Spinal pain in the lumbar region (lower back) and cervical region (neck) are highly prevalent and are often the causes for many lost work days. Lumbar muscle strains and sprains are the most common causes of low back pain. The thoracic spine can also be a site of spinal pain, but because it is much more rigid, the thoracic spinal area is much less frequently injured than the lumbar and cervical spine.
The lumbar and cervical spine are prone to strain because of its weight-bearing function and involvement in moving, twisting and bending. Lumbar muscle strain is caused when muscle fibers are abnormally stretched or torn. Lumbar sprain is caused when ligaments — the tough bands of tissue that hold bones together — are unusually stretched. Both of these can result from a sudden injury or from gradual overuse.
When the lumbar spine is strained or sprained, the soft tissues become inflamed. This inflammation causes pain and may cause muscle spasms. Even though lumbar strain or sprain can be very debilitating, neither usually requires neurosurgical attention.
Spinal pain can be caused by things more severe that might require surgical consideration. These usually involve spinal pain that radiates into arms, legs or around the rib cage from back toward the anterior chest.
A single excessive strain or injury may cause a herniated disc. However, disc material degenerates naturally as people age, and the ligaments that hold it in place begin to weaken. As this degeneration progresses, a relatively minor strain or twisting movement can cause a disc to rupture.
Certain individuals may be more vulnerable to disc problems and, as a result, may suffer herniated discs in several places along the spine. Research has shown that a predisposition for herniated discs may exist in families, with several members affected. This does not necessarily mean that disc disease is a hereditary condition but it can run in families.
Lumbar spine (lower back) — Sciatica frequently results from a herniated disc in the lower back. Pressure on one or several nerves that contribute to the sciatic nerve can cause pain, burning, tingling and numbness that radiates from the buttock into the leg and sometimes into the foot. Usually one side (left or right) is affected. This pain is often described as sharp and electric shock-like. It may be more severe with standing, walking or sitting. Along with leg pain, the patient may experience low back pain. Using the term radiculopathy may be more appropriate, rather than using the term sciatica, since all leg pain isn’t necessarily “sciatica.”
Cervical spine (neck) — Symptoms may include dull or sharp pain in the neck or between the shoulder blades that radiates down the arm to the hand or fingers, or numbness or tingling in the shoulder or arm. The pain may increase with certain positions or movements of the neck.
Thoracic spine — Symptoms of a thoracic disc herniation can be comprised of posterior chest pain radiating around one or both sides of the rib cage. Such pain is usually triggered by physical exertion and can even be caused by taking a deep breath. Bands of numbness around the chest wall can also be present. Herniated discs of the thoracic spine are relative rare compared to cervical and lumbar disc herniations.