Yes, there is plenty of medical research supporting a connection between neck pain secondary to back pain in veterans.
Back conditions can cause significant strain on the surrounding areas of the body, and over time, this can lead to chronic neck pain.
The spine is a connected system, so when one part, like the lower back, is injured, it can create a ripple effect, causing pain and discomfort in the neck.
To prove secondary service connection for neck pain secondary to back pain, you’ll need to show three key things to the VA including: (#1) a medical diagnosis of neck pain, (#2) proof of a service-connected back condition, and (#3) medical nexus evidence (nexus letter) showing how your service-connected back condition caused or aggravated your neck pain.
The VA rates neck pain and limited range of motion under the General Rating Formula for Diseases and Injuries of the Spine with ratings ranging from 10% to 100%, depending on the severity of symptoms, limitation of range of motion, and negative impacts on your work, life, and social functioning.
In this article, we’ll walk you through the entire process of filing a secondary claim for neck pain connected to back pain.
We’ll cover how the VA rates neck pain, the medical evidence you’ll need, how to prove secondary service connection, and the importance of a strong nexus letter.
Table of Contents
Summary of Key Points
- Connection Between Neck and Back Pain: Medical research supports the link between back conditions and the development of neck pain due to the spine’s interconnected nature. Injuries in one area can cause strain and compensatory pain in another.
- Evidence for Secondary Service Connection: Veterans need to provide three key pieces of evidence to claim neck pain secondary to back pain: a medical diagnosis of neck pain, proof of service-connected back pain, and a nexus letter linking the two conditions.
- VA Rating Criteria: The VA rates neck pain based on the General Rating Formula for Diseases and Injuries of the Spine, with ratings ranging from 10% to 100%, depending on factors like range of motion, severity of pain, and impact on daily functioning.
- Importance of Medical Evidence: To build a strong claim, veterans must provide detailed medical records, a well-written nexus letter, and documentation showing the severity of symptoms and negative impacts of neck pain on your work, life, and social functioning.
Neck and Back Pain Defined for VA Disability Benefits
Neck Pain (Cervical Pain)
Neck pain, medically referred to as cervical pain, affects the upper region of the spine.
It’s a common issue for veterans and can result from various causes such as muscle strain, degenerative disc disease, or injuries sustained during service.
Symptoms of neck pain may include stiffness, limited range of motion, headaches, and radiating pain into the arms.
In chronic cases, neck pain can significantly interfere with daily functioning, including work and social activities.
Back Pain (Lumbar Pain)
Back pain typically refers to discomfort in the lower (lumbar) region of the spine.
It’s one of the most prevalent disabilities among veterans and is often caused by physical activities during service, such as heavy lifting, prolonged standing, or injury.
Common diagnoses for back pain include conditions like herniated discs, spinal stenosis, and degenerative disc disease.
Symptoms can include localized pain, difficulty bending or standing, and radiating pain into the legs, known as sciatica.
Neck Pain and Back Pain: Is There a Connection?
Yes, there is a clear medical connection between neck pain and back pain, particularly when one region of the spine is injured or compromised.
The spine functions as an interconnected system, and an issue in the lumbar (lower) region can lead to compensatory changes in posture or gait, putting additional strain on the cervical (neck) region.
This biomechanical stress can result in neck pain, often manifesting as muscle tightness, reduced range of motion, and nerve impingement.
For example, a veteran with a service-connected lower back condition may alter their posture or movements to avoid aggravating their back pain.
Over time, this can strain the muscles and joints in the neck, leading to chronic pain in other areas, including the neck.
Additionally, degenerative changes in one part of the spine often spread to other areas, contributing to both neck and back pain.
Medical Research Between Neck Pain and Back Pain
Current medical research supports the connection between neck pain and back pain, often focusing on the biomechanical and neurological relationships between these two regions of the spine.
Here are key findings from two recent studies:
- Biomechanical Link Between Neck and Back Pain: Research shows that dysfunction in the lumbar spine (lower back) can affect posture and movement patterns, placing additional strain on the cervical spine (neck). For example, when patients alter their posture to alleviate lower back pain, they may inadvertently place more pressure on the cervical spine, leading to neck pain. A study published in Spine highlights the interdependence of spinal segments and how pain in one region can affect other areas.
- Degenerative Disc Disease and Pain Migration: Degenerative disc disease, common in both the cervical and lumbar spine, can cause a chain reaction of pain. A review of patients with combined cervical and lumbar disc degeneration found that pain often starts in one region (typically the lower back) but migrates to the neck as spinal degeneration progresses. This is supported by studies that investigate how spinal diseases do not remain isolated and can spread through connected spinal structures.
These findings underscore the importance of considering both the cervical and lumbar spine in treatment and VA disability claims, as dysfunction in one area often leads to compensatory issues in another.
What is the VA Rating for Neck Pain Secondary to Back Pain?
The VA rates neck pain secondary to back pain under the General Rating Formula for Diseases and Injuries of the Spine, found in the 38 CFR, Part 4, the Schedule for Rating Disabilities (VASRD).
Neck pain can be rated by the VA at 10%, 20%, 30%, 40%, 50%, or 100% based on the severity of your symptoms.
The rating depends on factors such as your limitation of range of motion, presence of pain, and whether there is ankylosis (complete immobility) of the neck.
Lower ratings are typically given for minor limitations in movement or mild pain, while higher ratings are assigned for severe mobility restrictions, constant pain, or total loss of movement in the cervical spine.
In general, the more severe your symptoms of neck pain, the higher the VA rating you’ll receive.
Neck Pain Secondary to Back Pain VA Rating Chart
| General Rating Formula for Diseases and Injuries of the Neck, Spine, and Back | VA Rating |
|---|---|
| Important: Use this rating formula for Diagnostic Codes (DCs) 5235 to 5243 unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes. With or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease rate as follows: | |
| Unfavorable ankylosis of the entire spine | 100% |
| Unfavorable ankylosis of the entire thoracolumbar spine | 50% |
| Unfavorable ankylosis of the entire cervical spine; or, forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine | 40% |
| Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine | 30% |
| Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis | 20% |
| Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height | 10% |
| Evaluate intervertebral disc syndrome (preoperatively or postoperatively) either under the General Rating Formula for Diseases and Injuries of the Spine or under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method results in the higher evaluation when all disabilities are combined under §4.25. | |
Important Medical Evidence to Service-Connect Neck Pain Secondary to Back Pain for VA Disability
To successfully file a claim for neck pain secondary to your service-connected back condition, you will need to provide the VA with specific medical evidence that meets their criteria for secondary service connection.
#1. Current Diagnosis of Neck Pain
The first step in proving your secondary service connection is obtaining a current medical diagnosis for neck pain.
This diagnosis must come from a qualified healthcare provider and should clearly outline the condition you’re experiencing, whether it’s cervical strain, degenerative disc disease, or another cervical spine disorder.
Medical imaging (such as MRIs or X-rays) that shows structural abnormalities in the cervical spine can strengthen your claim.
#2. Evidence of Service-Connected Back Pain
Since your neck pain is being claimed as secondary to your service-connected back condition, you must already have a confirmed service-connected rating for your back pain.
The VA will require evidence, such as your VA Rating Decision that shows your back pain is recognized as a service-connected disability rated at 0% or higher.
#3. Nexus Letter From a Private Healthcare Provider
A crucial piece of evidence in any VA claim for secondary service connection is a Nexus Letter from a private healthcare provider.
This letter must establish the link between your service-connected back pain and your current neck pain, stating that it is “at least as likely as not” (a 50% or greater probability) that your back condition has caused or aggravated your neck pain.
Your healthcare provider should explain how your back condition affects your posture, mobility, and the biomechanics of your spine, leading to compensatory stress on your neck.
A well-written, detailed nexus letter with high probative value is mission critical for winning your VA claim!
#4. Documentation of Severity of Symptoms and Negative Impacts on Your Work, Life, and Social Functioning
The VA will also need to understand the severity of your symptoms and how your neck pain negatively impacts your work, life, and social functioning.
Be prepared to submit evidence that shows how your neck pain limits your ability to work, perform daily tasks, and engage in social activities.
This can include:
- VA or Private Treatment Records: These records should detail your symptoms, treatments (e.g., physical therapy, medications), and how your neck pain affects your daily life.
- Lay Evidence: Both your own statement and those from family members or friends can describe how your neck pain limits your ability to function.
- Disability Benefit Questionnaires (DBQs): If available, a DBQ filled out by your healthcare provider can document the severity of your condition and any functional limitations you experience.
Conclusion & Wrap-Up
In conclusion, the connection between neck pain and back pain in veterans is well-supported by medical research.
Your spine is a complex, interconnected system, and when one part—like the lower back—suffers an injury, it can lead to compensatory issues in other areas, such as the neck.
This isn’t just theoretical; it’s a real, tangible link that can impact your daily life, limiting your mobility, and causing pain.
To successfully claim VA disability for neck pain secondary to back pain, you need to gather key evidence.
This includes a current medical diagnosis of neck pain, proof of your service-connected back condition, and a strong nexus letter from your healthcare provider that explains how the two conditions are linked.
Remember, the VA rates neck pain under the General Rating Formula for Diseases and Injuries of the Spine, and your rating will depend on the severity of your symptoms, limitations in your range of motion, and how much your condition impacts your ability to function day-to-day.
By taking the right steps—providing the necessary medical evidence, securing a strong nexus letter, and filing your claim properly—you can make sure your neck pain gets recognized as secondary to your back pain, and receive the compensation you deserve.
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About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.
