Arm pain is often related to neck pathology. Nerve compression by a displaced intervertebral disc fragment can result in arm pain. This pain demonstrates a very specific distribution according to the spinal level affected. There are other causes of arm pain that can mimic neck pathology such as shoulder pathology or other nerve entrapments. A thorough physical examination and imaging studies will locate the problem and an appropriate treatment plan can then be decided upon.
In the majority of instances neck pain is benign and, as such, it can be treated conservatively. Most neck pain is caused by muscle or ligament sprains which recover in time. Neurological symptoms such as arm pain, loss of arm strength, altered sensation or balance deterioration are considered as more serious. Neck pain which does not resolve itself within 6 weeks, or which is very severe, warrants investigation.
Lower back pain is a very common condition experienced by most of us at some stage in our lives. Most causes of lower back pain are self-limiting with the pain resolving without any treatment in about 85% of cases. Such pain is likely due to a muscle strain or early degenerative changes in the spine. However, danger signs include pain which does not resolve or respond to pain medication, a history of significant trauma, night pain associated with weight loss and systemic symptoms such as suffering from a fever or generally feeling unwell. Associated leg pain can also be a sign of nerve impingement and thus warrants further investigation.
Leg pain is commonly associated with lower back pathology. A variety of causes can result in nerve root entrapment in the lower back, which causes leg pain in the absence of pathology in the leg itself. Most commonly the pain manifests in a single leg and in a specific part of the leg alone. If there is narrowing of the spinal canal patients can sometimes develop generalized leg pain in both legs with associated weakness. Clinical examination and relevant imaging studies will highlight the specific pathology.
Pain in the upper part of the back is less common with most cases ascribed to muscle strains, poor posture, and in some cases, a deformity of the spine. If pain does not resolve within a reasonable period of time, or if it is associated with systemic illness, further investigation is required. A history of trauma and cancer, particularly in older persons, could also be a cause for concern. The vast majority of upper back pain cases is treated conservatively and tends to resolve completely without invasive treatment.