You’ve probably dealt with back or neck pain at some point, and you know how it can throw your whole day off, or even your whole week.
But how do you know if it’s just a pulled muscle or something that could be nerve-related? Sometimes, the difference is simple. Other times, it’s not so clear.
Nolan Fisher, DO, a physical medicine and rehabilitation specialist at Banner - University Medicine, shared how you can spot the difference between muscle and nerve pain, how to treat your pain at home and when it’s time to get care.
What are the most common causes of neck and back pain?
Dr. Fisher said, “For most people, muscle pain is a common reason for back or neck soreness.” Overuse, poor posture, a new workout or just a long stretch at your desk can make your muscles tight and achy. Even stress can play a role.
But nerves can also be involved. If something presses on a nerve, like a herniated disk, bone spur or inflammation, you can get sharp, shooting pain or numbness.
Most back and neck pain improves with time. But if your symptoms are intense, long-lasting or affecting how you move, it’s important to get checked out.
How can you tell if it’s muscle pain or nerve pain?
Muscle pain and nerve pain feel different and can appear in different ways. Here are some signs to help you figure it out.
Muscle pain
Muscle pain is often caused by:
- Overuse
- Strain
- Poor posture
- Stress or tension
“Muscle pain typically happens after sports, exertion or repetitive activity,” Dr. Fisher said.
It usually feels like:
- Soreness or aching in one spot
- Stiffness, tightness or tenderness in your back or neck muscles
- Pain that gets worse when you move a certain way or lift something heavy
It usually doesn’t cause numbness, tingling, weakness or coordination problems. It often gets better with rest, heat, gentle stretching or over-the-counter (OTC) pain relievers.
Nerve pain
Nerve pain may be caused by:
- A herniated or slipped disk
- A pinched nerve
- Spinal stenosis (narrowing of the spine)
It usually feels like:
- Sharp, shooting, burning or electric-like pain
- Pain that travels (radiates) down your arm or leg
- Numbness, tingling or a “pins and needles” feeling in the arms, legs, hands or feet
- Muscle weakness in your hand, arm, leg or foot
Nerve pain may make it harder for you to grip, walk or balance. It may not get better with regular rest or stretching.
What should you do if you're not sure about the cause?
Muscle pain and nerve pain have these key differences:
- Muscle pain tends to stay in one area, feels sore and gets better when you rest or stretch. It doesn’t usually affect your coordination or strength. “Muscle pain is duller, throbbing and more achy,” Dr. Fisher said.
- Nerve pain often radiates down the limbs, feels sharp or burning and may cause numbness or weakness. It can make it harder to move, grip or walk. “Nerve pain can be achy and dull, but typically it’s more sharp, electrical or burning,” Dr. Fisher said. “Nerve pain tends to have a wider range of symptoms, including numbness, tingling and weakness.”
If you aren’t sure what type of pain you have, talk to your health care provider. Muscle pain might get better with home treatment, but nerve pain usually needs professional care.
To learn more about what could be behind your pain, try our free back and neck pain assessment tool.
When is it time to see a doctor?
“Regardless of if your pain is muscular or nerve related, if it doesn’t get better with rest and OTC pain medications, or if it is causing numbness, tingling or weakness, you should talk to your doctor,” Dr. Fisher said. Contact your provider if your symptoms are spreading, aren’t getting better, are affecting your strength or last more than two weeks.
Even if you feel like you can manage symptoms, getting the right diagnosis can help you heal faster and avoid long-term problems. “Getting the right diagnosis means you get the right treatment plan,” Dr. Fisher said. “It’s important to find out what the cause is, because if you don’t you risk further injury and symptoms that get worse.”
Certain symptoms mean you should reach out to your health care provider quickly:
- Severe, sudden pain that doesn’t get better
- Numbness or tingling that won’t let up
- Weakness in your arm, hand, leg or foot
- Trouble walking, balancing or using your hand(s)
- Difficulty controlling your bladder or bowels — this is an emergency
- Pain after a fall, injury or trauma
How do doctors treat muscle and nerve pain?
Most muscle pain gets better with self-care, rest, stretching and physical therapy. OTC pain medicine, hot or cold packs and movement often help.
Nerve pain may need medicine, injections or, in rare cases, surgery.
How can you keep your neck and back healthy?
While you can’t completely avoid neck and back pain, you can reduce your risk. These tips can help:
- Pay attention to your posture, especially if you sit at a desk or drive a lot
- Move often and try to get some light activity every hour
- Use good lifting form and avoid sudden, twisting movements
“For most people, the reason they have nerve-related pain coming from their neck or back is the accumulation of their day-to-day activities,” Dr. Fisher said. “When you put a little less stress on your neck and back every day, that can lead to a lot of pain relief over time.”
How Banner Health can help
At Banner Health, our spine and nerve care teams can help figure out what’s causing your pain and create a plan to help you feel better. We offer:
- Imaging and diagnostic testing
- Physical therapy and pain management
- Personalized treatments based on your condition and lifestyle
Whether your pain is muscle-related or something more, we’re here to help you move forward.
Other useful articles
- Nerve Flossing Could Help With Nerve Pain. Here’s What to Know
- How to Tell if Sciatica Is Triggering the Pain in Your Back
- 8 Reasons Your Back Might Hurt More as You Get Older
- Recognize the Signs and Neurological Side Effects of Whiplash
