For the older adult. aging and degeneration cause the symptoms listed. Treatment is often the same no matter what the cause is anyway. Patients are more likely to get a specific diagnosis based on more advanced testing (lab work, X-rays, MRIs) if they don't get better with conservative care.
Patients who are hospitalized are also more likely to be given a pathology-based diagnosis. If no pathology can be determined, then the physician once again relies on a symptom-based diagnosis.
Medical researchers are very busy trying to find ways to better classify or group patients with neck or back pain. These type of groupings is called a taxonomy. Improving taxonomy for painful musculoskeletal conditions could help direct research and ultimately find better treatment for each condition.