When back or neck pain needs a closer look

Back and neck pain are among the most common reasons people seek medical care, but surgery is not the first step for most patients. 

According to Dr. JR Woodall, assistant professor of orthopaedic surgery at the University of Mississippi Medical Center, the majority of neck and back pain improves with conservative care such as physical therapy, anti-inflammatory medications and lifestyle changes. 

“Most patients with neck or back pain will improve with conservative treatment,” Woodall said. “A good physical therapy program that leads to consistent exercise and healthy movement habits is often the foundation of spine care.” 

When the source of pain can be clearly identified, targeted injections guided by imaging may also help reduce inflammation and relieve symptoms. These approaches allow many patients to return to daily activities without surgery. 

While many aches resolve on their own, some symptoms signal the need for evaluation by a spine specialist. 

“Anytime neck or back pain is accompanied by radiating arm or leg symptoms—including pain, weakness or numbness—that should be a red flag,” Woodall said. Pain that interferes with sleep or persists longer than six weeks is also a reason to seek care. 

These symptoms may indicate pressure on spinal nerves or the spinal cord, a condition known as spinal stenosis. If severe nerve compression goes untreated, it can lead to permanent nerve damage and loss of function. 

“Loss of strength, sensation or coordination in the arms or legs are warning signs that shouldn’t be ignored,” Woodall said. 

One of the most important—and nuanced—parts of spine care is determining when surgery is appropriate and when it is not. 

“This is the most important duty of being a spine surgeon,” Woodall said. “Surgery is appropriate when a patient’s clinical symptoms are perfectly explained by imaging findings and confirmed with diagnostic testing.” 

Even after diagnosis, nonsurgical options are explored first whenever possible. Surgery is typically considered only after conservative treatments fail to provide relief or when patients experience progressive neurologic decline. 

Woodall also emphasizes setting realistic expectations. “I’m very confident I can relieve arm or leg pain, weakness and numbness caused by a compressed nerve,” he said. “But it’s important for patients to understand that surgery can’t always guarantee complete relief of neck or back pain.” 

For patients who do need surgery, advances in minimally invasive spine techniques have transformed recovery and outcomes. 

“The most important advances have been technologies that allow us to access the spine safely through very small incisions,” Woodall said. “We can perform restorative procedures while minimizing disruption to surrounding muscles, tendons, ligaments and joints.” 

Improved real-time nerve monitoring during surgery further enhances safety and precision. As a result, many spine problems that once required large open surgeries, long hospital stays and up to a year of recovery can now be treated in less than an hour, often with same-day discharge. 

“Many patients make a full recovery in under three months,” Woodall said. 

Recovery varies depending on the procedure, but most patients are up and walking the day of surgery. Many follow a progressive walking program, working toward 30 minutes twice daily by six weeks after surgery. Some benefit from formal physical therapy, while others recover independently. 

Patients often notice immediate relief of arm or leg nerve pain, while neck or back pain improves more gradually over six to twelve weeks as inflammation resolves and tissues heal. 

For those living with chronic spine pain—or hoping to avoid it Woodall encourages early evaluation with a spine specialist and proactive care. 

“Even when we don’t have a definitive fix for neck or back pain, it’s worth understanding your options,” he said. 

Maintaining a healthy weight, staying active with good posture and body mechanics, strengthening core muscles and avoiding nicotine all play a role in long-term spine health. 

Preventive care and early diagnosis lead to better quality of life, Woodall said. “I’ve seen patients live with worsening symptoms for years before seeking care—and I’ve also seen how much better they do when problems are addressed earlier. 

To schedule an appointment with orthopaedics, call 601-984-6525 or go online here.

The above article appears in CONSULT, UMMC’s monthly e-newsletter sharing news about cutting-edge clinical and health science education advances and innovative biomedical research at the Medical Center and giving you tips and suggestions on how you and the people you love can live a healthier life. Click here and enter your email address to receive CONSULT free of charge. You may cancel at any time