Neck and Back Pain

Many people have experienced a stiff neck at some point, and some live with chronic neck pain and headaches. Neck pain is generally caused by poor posture – forward head carriage is very common and causes muscle imbalances in the neck and shoulders.

Pain in the shoulders or arms is very often related to damage to structures in the neck. Referred pain can develop even if you don’t feel any soreness in your neck. Muscular tension will develop in the neck and shoulders as the result of poor posture, and can cause a deep pain to radiate down the arm which will often get worse through the day.

To keep your neck limber and healthy:

  • Pay attention to your head position while driving, watching TV, and working on the computer – ensure that ears are aligned over the shoulders

  • Avoid sleeping on your stomach and choose a pillow that properly supports your head

  • Monitor your vision and keep your prescription current

  • Walk, stand, and sit with good posture

  • Stretch gently to maintain flexibility

 

Here are some common neck and back problems that respond to conservative treatment:

 

Strain/Sprain Most episodes of acute pain are due to a muscle strain or joint sprain. This type of injury can be caused by a sudden force (such as from a car accident or a sudden awkward movement), or from faulty posture or long periods of excessive stress (such as from sleeping in the wrong position or carrying something heavy). Local pain will be reproduced by movements of the neck or back that stress the injured tissue. Sometimes a dull ache may be felt in another area. Therefore, it is difficult for the brain to determine the source of an injured tissue and we often see pain referred to different structures. Conservative care, such as ice, stretching, trigger point therapy or manipulation can help alleviate this painful condition. Spinal rehabilitation is also necessary to restore the previously injured tissues to their original functional state.

 

Osteoarthritis (Spinal Degeneration) Osteoarthritis patients typically feel their worst at the beginning and end of the day, and feel the best while moving and staying warm. These people usually prefer warm sunny weather over rain. Similar symptoms are experienced in people with degeneration of weight bearing joints (hips, knees). Degeneration in the cartilage of the facet joints can produce pain and tends to occur in older adults (over 60 years old). The facet (spinal) joints are designed to move against smooth surfaces, but as the cartilage degenerates it develops a lot of friction and there is accompanied loss of motion. The degeneration may produce bone spurs that can cause narrowing of the space where the nerve exits the spine. This would result in pain, tingling or numbness radiating into the arm and hand for the neck, or the leg and foot for the back. The types of treatment that are helpful mainly center on keeping the normal motion of the joints. Range of motion exercises and manipulation can all help preserve motion and lessen the pain. Traction may be beneficial in relieving any compression of the nerves.

 

Herniated Disc Similar to the nerve compression seen in osteoarthritis, discomfort that radiates into the arm or leg can also be caused by a herniated disc irritating a nerve in the neck or back respectively. There is hardly any discomfort in the neck or back and the majority of the pain, tingling or numbness will be found in the extremities. Most of the symptoms are temporary and can be treated successfully with conservative care.

 

The vast majority of episodes of neck or back pain will get better with time and can be addressed with conservative care. However, there are a few symptoms that are possible indications of a serious condition and may require immediate attention. Signs on a more serious condition include:

  • Fever and chills

  • History of cancer with/or recent unplanned weight loss

  • Significant arm or leg weakness

  • Sudden bowel and/or bladder incontinence

  • Severe, continuous abdominal and back pain

  • Severe trauma