When Should I Worry About...

5 Signs It's Time to See a Spine Specialist

March 27, 2024 - Katie McCallum

If you're struggling with chronic neck or back pain, your doctor may recommend seeing a spine specialist — a physician specially trained to diagnose and treat conditions that stem from an issue with the spine.

Your spine is a complicated structure: It must be strong enough to provide structure and support to your body but not so rigid you can't bend and move as needed. When something is wrong with the way the components of your spine fit or work together, pain or other neurological symptoms, like numbness and weakness, can result.

"A spine issue is often felt as either neck pain or back pain, depending on where the problem is occurring exactly," explains Dr. Einar Bogason, a neurosurgeon specializing in spine surgery at Houston Methodist. "The underlying cause is commonly some type of degenerative change in the spine, which becomes more prevalent with age."

The conditions treated by a spine specialist include spinal stenosis, herniated disc, spondylolisthesis, sciatica and more.

Signs to see a spine specialist

Not all neck or back pain is caused by one of the spine conditions listed above. Muscle sprains and strains due to overuse or injury can also lead to it. So can poor posture.

So how do you know when pain might be due to a degenerative issue that's best addressed by a spine specialist? Dr. Bogason cites the following five signs:

1. Neck or back pain that won't go away

If neck pain or back pain lingers for weeks or months, it's likely time to see a spine specialist for a thorough evaluation.

"We want to make sure we're not missing a problem related to the spine," explains Dr. Bogason. "A spine specialist is looking for very specific issues that your primary care doctor or other types of specialists might not be as focused on, like signs of degenerative disc degeneration or nerve compression."

2. Unexplained weakness, numbness or tingling in the arms or legs

Some spine problems cause obvious pain, but not all.

"This is most true with the neck," says Dr. Bogason. "For instance, when spinal stenosis causes compression of the spinal cord, neck pain can be very subtle."

Instead, weakness, numbness or tingling in the hands might be the more noticeable symptom. If this can't be explained by common causes — like carpal tunnel syndrome, tennis elbow, golfer's elbow or neuropathy — consider being evaluated by a spine specialist.

"It's important to identify the cause," adds Dr. Bogason. "If it's spinal stenosis and we don't intervene, the issue will progress and can eventually also affect the legs."

3. Neck pain is accompanied by arm pain

"When symptoms start to evolve and pain is no longer limited to your neck — that is, when it travels down into the arms, hands and fingers — that indicates to us that it's more likely to be a problem with the spine," says Dr. Bogason.

For instance, neck pain might be caused by a herniated disc that's putting pressure on nerves in the spine.

4. Back pain is accompanied by leg pain

Similar to how neck pain that travels to the arm can be a warning sign, back pain that extends into lower extremities can also signal a problem originating in the spine.

Dr. Bogason adds that when symptoms have progressed to this stage, more advanced treatments — options beyond physical therapy and over-the-counter pain relievers — are often needed. A spine specialist can help determine the best way to manage the condition.

5. Conservative treatment of a spine condition has failed

If you know pain is caused by a spine condition but the issue hasn't improved with conservative treatment, it's time to see a spine specialist.

"We always start with the least risky options — physical therapy, over-the-counter pain relievers — but if these aren't working, there are several other treatments we can try," explains Dr. Bogason. "These range from prescription medications and injections targeting nerve pain to surgery in some cases."

Medications help alleviate pain until the problem improves with physical therapy over time, but the goal of spine surgery is to correct the problem within the spine. For instance, if a nerve compression is caused by a herniated disk or bone spur, surgery can relieve the pressure that's generating the pain.

"If extensive correction is needed, to the point where we remove parts of the spine required for structural stability, spinal fusion is then needed," explains Dr. Bogason. "This involves using screws and rods to help support those areas of the spine."

A spine specialist can help you understand all of your treatment options, as well as which is best for you based on your specific condition and lifestyle.

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Categories: When Should I Worry About...