Back & Neck Pain

Understanding Back & Neck Pain

Determining the Cause of Back & Neck Pain

Your spine has five sections of vertebrae: the neck or cervical spine, the mid-back or thoracic spine, the lower back or lumbar spine, the base of the spine or sacrum, and the tailbone or coccyx. Pain generated from each area can have different causes. Some of the conditions that cause pain in these areas include:

• Muscle / ligament strain
• Disc herniation (slipped disk or ruptured disk) & degenerative disc disease
• Sciatica
• Spinal stenosis
• Scoliosis
• Ankylosing spondylitis
• Brain tumors
• Spinal tumors
• Torticollis
• Whiplash

To treat your back and/or neck pain, your physician must first determine the cause. Your physician may use a combination of:

• Medical history
• Physical exams
• Diagnostic tests, including imaging

Once your physician determines the origin of your pain, he or she can work with you to develop the best treatment plan to address your specific condition and pain.

Treatment

When you suffer from back or neck pain, you want relief right away. IU Health physicians use a specialized process to quickly determine the cause of your pain and treat it — often on the same day.

IU Health physicians’ collaborative approach means we have the resources, tools, devices and specialists to treat many back or spine conditions, no matter how simple or complex.

Physicians use a wide array of diagnostic technologies and imaging tests to quickly determine the source of your back or neck pain and treat it promptly.

Our affiliation with the Indiana University School of Medicine Department of Neurology gives you access to the latest research and newest treatments. This expertise and experience restores your original level of function or get you as close as possible.

IU Health neurosurgeons are leaders in surgical procedures used to restore joint function and preserve motion. IU Health neurosurgeons are pioneers in the use of intraoperative MRI scanner for brain and spine surgery, as well as the use of an innovative mesh bone implant to improve outcomes for minimally invasive spine surgery.

Navigating the healthcare system can be overwhelming. Our patient advocates work with you and your family to coordinate your care, to manage financial and health insurance requirements and to follow up with you after appointments. This makes your experience efficient and straightforward, so you can focus on your health and recovery.

We use a step-by-step, treatment ladder approach to reduce and remove your back and/or neck pain and solve the problems causing your discomfort. Medicines are often the starting point, followed by physical therapy and sometimes surgery, depending on your condition.

Imaging Tests

Your physician or neurosurgeon will use a variety of tests to look at your brain, spine and neck to diagnose the source of your back and/or neck pain. Common imaging tests include:

• X-ray
• Magnetic resonance imaging (MRI)
• Computed tomography (CT) scan

Diagnostic Evaluations

Your physician may decide to conduct more advanced tests to better understand your condition. These can include an electromyogram (EMG) to study nerve and muscle function, a myelogram to study your spinal cord and an arthroscopy to investigate internal joint functions.

Medicines

Your physician may prescribe a variety of medicines to reduce pain and inflammation of your spinal cord. These can be taken orally, intravenously or by one of several pain management techniques.

Neurorehabilitation

We use a team approach at our Neurorehabilitation & Robotics lab, where we tailor physical and occupational therapy to restore you to pain-free movements and strengthen your muscles.

Pain management

If regular medicines and physical therapy do not remove your pain, your physician may prescribe more advanced pain management techniques. These include:

• Nerve block: An injection in your spine that blocks the function of specific nerves that are causing your pain, much like an epidural used for women in labor.
• EMG-guided botulinum injections: The botulinum toxin blocks neurotransmitter messages between your nerves and muscles. This reduces and eliminates muscle spasms. We are studying the use of botulinum toxins to prevent back and neck pain.
• Spinal cord stimulator: A wire electrode is implanted along your spine. Electrical energy is sent into your spinal cord from a stimulation unit. This short-circuits the pain signal that goes from your spinal cord to your brain. It is often used to treat sciatica.
• Pain pump: In cases of hard-to-control pain, your neurosurgeon may implant a pump that delivers pain medicine, such as morphine and anesthetics, to the space around your spinal cord. Pain pumps are used to treat conditions such as chronic pain from scar tissue, axial somatic pain and muscle spasticity from multiple sclerosis.

Surgery

If your physician recommends surgery to treat your back or neck pain, our neurosurgeons are experts and innovators in the latest minimally invasive procedures.

We perform image-guided surgery to generate the safest outcomes with the fewest complications. Our back and neck pain surgical procedures include:

• Intraoperative MRI: We are the first health system in Indiana to offer this procedure. The intraoperative MRI provides your neurosurgeon with images of your brain or spine during surgery.
• Percutaneous pedicle screw placement: We use computer-guided images and minimally invasive surgery to place screws in the spine to add strength and stability.
• Laminectomy: This surgical procedure is used to relieve pressure on your spinal cord caused by a variety of issues, including a herniated disc or tumor.
• Artificial discs: To preserve your range of motion, we are innovating the use of artificial disks to treat arm and neck pain. These discs cushion the space between the vertebrae in your spine and prevent fusion of the bones. This keeps you active longer and can prevent a second surgery. We are researching the effectiveness of these artificial discs.
• Mesh bone implants: We are also researching the use of mesh bone implants between spinal disk spaces to enhance fusion and make minimally invasive spine surgery safer.