Cervical and lumbar spine

Cervical and lumbar spine pain are major causes of disability and distress. Careful assessment is needed of the nature and extent of the problem, for diagnosis and exclusion of important (treatable) differential diagnoses, and for the formulation and engagement of the patient in an appropriate treatment plan. Acute spinal pain frequently does not indicate underlying joint pathology. Chronic spinal pain is often associated with intervertebral disc disease or which is often classified together with facet joint osteoarthritis as spondylosis. Sciatica, brachalgia, or spinal claudication may each be a consequence of either spondylosis or intervertebral disc prolapse. Simple mechanical low back and neck pain may respond well to conservative management with analgesics and physiotherapy. Specific spinal problems, such as neuronal compromise, may require additional treatments. The roles of injections and surgery in the management of spinal pain continue to evolve. Although ongoing management is largely determined by the individual's clinical response, comprehensive health economic analyses inform healthcare policies which may limit treatment availability. Many people with spinal problems suffer long-term or recurrent pain and disability, with significant psychological and social impact. Multidisciplinary approaches are needed to facilitate pain management and enable people with spinal pain to lead fulfilling lives when the underlying condition cannot be cured.

Cervical and lumbar spine

Cervical and lumbar spine pain are major causes of disability and distress. Careful assessment is needed of the nature and extent of the problem, for diagnosis and exclusion of important (treatable) differential diagnoses, and for the formulation and engagement of the patient in an appropriate treatment plan. Acute spinal pain frequently does not indicate underlying joint pathology. Chronic spinal pain is often associated with intervertebral disc disease or which is often classified together with facet joint osteoarthritis as spondylosis. Sciatica, brachalgia, or spinal claudication may each be a consequence of either spondylosis or intervertebral disc prolapse. Simple mechanical low back and neck pain may respond well to conservative management with analgesics and physiotherapy. Specific spinal problems, such as neuronal compromise, may require additional treatments. The roles of injections and surgery in the management of spinal pain continue to evolve. Although ongoing management is largely determined by the individual’s clinical response, comprehensive health economic analyses inform healthcare policies which may limit treatment availability. Many people with spinal problems suffer long-term or recurrent pain and disability, with significant psychological and social impact. Multidisciplinary approaches are needed to facilitate pain management and enable people with spinal pain to lead fulfilling lives when the underlying condition cannot be cured.