Back and Neck Pain

Back and neck pain are among the most prevalent and disabling conditions worldwide. Low back pain (LBP) alone affects over 619 million people globally (2020), and neck pain affects hundreds of millions. Both conditions rank at or near the top of the Global Burden of Disease for musculoskeletal disorders. Risk factors are multifactorial: occupational factors (heavy lifting, poor ergonomics), obesity, smoking, and age are prominent for back pain, while psychosocial stressors (anxiety, depression, low social support) and musculoskeletal or systemic diseases contribute to neck pain. Diagnosis rests on clinical history and exam, with imaging reserved for red flags (e.g. neurologic deficits, suspected fracture, infection, or malignancy). Treatment is usually conservative: maintaining activity, analgesics (NSAIDs are first-line, opioids avoided), and structured exercise or physical therapy. Multiple meta-analyses have shown that exercise-based therapies (motor control, stretching, strengthening) improve pain and function in chronic neck and back pain. Adjunctive therapies (cognitive-behavioral therapy, acupuncture) also benefit selected patients. Epidural steroid injections can reduce radicular sciatica pain in the short term. Surgery is indicated for specific cases (e.g. refractory radiculopathy, myelopathy, cauda equina syndrome); early microdiscectomy yields faster relief of sciatica than continued conservative care, though long-term outcomes are similar. Prevention emphasizes core strengthening and ergonomics; combined exercise and education programs halve the risk of future low back pain episodes and similarly reduce incident neck pain. Prognosis is generally good for acute pain, but chronic and recurrent pain are common and are driven by degenerative changes and psychosocial factors. This report reviews the latest evidence from systematic reviews, meta-analyses, and clinical guidelines on the causes, pathophysiology, epidemiology, diagnosis, management (non-surgical and surgical), prevention, and outcomes of back and neck pain.