A slipped or prolapsed disc can irritate or compress a spinal nerve. In the lower back this may cause sciatica, with pain travelling into the buttock or leg. Many patients improve without surgery. Surgical evaluation may be appropriate when symptoms are severe, persistent, progressive or associated with neurological weakness or specific emergency warning signs.

Possible symptoms may include:

• Back pain with pain radiating into the leg

• Tingling or numbness

• Weakness in the leg or foot

• Pain aggravated by coughing, sneezing or certain movements

Degenerative changes in the cervical spine can compress a nerve root or, in some patients, the spinal cord. Symptoms and imaging need to be interpreted together. Treatment may include medicines, physiotherapy, activity modification or surgery, depending on the degree of compression and neurological involvement.

Possible symptoms may include:

• Neck pain radiating into the shoulder or arm

• Numbness or tingling in the hand

• Weakness of the arm or hand

• Loss of hand dexterity

• Imbalance or difficulty walking

Lumbar canal stenosis is narrowing around the nerves in the lower spine. It commonly causes leg pain, heaviness, numbness or weakness while standing or walking. Some patients obtain relief by sitting or bending forward. Surgery may be considered when symptoms significantly limit activity or neurological deficits progress despite appropriate non-operative care.

Possible symptoms may include:

• Pain or heaviness in one or both legs while standing or walking

• Tingling or numbness in the buttocks, thighs or legs

• Weakness or tiredness in the legs

• Reduced walking distance or the need to stop frequently

• Symptoms that improve with sitting or bending forward

• Lower-back pain, which may or may not be present

Spondylolisthesis occurs when one vertebra shifts relative to another. It may be associated with back pain, nerve compression or instability. Management depends on symptoms, neurological findings, imaging and the extent to which the condition affects daily activity.

Possible symptoms may include:

• Persistent lower-back pain or stiffness

• Pain radiating into the buttock or leg

• Tingling or numbness in the leg or foot

• Weakness in the leg or foot

• Difficulty standing or walking for prolonged periods

• Tightness or muscle spasms in the lower back or hamstrings

Tumours can arise from the vertebrae, spinal cord, nerve coverings or surrounding tissues. Symptoms depend on their location and may include pain, weakness, numbness or changes in bladder and bowel function. Treatment is planned according to the tumour type, spinal stability, neurological status and the need for tissue diagnosis or decompression.

Possible symptoms may include:

• Persistent or worsening neck or back pain

• Pain radiating into an arm or leg

• Tingling, numbness or altered sensation

• Weakness in the arms or legs

• Difficulty walking, imbalance or recurrent falls

• Changes in bladder or bowel function

Spine injuries may involve the bones, ligaments, discs, spinal cord or nerve roots. Urgent assessment is important when there is weakness, altered sensation, severe pain or suspected instability. Treatment may range from immobilisation and observation to decompression and stabilisation surgery.

Possible symptoms may include:

• Severe neck or back pain following an injury

• Pain radiating into an arm or leg

• Tingling, numbness or altered sensation

• Weakness or loss of movement in an arm or leg

• Difficulty standing, walking or maintaining balance

• Changes in bladder or bowel control