Straight answers to the questions people ask about the spine

Most low back pain is called non-specific, meaning no single damaged structure or disease can be named as the cause. Strained muscles and ligaments are a common explanation, and rarer causes are checked for when warning signs appear.

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Most back pain improves within a few weeks, and many people feel better much sooner. Some episodes last longer or keep coming back, and pain beyond about 12 weeks is usually called chronic.

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Most people with low back pain do not need a scan. Guidelines advise against routine imaging, and scans are kept for cases with warning signs or where the result is likely to change the treatment plan.

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Back pain needs emergency care when it comes with numbness or weakness in both legs, numbness around the genitals or anus, new bladder or bowel changes, or follows a serious accident. These can signal cauda equina syndrome, a nerve emergency.

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Health bodies advise against long periods of bed rest for back pain and encourage people to stay as active as they comfortably can. A short period of taking it easy in the first days is mentioned by some sources.

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Most neck pain comes from everyday strain, posture, wear in the neck joints, a pinched nerve or an injury such as whiplash. Health bodies say it is usually not a sign of serious disease, although a few causes need prompt care.

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Neck pain is usually short-lived and not dangerous, but the NHS and Mayo Clinic name warning signs: severe pain after an injury, numbness, weakness, tingling, or pain that spreads or does not settle. These call for a clinician, and some call for emergency care.

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Whiplash is a neck injury caused by a sudden, forceful movement of the head, most often in a traffic accident. The NHS says it usually gets better within 2 to 3 months, though some people have symptoms for longer.

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Yes, in some people. A cervicogenic headache is head pain that comes from a disorder of the neck, but it is hard to diagnose, it overlaps with migraine and tension-type headache, and the evidence on treatment is mixed.

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A tension-type headache is the most common headache type, usually a mild to moderate pressing pain on both sides of the head. Its exact causes are not known, and stress, poor sleep and neck or head strain are listed as common triggers.

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A slipped disc, also called a herniated or prolapsed disc, is when part of the soft cushion between two spinal bones pushes outward. It causes symptoms only if it irritates a nearby nerve, and many people never know they have one.

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Sciatica is pain, tingling or numbness along the path of the sciatic nerve, usually in the buttock and the back of one leg. It describes a symptom with several possible causes, and it usually improves within weeks to months.

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Spinal stenosis is a narrowing of the spaces inside the spine that can press on the spinal cord or nerve roots. It develops slowly, becomes more common with age, and some people have no symptoms at all.

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A pinched nerve in the neck, called cervical radiculopathy, happens when a nerve root leaving the cervical spine is compressed and inflamed. It typically causes pain, tingling or weakness down one arm, and most cases improve without surgery.

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Many disc changes seen on spine scans, such as degeneration and bulges, are common in people with no pain, and they become more common with age. A scan finding needs to be read alongside your symptoms and examination.

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Public health bodies say spine surgery is usually considered only after other treatments have not helped enough, or when nerve symptoms such as worsening weakness appear. Most people with disc-related pain improve without an operation, so the decision is made case by case with a clinician.

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A discectomy is surgery to remove all or part of a spinal disc that is pressing on a nerve, most often a herniated disc. A microdiscectomy uses a smaller incision and a microscope, and minimally invasive versions work through narrow tubes.

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Spinal fusion is surgery that permanently joins two or more bones of the spine so they no longer move against each other. Public health sources say it works well for some problems, such as instability or curvature, and that results are mixed for back pain with an unclear cause.

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Spinal decompression surgery removes bone or tissue that is crowding the spinal cord or nerves, with the aim of relieving pressure. Laminectomy, laminotomy and foraminotomy are the best known types, and they differ in which part of the bone is opened.

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Spine surgery carries the risks of any operation, such as infection, bleeding and blood clots, plus some specific to the spine, including nerve injury and a leak of spinal fluid. The chance of each depends on the person and the procedure, so a surgeon is the right source for individual figures.

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Recovery depends on the operation. The NHS says a return to work after lumbar decompression may be possible around 4 to 6 weeks, while Mayo Clinic says bones can take several months to fuse after a spinal fusion.

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Guidelines from NICE, the NHS and the WHO all include exercise in care for low back pain. A Cochrane review found moderate-certainty evidence that exercise probably reduces long-lasting low back pain, though the gain in function was small.

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Physiotherapy for back pain usually begins with questions about your symptoms and a physical check, then may include exercises, advice and hands-on treatment. NICE says hands-on care should only be part of a package that includes exercise.

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Mayo Clinic and NIAMS suggest side sleeping with a pillow between the knees, or back sleeping with a pillow under the knees. Cleveland Clinic adds that no single position suits everyone, so people may need to experiment.

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Chronic low back pain is pain in the lower back that lasts or keeps returning beyond 3 months. The WHO, NICE and NIAMS all use a time threshold, and guidelines favor education, exercise and other non-surgical approaches, and advise against routine opioids.

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