Spine and Neck Conditions

Most neck and back pain settles: Within weeks, usually without a scan or an operation.
Two kinds of specialist here: A neurosurgeon and an orthopaedic spine surgeon, so you need not choose before booking.
A few signs need seeing today: They are rare, but easy to dismiss as a bad back.

Start with where you feel it

Most spine and neck conditions are easiest to tell apart by what you notice. Find the line closest to yours, and start with that page.

What you notice	Start with
Pain that stays in the neck	Neck pain
Pain, numbness or tingling down one arm	Cervical radiculopathy, also called sciatica of the neck
Dropping things, fumbling buttons, unsteady walking	Cervical myelopathy
Neck pain after a sudden jolt, such as a car accident	Whiplash injury
Pain shooting down one leg	Slipped disc
Leg pain on walking that eases on sitting	Spinal stenosis
Back pain worse leaning backwards, easier leaning forwards	Facet joint syndrome
One-sided pain low in the back and buttock	Sacroiliac joint dysfunction
Pain at the base of the spine, worse on sitting	Tailbone pain
Back pain better with movement, worse after rest	Ankylosing spondylitis
Sudden back pain with osteoporosis	Spinal compression fracture
A sideways or forward curve of the spine	Scoliosis or kyphosis
Not sure	Back pain, or answer three questions

Some signs need seeing today: numbness around the groin, buttocks or inner thighs, difficulty passing urine, or loss of bladder or bowel control; weakness in both legs, or weakness in one leg worsening by the hour. They are rare, but easy to dismiss as part of a bad back. See back pain for the full list.

Neck

Neck pain — most is muscular and settles; what matters is whether it stays in the neck
Cervical radiculopathy — a pinched nerve sending pain, numbness or weakness down one arm
Sciatica of the neck — the same pinched neck nerve, and how to tell it from a shoulder or wrist problem
Cervical myelopathy — pressure on the spinal cord in the neck, often with clumsy hands and no neck pain
Myelopathy — pressure on the spinal cord itself, and why where it happens changes the symptoms
Cervical spondylosis — age-related wear in the neck that most people never feel
Whiplash injury — neck strain from a sudden jolt, often a car accident

Lower back and pelvis

Back pain — most settles; the few signs that need urgent attention, and the common causes
Lower back pain — the most loaded part of the spine, and which nerve level explains leg symptoms
Slipped disc — a disc pressing on a nerve and sending pain down a leg or arm
Annular tear — a crack in the outer ring of a disc, and why it heals slowly
Spinal stenosis — narrowing around the nerves, causing leg pain on walking
Spondylolisthesis — a vertebra slipping forward on the one below
Facet joint syndrome — wear in the small joints at the back of the spine, worse leaning backwards
Sacroiliac joint dysfunction — one-sided pain low in the back and buttock
Tailbone pain — pain at the base of the spine, often worse on sitting

Spine shape and bone

Scoliosis — a sideways curve of the spine, in teenagers and adults
Kyphosis — a forward curve of the upper back, and the three types
Ankylosing spondylitis — inflammatory back pain, better with movement and worse after rest
Spinal compression fracture — a collapsed vertebra, usually from osteoporosis

Treatments for spine and neck conditions

Most spine and neck conditions settle without an operation, with time, exercise and sometimes an injection. For the few that need more, these are the main procedures:

Decompression surgery — relieving pressure on trapped nerves
ACDF surgery — removing a worn or herniated disc through the front of the neck and joining the two vertebrae
Neuromodulation — changing how nerves send pain signals, rather than destroying them

Who you will see

Spine and neck conditions here are seen by two specialists, and you do not have to choose between them before booking.

Dr Mathew Tung, a neurosurgeon treating brain, spine and nerve conditions, practising since 1984 and specialising in neurosurgery since 1991.
Dr Lim Heng Hing, a Senior Consultant Orthopaedic and Spine Surgeon, with a spinal focus since 1996.

See spine surgery at this clinic for how the two work together.

Common questions

Should I see a neurosurgeon or a spine surgeon?

You do not have to decide before booking. Both work from this clinic, treat many of the same neck and back conditions, and work together when that helps.

Do I need a scan for back or neck pain?

Usually not at first. Most back and neck pain settles within weeks without one, and scans often show wear that is not causing the pain. A scan is arranged when the symptoms or examination call for it.

Will I need surgery?

Most people do not. The large majority of spine conditions settle with time, exercise and sometimes an injection. Surgery is kept for the few that do not, or where a nerve or the spinal cord is under threat.

Can a neck problem cause symptoms in the arm or hand?

Yes. A pinched nerve in the neck can send pain, numbness or tingling down one arm — see cervical radiculopathy — and pressure on the spinal cord can make the hands clumsy, as in cervical myelopathy.

Can a back problem cause leg pain?

Yes. A slipped disc can press on a nerve and send pain down a leg, and spinal stenosis causes leg pain on walking that eases on sitting.

Do I need a referral to see a specialist for spine and neck conditions?

No. Bring any X-ray, MRI or CT reports, and be ready to say where you feel it and what makes it worse.

All conditions · Neurosurgery · Spine surgery · Sciatica · Neuropathic pain