Medically reviewed by Dr. David L. Greenwald, MD, FAANS, FACS — dual board-certified spine surgeon & neurosurgeon. Last reviewed October 2026.

Back and neck pain can come from the discs, the facet joints, the muscles, or the nerves — and the key to lasting relief is knowing which one. Desert Spine and Pain diagnoses and treats the full range of back, neck, and spinal pain for patients across Phoenix, always starting with the least invasive option that works.

What Causes Back & Neck Pain

What Is Back Pain?

Back pain is one of the most common reasons people see a doctor — but it is a symptom, not a diagnosis. The ache, stiffness, or sharp catch you feel in your back or neck is your body signaling that something in the spine — a disc, a joint, a muscle, or a nerve — is irritated or under strain. Pinpointing exactly which structure is responsible is what separates lasting relief from months of trial and error.

Doctors generally sort back pain by how long it lasts. Acute pain comes on suddenly — often after lifting, twisting, or an injury — and usually settles within a few weeks. Chronic back pain persists for three months or longer, and it is the kind that most often needs a specialist's eye to resolve. At Desert Spine and Pain we treat the full spectrum: everyday strains that simply need the right guidance, and complex, long-standing pain that has not responded to anything else. Whatever stage you are at, the goal is the same — a precise diagnosis and a plan built around getting you back to the activities you love.

Back & Neck Pain Conditions We Treat

"Back pain" is really an umbrella term for several distinct conditions, each with its own cause and its own best treatment. These are the back and neck conditions we diagnose and treat most often — choose the one that best fits your symptoms to learn more about it and how we treat it.

Back Pain Symptoms

Back and neck pain rarely feels the same from one person to the next, and the pattern of your symptoms is one of the biggest clues to its source. The most common presentations we see include:

• Axial pain — a deep, aching, or dull pain centered in the back or neck that does not travel down a limb, often from the discs, facet joints, or muscles.
• Radiating pain — sharp, burning, or electric pain that shoots into a buttock, leg, shoulder, or arm, usually a sign that a nerve is being pinched or irritated.
• Numbness and tingling — "pins and needles" or loss of sensation in an arm, hand, leg, or foot, which points to nerve involvement.
• Weakness — difficulty lifting the foot, gripping, or holding your posture, which can mean a nerve is under pressure.
• Stiffness and limited motion — trouble bending, turning, or standing up straight, often worse in the morning or after sitting for a while.

Your pain may be constant or come and go, and it can flare with specific movements — bending forward, arching back, sitting, standing, or walking for long periods. Paying attention to what makes your pain better or worse gives your specialist valuable information about the structure behind it.

What Causes Back & Neck Pain?

The spine is a stack of bones (vertebrae) cushioned by discs, connected by small facet joints, and supported by muscles and ligaments — all surrounding the spinal cord and the nerve roots that branch from it. Pain can arise from any of these structures, and often from more than one at the same time:

• Disc problems — a herniated, bulging, or degenerating disc can press on a nearby nerve or become a pain source in its own right.
• Facet joint arthritis — wear in the small joints at the back of the spine is a frequent cause of axial back and neck pain.
• Muscle and ligament strain — overuse, heavy lifting, or a sudden awkward movement can pull the soft tissues that support the spine.
• Pinched nerves — a compressed nerve root produces the radiating pain, numbness, or weakness seen in conditions such as sciatica.
• Spinal stenosis — age-related narrowing of the spinal canal that crowds the nerves, often causing leg symptoms that worsen with walking.
• Injury and trauma — car accidents, falls, and sports injuries can cause whiplash, fractures, and soft-tissue damage that lead to lasting pain.

Because several of these can overlap, a careful, structure-by-structure evaluation is the only reliable way to know what is actually driving your pain — and what will relieve it.

How Back Pain Is Diagnosed

An accurate diagnosis is the foundation of effective treatment. Dr. Greenwald begins with a thorough history — when the pain started, what makes it better or worse, whether it radiates, and how it is affecting your work and sleep — followed by a focused physical exam that tests your strength, reflexes, sensation, and range of motion.

When imaging is needed, an X-ray, MRI, or CT scan lets us see the discs, joints, bones, and nerves in detail. Because Dr. Greenwald is both a spine surgeon and a neurosurgeon, he reads that imaging with a trained eye for nerve involvement that a more general provider may overlook. In some cases a diagnostic injection — numbing a specific joint or nerve to see whether your pain goes away — is the most direct way to confirm the exact pain generator before any treatment plan is set. The result is a plan aimed at the real cause, not a guess.

Back Pain Treatment Options

Once we know the source of your pain, treatment follows a least-invasive-first path — beginning with the simplest options that can work and escalating only when they are not enough. The large majority of our patients never need surgery.

• Conservative care. Activity modification, physical therapy, and targeted exercise resolve a large share of back and neck pain, sometimes with short-term anti-inflammatory medication to calm a flare.
• Image-guided injections. When conservative care is not enough, precisely placed epidural steroid or facet joint injections can reduce inflammation and relieve pain directly at its source.
• Nerve blocks and radiofrequency ablation. For pain driven by specific nerves or joints, these minimally invasive procedures can deliver longer-lasting relief without surgery.
• Minimally invasive surgery. When a nerve needs to be freed or a segment stabilized, modern minimally invasive techniques can relieve pain that nothing else has touched — through small incisions, with less disruption and a faster recovery than traditional open surgery.

When surgery is the right answer, it is a positive, function-restoring step — not something to fear or put off indefinitely. And because one surgeon manages your care from the first evaluation through any procedure, your treatment stays coordinated at every stage.

How We Approach Back Pain at Desert Spine and Pain

Our philosophy is straightforward: find the real source of your pain, then treat it with the least invasive option that will truly fix it. Because back and neck pain can come from several structures at once, we take the time to pinpoint the actual cause rather than treating symptoms in the dark.

As a dual board-certified spine surgeon and neurosurgeon, Dr. Greenwald evaluates both the mechanical and the neurological sides of your problem — the bones and discs and the nerves — so your plan is built around what is genuinely driving your pain. You will always get an honest recommendation, including when a less-invasive option should be tried first, and you will understand each step before you take it.

When to See a Back Pain Specialist

Many episodes of back pain ease on their own within a few weeks. It is time to see a specialist when your pain lasts longer than that, keeps coming back, radiates into an arm or leg, or begins to limit your work, sleep, or daily life. Getting evaluated early usually means more treatment options and a faster path to relief — and it lets us rule out the less common but serious causes of back pain.

Proudly Serving the Greater Phoenix, Arizona Area

Why Choose Our Back & Neck Pain Specialists in Phoenix

Your pain is diagnosed and treated by a specialist who is both a board-certified spine surgeon and a neurosurgeon — so both the mechanical and the neurological causes are evaluated by one expert. We welcome out-of-network patients, require no referral, and partner closely with personal-injury attorneys for accident-related back and neck pain.

Back & Neck Pain: Frequently Asked Questions