pain caused by muscle strain or injury, neurological back pain causes include nerve compression or damage. This type of pain may stem from conditions such as herniated discs, spinal stenosis or sciatica, which involve pressure on or irritation of the nerves in the spine. Symptoms of neurological back pain can include sharp, radiating pain, numbness, tingling and weakness, particularly in the lower back and legs. Neurological back pain requires targeted treatment to address its symptoms.

How is neurological back pain diagnosed?

Doctors begin with a patient's medical history, symptoms and results from a physical examination. Often, initial treatments are conservative, focusing on noninvasive methods. However, if these are ineffective, the healthcare provider may recommend further diagnostic tests to understand the cause of pain better and develop a treatment plan for managing back pain. Imaging studies like CT scans, MRIs and X-rays help doctors see the spine. Other specialized tests may also be used, such as discography, which evaluates intervertebral discs; a myelogram to examine the spinal canal; selective nerve root blocks to identify specific nerve pain sources; and electromyography or nerve conduction studies to assess nerve and muscle health.

Treatment Options for Neurological Back Pain

Neurological back pain treatment varies and is unique to each patient. Common approaches include medications like NSAIDs, opioids, anticonvulsants and antidepressants to manage pain. Non-pharmacological treatments, such as physical, cognitive, behavioral and complementary therapies like acupuncture, are also beneficial. In more severe cases, interventional procedures such as nerve blocks or surgical options may be considered. A multidisciplinary approach is crucial for effectively managing the physical and emotional aspects of neurological back pain.

If surgery is advised, neurosurgeons can choose from several approaches to alleviate nerve root pressure, depending on the specific condition. Options include minimally invasive techniques, open decompression or spinal fusion using bone grafts and stabilizing hardware to secure the vertebrae.

Surgery can help restore mobility and improve the quality of life for many patients, though weighing the potential benefits against the risks is essential. While many patients report significant pain relief after surgery, it does not guarantee complete elimination of pain. Postoperative physical therapy may also be needed to optimize recovery.

Managing neurological back pain often involves a commitment to ongoing care and lifestyle adjustments. Patients are encouraged to engage in regular low-impact exercise to help improve flexibility and reduce back strain without putting excessive pressure on the spine. Desert Care Network’s multidisciplinary approach combines therapies for those with chronic pain to offer a comprehensive solution.

Some common signs of spinal tumors may include:

• Pain (back and/or neck pain, arm and/or leg pain)
• Muscle weakness or numbness in the arms or legs
• Difficulty walking
• General loss of sensation
• Difficulty with urination
• Change in bowel habits
• Paralysis to varying degrees
• Spinal deformities
• Pain or difficulty with standing

Once tumors have presented obvious symptoms relating to the spine, it is because cancer has moved from another location in the body, such as a kidney or breast, to the spine. This tumor has now metastasized. While the word “metastasized” sounds intimidating, there are many options today for patients facing this diagnosis.

Types of Spinal Cancer

• Hemangioblastoma - A hemangioblastoma is a benign (non-cancerous) vascular tumor located along the spine.

• Hemangioma - Spinal hemangiomas are benign tumors often found in the mid-back (thoracic) and lower back (lumbar).

• Meningioma - A meningioma is a tumor that grows in the protective lining of the brain and spinal cord.

• Metastatic tumors - A metastatic tumor is a cancerous (malignant) growth that spreads from another part of the body.

• Neurofibroma - Neurofibromas are benign (non-cancerous) tumors of the peripheral nerves.

• Schwannoma - A schwannoma is a spinal tumor that arises from the lining of the nerve cells of the spine.

• Vascular malformation - A vascular malformation is an abnormal collection or tangle of blood vessels on, in, or near the spinal cord.

Spine Services

Spine care at Desert Care Network begins conservative treatment plans that may include core muscle strengthening to improve range of motion and body mechanics and other non-operative treatment modalities. If surgery is recommended, our team of spine and neurosurgeons will customize treatment options that maximize surgical outcomes and speed recovery. 

Our patient education program helps coordinate pre-operative and post-operative care, including tours of inpatient facilities, brace fitting, activity restrictions, physical therapy, and home health. The overriding goal of these programs is to customize treatment options for the individual patient and facilitate the transition of care from the clinic to the hospital setting, thereby returning patients to work and recreation as soon as possible.