Back or neck pain diagnosis and treatment

Do you suffer from back or neck pain complaints?

Back or neck pain is a common complaint. Approximately 80% of people have back problems and 70% suffer from neck pain problems. Did you know that there is already a possibility of chronic back or neck pain if your back/neck problems are present for more than 12 weeks in recurring periods? At the David Reference Center, we treat patients who have had back or neck pain for an unnecessarily long time.

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About Low Back Pain Disorders

Non-specific low back pain is defined as low back pain for which no specific cause can be identified. This is the case in about 90% of all patients with low back pain. The most obvious symptom in these patients is a pain in the lumbosacral region. The pain may also radiate to the gluteal region and the upper leg. It may be increased when the patient adopts a particular position, makes certain movements or lifts or moves heavy objects. The patient has no general symptoms of the disease, such as fever or weight loss. The pain may be continuous or occur in episodes.

Specific low back pain is divided into:

  • the lumbosacral radicular syndrome, a form of specific low back pain characterized by radicular pain in one leg, which may or may not be associated with neurological deficits;
  • back pain resulting from a possibly serious underlying specific disorder, such as (osteoporotic) vertebral fractures, malignities, ankylosing spondylitis, severe forms of vertebral canal stenosis, or severe forms of spondylolisthesis.


Types of back complaints

Prognosis and Acute low back often improve spontaneously, although there is a risk of residual complaints or recurrence. Over 90% of people suffering an episode of low back pain do not turn to sick leave. Of those who do, 75% usually resume work within 4 weeks. There is a smaller group, however, whose complaints persist, which may lead to prolonged absence from work and a low probability of full recovery.

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Neck pain disorders

Neck pain constitutes the fourth largest category of complaints and symptoms relating to the musculoskeletal system. Most people (approximately 70%) suffer from some form of neck pain during their lives, although it will generally cause little or no interference with their daily activities.

Roughly 20% of the European population suffering from neck pain visits a doctor or physical therapist at any given point in time. In the general population, 50–85% of patients with neck pain report recurrent or persistent neck pain in the subsequent 5 years. Neck pain usually decreases by 45%, accompanied by a decrease in the limitations in activities and/or participation, within 6 weeks of pain onset. This reflects a normal course of recovery. However, if the pain and the limitations in activities and/or participation do not improve or become worse in the first 6 weeks, the course of recovery is considered deviant.

Neck pain may fluctuate in severity. Recurrent pain and limitations in activities and/or participation in the first 6 weeks after the first symptoms are considered the same episode of neck pain. The term ‘recurrent pain’ is used when pain recurs after 6 weeks, either once or on multiple occasions. In this case, there may be other functional or anatomical disorders that affect the extent to which activities and/or participation are limited.

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How to classify neck pain?

The severity of neck pain is classified into four grades or levels, Grades I to IV.

Grade I: Neck pain and associated disorders with no signs or symptoms suggestive of major structural pathology and no or minor interference with activities of daily living.
Grade II: Neck pain without signs or symptoms indicative of major structural pathology but may significantly affect daily activities.
Grade III: Neck pain without signs or symptoms indicative of major structural pathology but with neurological symptoms possibly caused by a cervical herniated disc or spinal stenosis, such as reduced tendon reflexes, muscle weakness, or sensory disorders (hypoesthesia or hyperesthesia) in the upper extremity.
Grade IV: Neck pain with signs or symptoms indicative of serious structural pathology. Major structural pathologies include (but are not limited to) fracture, vertebral dislocation, injury to the spinal cord, infection, neoplasm, or systemic disease including the inflammatory arthropathies.