Back and Neck Pain are Not Always Spine Issues

Dr. Derman // photo courtesy Texas Back Institute

Dr. Peter Derman Discusses Common Back Issues

Back and neck pain do not always indicate spine issues. According to Dr. Peter Derman, orthopedic spine surgeon at Texas Back Institute, there are a number of instances in which back and neck pain can actually be caused by problems elsewhere. It is therefore important to seek out a spine specialist who performs a thorough physical exam to identify when perceived back or neck issues may be emanating from elsewhere.

Patients with neck and shoulder pain, for instance, may be suffering from a rotator cuff injury. Similarly, people with carpal or cubital tunnel syndrome may attribute their symptoms to a neck issue. “I often have patients who come to see me because they think they have a pinched nerve in their neck causing pain, tingling or numbness in their hand,” Dr. Derman said. “Occasionally, peripheral nerve compression – such as carpal or cubital tunnel syndrome – is the true culprit.”

Similarly, there is significant overlap between the symptoms of hip and lower back problems. Pain and tenderness over the outside of the hip can be confused for sciatica but is often due to a condition known as greater trochanteric bursitis, which is caused by inflammation overlying the hip itself. Hip arthritis may also present with symptoms similar to sciatica.

The act of solving these puzzles and generating individualized treatment plans to get people back to the activities they enjoy is incredibly rewarding.”

When the diagnosis is unclear, or if patients have problems stemming from multiple sites, spine specialists work closely with colleagues who specialize in hip or upper extremity problems to formulate a customized treatment plan.

Beyond the shoulders and hips, there are additional non-spinal causes of back and neck issues. The sacroiliac joint (also known as the SI joint) is the junction between the spine and the pelvis. Issues with this joint can produce lower back pain with unique characteristics and specific treatment options.

People with poor posture and those who sit all day at work often experience myofascial pain, a general term for a number of soft tissue problems. “Their back or neck pain may originate from muscle fatigue and tension rather than from a structural spine issue,” Dr. Derman explained. “Such patients often benefit from physical therapy, anti-inflammatories, muscle relaxers and/or deep tissue massage.” Similar treatment is beneficial for strains in the back and neck muscles that may occur with bending, twisting or lifting while exercising or during routine activities.

Even pain coming from internal organs can be experienced as back pain. For instance, urinary tract infections and large uterine fibroids can manifest as lower back pain.

“The human body is incredibly complex, with interconnectedness between the spine, nerves, musculoskeletal system and other bodily functions,” Dr. Derman said. “Each patient and problem is unique. The act of solving these puzzles and generating individualized treatment plans to get people back to the activities they enjoy is incredibly rewarding.”

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Texas Back Institute 
6020 W Parker Rd #200
Plano, TX 75093


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