Back & Neck Pain
Back and Neck Pain: The Neurological Evaluation
Most back and neck pain is muscular and improves. A neurological evaluation matters when pain radiates into an arm or leg, or when there is numbness, tingling, or weakness — signs that a nerve may be involved.
Why see a neurologist for back or neck pain?
A neurologist's role is to determine whether a nerve or the spinal cord is involved, which nerve is affected, and how severely. That answer shapes treatment and determines whether additional imaging or a surgical opinion is needed.
- Pain that radiates into the arm, hand, leg, or foot
- Numbness or tingling in a specific distribution
- Weakness, dropping objects, or foot dragging
- Pain that has not improved as expected
- Symptoms following a fall, accident, or work injury
- Imaging findings that do not match your symptoms
Radiculopathy: a pinched nerve
Radiculopathy occurs when a nerve root is irritated or compressed as it exits the spine. Because each nerve root serves a predictable area, the pattern of pain, numbness, and weakness helps identify the level involved.
Cervical radiculopathy (neck)
Lumbar radiculopathy (low back)
Other neurological causes considered
- Disc herniation and degenerative disc disease
- Spinal stenosis (narrowing of the spinal canal)
- Spinal cord compression (myelopathy)
- Peripheral neuropathy mimicking radiating pain
- Nerve entrapment outside the spine
- Muscular and joint-related pain without nerve involvement
Evaluation and testing
- Detailed history of onset, activities, and injury
- Neurological examination including strength, sensation, and reflexes
- EMG and nerve conduction studies to test nerve function when indicated
- Review of existing MRI or CT imaging
- New imaging when clinically appropriate
- Laboratory studies when a systemic cause is suspected
Imaging shows structure; EMG and nerve conduction studies show function. Used together, they clarify whether an imaging finding is actually responsible for your symptoms.
Read: When should I see a neurologist for back pain? →Treatment approach
Many patients with nerve-related back and neck pain improve without surgery. Treatment is directed by the diagnosis and may involve activity modification, physical therapy, medications for nerve pain, and coordination with other specialists. Referral for a surgical or interventional opinion is made when the findings warrant it.
Seek emergency care
Injured at work?
Back and neck injuries that occur at work require documentation of the mechanism of injury and objective findings, in addition to treatment.
Work-related injury evaluation →Frequently asked questions
- When should back or neck pain be seen by a neurologist?
- Neurological evaluation is helpful when pain radiates into an arm or leg, or when there is numbness, tingling, weakness, or loss of coordination — findings that suggest a nerve, nerve root or the spinal cord is involved.
- What is radiculopathy?
- Radiculopathy means a nerve root leaving the spine is irritated or compressed. It typically causes pain, numbness or weakness following the path of that nerve into the arm or leg.
- Is this a spine surgery practice?
- No. This is neurological evaluation of symptoms associated with back and neck disorders — identifying whether nerves are involved and how severely — with referral for surgical or orthopedic opinion when that is appropriate.
- What testing may be involved?
- Evaluation begins with history and neurological examination. EMG and nerve conduction studies, and review of existing or new imaging, may be used when they are likely to change understanding of the problem.
Request a Neurology Appointment
Text 815-276-7050 with your first name and the word "appointment," or call 815-337-7100 to schedule. Our office will follow up to confirm your evaluation.
In-person visits and televisits (telehealth) are both available.
What happens after you text
Text 815-276-7050 with your first name and the word "appointment." Our office calls you back to schedule — you do not need to fill out a form.
When you'll hear back
Texts and calls received during office hours are typically returned the same business day. You can also call 815-337-7100 directly.
Insurance and referrals
Insurance participation and referral requirements vary by plan. Our office will confirm what your plan requires before your visit.
Please do not send urgent or emergency medical information by text. If you believe you are experiencing a medical emergency, call 911 or seek emergency medical attention. Please avoid sending sensitive medical information by ordinary SMS unless instructed otherwise.