Our emergency departments are currently extremely busy, and you may face a long wait to be seen. More information is available on alternative services.
Hastings and Rother Musculoskeletal (MSK) Service
Pain coming from the spine makes up such a large proportion of our MSK caseload, especially lower back problems.
Due to the high prevalence of lower back pain, there is a large amount of information available, from family, friends and online – some can be helpful, some can be vague, and some can even be harmful due to misinformation.
Your GP, Advanced Practitioner or Physiotherapist might have given you a diagnosis already, and directed you here.
However, if you have any of the following problems that accompany your back or neck pain, you need to seek Emergency Care via NHS 111 or the Emergency Department:
When to seek urgent help for your back pain – Summary of these symptoms as an animated video:
When to seek urgent help for your back pain – Summary of these symptoms in written format:
Below you will find information and resources designed to help you make sense of your back or neck pain, dispel any unhelpful myths, outline your options, and help you on your road to recovery.
If you would like a more in depth understanding of the anatomy of the spine, visit – AnatomyZone – Your Guide to Human Anatomy and search ‘spine’.
Head and Neck pain (cervicogenic headache) is what’s called a ‘secondary headache’, in that the problem is not in the head itself, but in the neck. Due to pain referral patterns – this can manifest as a headache.
Cervicogenic headaches usually present as one sided, and are accompanied by shoulder and neck tension, and possibly reduced neck movement. If neck pain worsens or improves and the headache subsequently worsens or improves – then this is a sign of a cervicogenic headache.
X-Rays and MRI’s are not routinely used for this, but might become relevant in more severe or persistent cases, or to rule out ‘Primary Headaches’ (emanating from the head itself).
This is the kind of back pain virtually all of us will encounter at one point in our lives.
It might last a few minutes after a long car journey. Perhaps it lasts a few days from sleeping on a different mattress or lifting an object awkwardly. But if you are here, then it’s likely your back pain has been around for several weeks, months or even years, and is having an impact on your quality of life. Sometimes back pain is accompanied by leg pain, tingling or numbness.
Trying to concisely explain what generally causes a person to have lower back pain is virtually impossible, due to the individual factors causing and contributing to each situation. So it is usually best done on an individual basis with your healthcare provider. However, you might find some of the general information and resources below to be helpful.
An MRI can help inform yes, in certain circumstances. But a lot less often than most people think. In fact, early unwarranted MRI’s can be associated with worse outcomes.
The Chartered Society of Physiotherapy – Back pain myth busters
Visit our Persistent Pain page for other options of managing lower back pain.
This is another kind of back condition that has more of a specific cause. Symptoms from spinal stenosis can be felt in the back but often more so in the buttocks and legs (called claudication) due to pressure on the spinal nerves as they pass through the spinal canal.
This typically occurs in people over 50 years old due to age related changes in the spine, and is classically worse when standing and walking, and relieved quickly by bending forwards or sitting.
An MRI can be indicated when symptoms are severe enough to consider surgery. Stenosis usually fits a pattern, therefore can be diagnosed from a thorough history and physical examination. Check out the poster in the Mechanical Back (+/- leg pain) section for more information on spinal MRIs.
Patient Infomation – Spinal Stenosis – Symptoms and Treatment
Visit our Persistent Pain page for other options of managing lower back pain.
Neck pain is another common complaint. Sprains and strains can occur in the gym, the garden, at work or in car accidents (whiplash). The demands of modern life can often mean lots of prolonged positions – in cars, desks, on phones etc which can also lead to neck pain. Like lower back pain, most neck pain is mechanical – originating from the muscles, from the joints including ligaments and discs or from the nerves.
If neck pain is also creating arm or hand weakness/numbness (radiculopathy) and there has been no progression with Physiotherapy – an MRI might be indicated. Neck X-Rays would be considered if there has been a trauma involved.
Visit our Persistent Pain page for other options of managing lower back pain.
