Pain that affects your back or neck is caused by some form of trauma to your spine. This column, made up of 33 bones and tissue, extends from your skull to your pelvis, and when healthy, your spine allows you to stand, bend and move in countless ways. But when you're in pain, your ability to do these things can be nearly impossible.

Whether the pain you’re experiencing is tolerable or not, it’s important to remain aware of how much it’s impacting your lifestyle. Some lower back pain can be managed easily while severe lower back pain could require surgery. The same could be said for varying levels of pain in your neck. Giving up activities like playing with your grandchildren or even taking long road trips doesn’t have to be permanent. By reading through this guide, we hope you’re able to better understand where your pain is coming from and what treatments are available. Regardless of whether you’re just starting to investigate your pain, or if you have already been diagnosed and are considering surgery, the following information can give you greater confidence in making the choice to seek help. As always, the OrthoNebraska team is available to answer any questions and help put you on a direct path to healing.

Have an injury that needs attention now? Our orthopedic urgent care locations are open 7 days a week, or come to our emergency room at 144th and Center.

Common Causes of Neck/Back Pain and Possible Signs of Injury

Most often, pain in your neck or back is caused by a sprain or strain. Poor posture, falls, twisting or lifting incorrectly, and a number of other movements can lead to pain or injury. It’s possible to heal with over-the-counter pain relievers and self care, but if pain in either your neck or back persists, take it seriously and get help. When pain is left untreated for too long, additional injuries can occur.

Common Back Pain Categories:

  • Strain: A muscle has been stretched too far and tears.
  • Sprain: Ligaments are damaged through movement.
  • Herniated Disk: The cushion between your vertebrae
    ruptures and irritates your nerves.
  • Spinal Stenosis: The space within your spine narrows and
    puts pressure on your nerves.

Common Neck Pain Categories:

  • Osteoarthritis: The protective cartilage in a joint breaks down and no longer allows smooth movement between bones.
  • Strains: Too many hours sitting hunched over can trigger muscle strains
  • Nerve Compression: Herniated disks or bone spurs in the vertebrae in your neck can put pressure on your nerves.
  • Injuries: Any activity that can cause whiplash, or a sudden jerk of your head backward and forward, can strain the soft tissues in your neck.
  • Diseases: Some diseases such as rheumatoid arthritis, meningitis or cancer can lead to neck pain.

Signs of Injury

Signs of a Neck Injury:

  • Pain Worsens by Holding Your Head in One Place for Long Periods (driving, sitting at your desk, etc.)
  • Muscle Tightness and Spasms
  • Decreased Ability to Move Your Head
  • Headache

Signs of Back Injury:

  • Constant Aching Pain
  • Muscle Spasms
  • Weakness
  • Limited Range of Motion
  • Headaches
  • Numbness In Your Legs or Feet
  • Shooting Pain Down Your Leg
  • Increased Pain Due To Lack of Movement
  • Possibly Even Bowel and/or Bladder Changes
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Tips for Managing Your Symptoms

If you feel your pain is manageable, there are steps you can take to help you get rid of back pain or neck pain. While some of these suggestions seem easy enough, it’s important to be careful and intentional in your self-care. If you don’t give your body enough time, your pain or injury could become much worse and require specialized care.

Pain associated with any area of your spine can potentially be managed by one or a combination of the following:

  • Avoid activities that trigger your pain but consider looking into back pain exercises or neck pain stretches.
  • Take over-the-counter medication as needed. However, if you feel you’re using the medication to simply mask the pain rather than reduce inflammation, you run the risk of further damaging your neck or back. Talk with a doctor to determine whether or not rest and over-the-counter medications are all you need to heal.
  • Use a heat pad/cold pack (or a combination of the two).
  • Consider massage therapy as a way to reduce muscle stiffness and increase blood flow.
  • Practice using good posture when standing and sitting.
  • Adjust your desk, chair or computer as needed to support better posture.
  • Take frequent breaks. Whether driving or standing in line, it’s important to avoid sitting or standing in the same position for long periods of time.
  • Avoid lifting or carrying heavy objects, especially bags with straps over your shoulder.
  • Adjust your sleeping position by placing a small pillow under your neck or elevate your thighs to help flatten your spinal muscles.

Consider a lifestyle change:

  • If you’ve been active, keep exercising but adjust as needed to reduce stress on your spine.
  • If weight could be causing or making your pain worse, evaluate your eating habits and level of activity in an effort to lose weight.
  • Stop smoking to help your body’s natural functions work at their fullest potential.
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Your Path to Healing Awaits!

Non-Surgical and Surgical Spine Treatment Options

Returning to a life without pain doesn’t always require surgery. Depending on the cause and severity of your pain, simply stopping a certain activity can alleviate back or neck pain. Non-operative care could include medication, physical therapy and interventional procedures.

The recommendation for surgery often has to do with pain levels, the amount of disability, the length of time you’ve been in pain and what treatments you’ve already tried. OrthoNebraska’s spine care team consists of spine surgeons, interventional spine specialists and extended care team members. We take a comprehensive approach, putting you at the center, to ensure everyone fully understands your pain, your lifestyle and your goals. This also helps you better understand your options and what to expect throughout your treatment and beyond. By working closely together we can identify the right path for your specific needs.

Non-surgical treatments could include any of those listed above as tips for self-care, as well as physical therapy to help you heal and improve strength. If more intensive options are needed, your treatment could include any of the following surgical solutions:

Non-Surgical Options for Back or Neck Pain Relief

Surgical Procedures for Back Pain

  • Decompression Surgery: This common back surgery, also called cervical or lumbar laminectomy, reduces pain in the legs caused by stenosis or compression in the spine.
  • Microdiscectomy: Treat pain caused by herniated discs, which occur when the soft center of the spinal discs between the bones in your back escapes and interacts with a nerve.
  • XLIF Spine Fusion: This minimally invasive surgery, also called Extreme Lateral Interbody Fusion, reduces back or leg pain.

Surgical Procedures for Neck Pain

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Ways to Identify if Surgery is the Right Option

More often than not, neck and back pain can be relieved through rest and self-care. However, if your pain persists for more than a couple months or worsens over time, surgery could be your best option. Working with OrthoNebraska’s interdisciplinary team, you have the opportunity to consider all of your options, beginning with over-the-counter medications to physical therapy, and finally surgery if necessary. Having experts by your side at each phase allows us to fully understand the causes of your pain and your maximum recovery potential.

As with most things, identifying your goals is a priority. Are you most concerned with regaining mobility, lowering or eliminating pain, getting back to a certain activity, or something else? Sharing your goals with your surgeon allows them to plan accordingly, and to speak openly with you and the rest of your care team about expectations.

Through open dialogue you remain at the center of your care, and both you and your healthcare team have a clearer understanding of what’s possible.

Our World Class Spine Team

Katie Berky, MD, Pain Medicine

Katie C. Berky, MD

Interventional Spine & Pain Management Physician

George Greene, MD

George M. Greene, MD

Retired Physician

Matthew Hahn, MD

Matthew G. Hahn, MD

Physiatrist / Interventional Spine

Matthew Miller, MD, Spine Surgeon

Matthew L. Miller, MD


Dr. Noah Porter

Noah E. Porter, MD

Orthopedic Spine Surgeon

Apollo Stack, MD, Interventional Spine & Pain Management

Apollo A. Stack, MD

Interventional Spine & Pain Management Physician

Learn More

When speaking with your spine surgeon about your back or neck surgery, consider addressing the following topics:

  1. Describe your goals, beginning with your primary goal and including any other wants you might have.
  2. Ask your surgeon if they feel these goals are realistic and discuss what is possible to help you and your care team manage expectations.
  3. Ask for details regarding the type of surgery your surgeon is recommending and why.
  4. Ask what problems this surgery will solve and what challenges you might continue to live with.
  5. Ask how long the surgery might take, and what the recovery plan looks like.
  6. Get a clear understanding of the possible risks you take by undergoing the surgery.
  7. Find out who your operating surgeon will be and request more information regarding their experience and their results with this particular surgery.
  8. Ask for a general idea of how long you will be in the hospital.It’s also necessary to ask what “Plan B” is if you would elect to not have this particular neck or back surgery.
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What to expect during recovery from surgery.

Immediately After Surgery

As part of your expectations with surgery, you should be prepared to start walking again with 24 hours of your spine surgery. Your treatment plan will include working with a physical therapist each day you’re in the hospital. During these sessions you’ll learn how to sit up, roll over, get up, walk, stand and use a walker. These specialists will play a key role in determining when you’ll be able to go home.

You should also expect some swelling to occur. This is very common and typically diminishes within a day or two following your spine surgery. Most likely, you will be asked to use an intermittent pneumatic compression device or you will wear compression leggings (TED hose) to support healing and prevent blood clots.

At any time during your stay, our Spine Team will be available to answer questions and offer details about your path to recovery.

Healing At Home

Whether you are pursuing self-care for healing or are recovering from spine surgery, what you use to fuel your body is incredibly important. Look for foods rich in antioxidants and protein as they help your muscles mend quickly using natural processes. You can also avoid inflammation by selecting complex carbohydrates such as whole grains and other options that are high in fiber. Staying hydrated will also support your body’s natural functions. Additionally, staying active — in a safe manner — can make your healing process more effective. This includes gentle exercises, walking and even learning the best sleeping position for back pain.

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The Cost of Neck or Back Surgery

In thinking about your care at OrthoNebraska, here are a few things to keep in mind:

  • Insurance: We participate in most major insurance plans, however, we encourage you to use your insurance directory or hotline to ensure OrthoNebraska is considered “In Network” for your specific plan.
  • Office Visit and Hospital Billing: To receive care from the OrthoNebraska team, we do require each patient to agree to our financial policy. This document outlines  expectations and opportunities to make it easier to provide care. If you are considering surgery, a member of our team will reach out to you in order to provide additional information and answer any questions you may have regarding your stay. We also offer an accessible standard charges list to give you greater insight into the OrthoNebraska Hospital’s prices for standard medical services in compliance with federal healthcare regulations.

Your total out-of-pocket costs will depend on a number
of factors, including, but not limited to:

  • Your insurance plan
  • Ability to receive financial assistance
  • The services ultimately provided during the patient’s procedure or treatment.
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Frequently asked questions

Sprains and strains, herniated discs, and stenosis are the most common causes of lower back pain. Sprains are injuries to your ligaments, which help hold the bones of your spine together. Strains are injuries to muscles or tendons that connect other muscles to back bones. Herniated discs cause sudden lower back pain and sometimes even numbness. The pain and numb feeling can extend through your buttocks, down your leg, and — for some people — all the way into the foot. Spinal stenosis is caused by bulging discs, thickened ligaments, or small growths squeezing on the spinal canal that holds the spinal cord
Many factors, often stemming from your lifestyle, can lead to pain in your spine. Some worth considering include:
  • Age
  • Weight of a child’s backpack
  • Genetics
  • Pregnancy
  • Stress
  • Weakened abdominal muscles
  • Weakened back muscles
  • Weight gain
  • Work environment risks (duration of your commute, desk/chair height, sitting too long, etc.)
Often neck or back pain will go away on its own with rest and over-the-counter medications. However, if you experience any of the following, consider making an appointment or if it just can’t wait come to any of our Urgent Care locations or our Emergency Department.
  • A fever
  • Unexplained recent weight loss
  • Pain in your chest
  • Swelling or a deformity in your back
  • Loss of bladder or bowel control
  • An inability to pass urine
  • Constant pain that won’t ease
  • Worse pain at night
  • Numbness around your genitals, buttocks or back passage
  • Tingling or numbness in your legs or arms
The most common diagnostic tests for neck and pain pain include:
  • X-ray: Images show the alignment of your bones and whether you have arthritis, broken or displaced bones.
  • CT scan: Detailed and cross section images of the bones in your spine; can reveal herniated discs or problems with bones, muscles, tissue, tendons, nerves, ligaments and blood vessels.
  • MRI scan: Detailed images of vertebrae, intervertebral discs and nerve roots to accurately diagnose spinal disorders and to rule out spinal infections or tumors.
In most instances, chronic pain (lower back pain, upper back pain, neck pain) occurs because your physiological condition is ongoing and unresolved (arthritis is one example). However, often the pain doesn’t appear to be caused by any disease, injury or detectable damage to the nervous system.
Sciatica is pain along the sciatic nerve. It is usually a sharp, burning pain originating in the buttock that travels down the back of the thigh and can go down the lower leg to the foot. Herniated discs in your back or spinal stenosis are common causes of sciatica. Treatment options range from conservative measures to injections to surgical options in severe cases.
Your lumbar region begins just below the ribcage. If someone refers to lumbar back pain, they are also referring to lower back pain. This type of pain is the number one cause of missed work in the United States.
The thoracic spine runs from the base of the next to the abdomen. It is the longest part of your spine, and is often considered the most complex. This type of back pain is also called upper back pain.
Many adults sit for long periods of time at a desk or workstation. When we hold our heads a certain way for too long, strains can occur. Here are a few ways you can prevent neck pain:
  • When working on your computer, place your screen at eye level.
  • Stretch regularly, especially if you tend to sit at a desk or have a long commute.
  • Try to sleep on your back versus your stomach or side.
  • Invest in a firm pillow that supports your head and neck.
  • Consider participating in yoga or Pilates.
  • Remember to practice good posture and avoid hunching forward.
Right back pain could include sprains and strains, kidney stones, infections and conditions that affect the intestines or reproductive organs. If your right back pain lasts more than a few weeks after rest and self-care, please make an appointment with one of our specialists. Left back pain could be a symptom of something originating from the kidneys, pancreas, colon or uterus. Upper back pain could stem from your shoulder, which could include tissue damage.
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