Back and Neck Pain

Diagnosing the cause of any pain will depend on assessment of where it occurs and the type of pain. Pain in both the back and neck may point towards some diseases or problems rather than others.  

Though we make a clear distinction between the back and the neck, they are both part of the spine and are not that different. The spine consists of thirty-three vertebrae, in several sections. The vertebrae in each section are anatomically a little different and adapted for slightly different functions.  

The neck, or cervical spine, consists of five vertebrae. In descending order, the other areas of the vertebral column are the thoracic spine, lumbar spine and the sacrum. The areas of the spine where problems most often arise are the neck and the lumbar spine, the area towards the base of the vertebral column, corresponding to the small of the back and beneath. The reason for this is simple: these are the areas of the spine that are most mobile and are therefore also more prone to injury and certain diseases. Lower back pain is by far the most common, whereas pain distributed throughout the spine is rarer. 

If you suffer from pain in both the back and neck, then it is possible that the problem lies in one of the conditions that can affect any area of the vertebral column. Osteoporosis is a condition associated with advancing age in which the bones of the spine become brittle and crumble. This can lead to trapped or compressed nerves that cause pain. In theory, this can affect any area of the spine although problems are still more likely to arise in the more mobile neck and lumbar regions. Slipped (or herniated) discs are also an age-related problem and can occur throughout the spine, though they are more common in the lumbar area than elsewhere. 

Arthritic conditions and some related immune system diseases (spondylosis and ankylosing spondylitis) also primarily cause problems in areas that are involved in movement. However, the physical effects of these diseases, which include both bone degeneration and bony growths, can affect any part of the spine. The middle spine (thoracic vertebrae) is less involved in movement but has joints with the ribs that can also be affected by arthritis and other conditions. Osteomyelitis and other diseases of bone, such as some cancers, can also potentially occur in any section of the spine.  

Widely distributed pain can also result from fibromyalgia and myofascial pain syndromes, in which muscle irritation and ‘tender spots’ occur. Though in these conditions pain, and sometimes inflammation, occurs throughout the body and not just along the spine, this is a possible cause of pain in both the neck and the back. 

Back and neck pain need not be the sign of something serious or sinister. Bad posture or sleeping in particular positions can cause discomfort that is not localised to one place. Similarly, injuries or muscle strains in one area of the back can lead to over-compensation and stress or damage in adjacent areas.