Neck and Back Pain

It’s not uncommon for people 40 and over to wake up in the morning and have a new ache or pain. It happens more so to those 50 and older. Neck and back pain are two of the most common complaints in the primary care sector. What’s important to know is when to seek medical care. Most neck and back pain symptoms will resolve on their own in a matter of days to weeks. The culprit is usually musculoskeletal or strained muscles, for one reason or another. A muscle relaxer can be helpful with these symptoms, along with rest, heat or ice, and some exercises to stretch the muscles slowly and consistently. The keyword here is time. 

For those symptoms that happen as a result of an incident, like working out at the gym, lifting something heavy at home, twisting or torqueing the core improperly, or the result of trauma, the game changes. Some patients will report hearing a “pop” sound in their neck or back when an acute or sudden injury happens. Others will report pain not only in the back or neck, but will complain of pain radiating or shooting down their arm(s) or leg(s). Even these symptoms can resolve on their own in a matter of days to weeks. But, if they don’t, here’s where you need to start on your journey to access the proper care. 

The first thing to do is to go see your primary care provider, whether it’s a physician, nurse practitioner, or physician’s assistant. If you don’t have a PCP, and need care more urgently, go to your local ER or urgent care facility. When you do see a provider, make sure you are clear with your symptom complaints. Do you have neck pain or back pain? When did it start? What were you doing at the time? How long has it been going on? Are there any other symptoms associated with it, such as arm or leg pain? Are you experiencing any weakness in your arms or legs that is new? Is it consistent (all the time) or does the pain come and go? What have you done at home to try and make it better? Examples would be time, heat, ice, over the counter medications, prescription medications, steroids, pain injections, steroid injections, any exercises or physical therapy or occupational therapy (for hands or arms), inversion tables, acupuncture, dry needling, massage therapy, etc. All of these therapies are classified as “conservative care measures” or “conservative care treatment”. 

Why is it important to tell the provider what you’ve done on your own to try and help the symptoms get better? One word – INSURANCE. In a worst case scenario, where surgery may be your only treatment option to resolve the pain you are experiencing, insurance is not going to approve the surgery unless there are documented items of conservative care treatment that you have tried and failed. And if you can, stop smoking, because insurance will use that as an excuse not to approve certain types of neurosurgical procedures as well. 

In the course of treatment workup, your provider may order x-rays, cat scans, or MRIs. These are common diagnostics that neurosurgeons use to determine if there is a surgical issue that needs addressing. If surgery is not indicated, continued time and conservative care treatment is going to be the care plan. Pain management is sometimes useful for those individuals where surgery is not indicated. It’s not the end-all, but it’s an option to consider. If pain management is your treatment plan, make sure you “click” with the doctor that treats you, as mental clarification of the diagnosis and treatment plan is just as important as the physical plan in helping individuals move forward with life. 


Sherry Missildine, MSN, RN, ACNP-BC, RNFA

Telemedicine NP, LLC