I worked under a world renowned neurosurgeon who specialized in spine surgery, specifically scoliosis, but we treated every spine pathology you can think of.
The real reason is because we can’t always ‘fix’ nerve pain. Muscle pain can be treated with muscle relaxants & PT, which usually resolves over time. What we call ‘mechanical’ back pain, such as arthritis (bones rubbing together) can be treated with advil/NSAIDS, & very successful surgeries, that generally resolve until very old age.
But nerve pain, while it can be treated with medication, PT, surgery, & other forms of both conservative & invasive therapy, is very pesky & tends to stick around. To elaborate, nerve pain is pain generated by current or prior compression of given nerve. Depending on the severity of the compression, the duration of the compression, & the person’s overall health, nerve pain can resolve on its own or be permanent & incurable.
We do not know the exact mechanism behind nerve pain on the micro-physiological level. We know it’s due to some irritation around the nerve itself, but we’re unable to determine what exactly is occurring, & thus a ‘cure’ is almost impossible. Hope this helps, let me know if you have other questions!
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