Understanding Low Back and Neck Pain

Back or neck pain? Understanding lumbalgia and cervicalgia

Pain affecting the spine — in the lower back (lumbalgia) or the neck (cervicalgia) — is one of the main reasons people seek medical care. Although frustrating, these conditions have effective solutions that begin with an accurate diagnosis.

My focus goes beyond the symptom: identifying whether the cause is purely mechanical (muscles, joints) or whether there is nerve compression (e.g. a disc herniation) that needs specialized management.

1. Conservative care (first line)

Most acute episodes improve without surgery:

• Specialized physical therapy to strengthen the core and improve posture.
• Strategic medication to control pain in the acute phase.
• Ergonomic guidance to prevent recurrence.

2. Minimally invasive in-office procedures

• Guided injections (fluoroscopy or ultrasound) delivering anti-inflammatory medication to the source of pain.
• Epidural injections near a nerve root affected by a herniation or stenosis.
• Facet joint injections for arthritis of the small spinal joints.

3. Spine surgery (selected cases)

Reserved for severe nerve compression or instability that has failed conservative treatment — with the goals of nerve decompression and vertebral stabilization.

When is it an emergency?

• Sudden loss of strength in the arms or legs.
• Loss of bladder or bowel control.
• Severe back pain after trauma or a fall.