Back Pain and Neck Pain

Low Back Pain and Neck Pain:

It is estimated that 80% of Americans will suffer from neck pain or back pain at some point in their lives, right now there are over 50 million Americans suffering from back or neck pain.  When pain becomes chronic or severe it is often caused by one or more of the following conditions: disk herniation, disk bulge, facet syndrome/arthrosis, stenosis, sciatica and degenerative disk disease

Disk Herniation:

As the disks of the lower back and neck degenerate from age or injury, the soft center portion(nucleus pulposus) can rupture through the surrounding outer ring (annulus fibrosus). This rupture is known as a herniated disk. A herniated disk can be very painful on its own, but can also press on the spinal nerves or spinal cord causing increased back and neck pain, or radiating pain into the legs or arms depending if the herniation is in the low back or the neck. This pain may be felt in the extremities on one or both sides, depending on the direction of the herniation. An MRI or CT scan can be used to diagnose a herniated disk.

Disk Bulge:

As the disks of the lower back or neck degenerate from age or injury, the outer ring of the disk (annulus) may be pushed out of its ideal shape by the soft center portion (nucleus). This loss of ideal shape or ‘bulge’ sometimes is large enough to cause pain from the disk itself, as well as put pressure on surrounding spinal nerves or the spinal cord. This may cause symptoms including: radiating pain into the arms or legs, numbness, tingling and muscle spasms. An MRI or CT scan can be used to diagnose a disk bulge. A ‘pinched nerve’ is caused when a nerve is compressed and is unable to conduct its signal properly. It can be caused by a disc herniation or bulge, stenosis, arthritis/degenerative disc disease or bone spurs. A pinched nerve in the low back can cause sciatica and symptoms into the lower extremities such as numbness, tingling, and pain. If in the neck, symptoms may radiate down the arms. An MRI, X-ray, CT scan or electromyogram can be used to diagnose a pinched nerve.

Degenerative Disk Disease:

Also known as Spondylosis, Degenerative Disk Disease refers to the narrowing of the normal “Disk Space,” between each Vertebra. The disks are fluid filled joints which allow your spine to move properly. Due to wear and tear, age or injury, these disks can lose hydration and decrease in height over time. This can eventually lead to pain and compression on the nerves that exit between the Vertebrae. An MRI, X-ray or CT scan can be used to diagnose Degenerative Disk Disease.


Sciatica is pain in the lower extremity which is caused by an irritation of the sciatic nerve. This pain is typically felt in the low back, and radiating down the posterior leg past the level of the knee. The sciatic nerve actually originates from multiple nerve roots in the lower portion of the spine, sciatica is often caused when a disk bulge or herniation begins to apply pressure to one of these nerve roots. This may cause pain not only in the back, but down the length of the sciatic nerve into the leg or legs. The symptoms you may also feel include: sharp pain, tingling of the lower extremities, numbness of the lower extremities and even weakness. An MRI, X-ray, CT scan or Electro-myogram can be used to determine the exact cause of sciatica.

Facet Syndrome:

The facets are the primary bony articulations in the spine.  Facet Syndrome may arise when the capsule surrounding the facet becomes entrapped or pinched.  Other predisposing factors for facet pain is degeneration, which is seen more often in middle-aged and older adults.  The facets are evaluated with x-ray, CT scan or MRI.


The term 'stenosis' literally means a narrowing.  In the spine, stenosis can apply to either the central canal or the lateral canals where the nerve roots exit the spinal column.  Soft tissue and bony factors can both contribute to stenosis, with disk bulges/herniations, ligamentous hypertrophy, facet hypertrophy, congenital abnormalities in shape and slippage of normal alignment all potential causes.  Symptoms may include pain in the back and  with standing walking which is relieved with rest and forward flexion.