Overview of Back and Neck Pain
Most people will experience some sort of back or neck pain during their lives. Pain can range from a little twinge, to mild soreness and stiffness, to a piercing, acute pain. Depending on the cause of the back or neck pain, the symptoms may last anywhere from a few days to several weeks. Pain is considered chronic if it lasts for longer than three months.
Many times, these aches and pains naturally resolve themselves as the minor injuries or muscle pulls that have caused them heal on their own. Sometimes the pain can worsen over time, particularly if you compensate for the soreness by straining muscles you don’t ordinarily use. If a very strong muscle in your back is pulled, for example, the weaker muscles may become strained as they try to do the big muscle’s job. Once this begins to occur it can result in a cascade of muscle pulls causing back pain to become progressively worse. This is why it is important to carefully assess any neck or back pain, monitoring intensity, and visiting your physician if there is no improvement or if the pain steadily worsens.
Causes of Back and Neck Pain
The back and neck are supported by a complicated network of bones, ligaments, muscles, tendons, and discs (in the spine). Most commonly, back and neck pain are caused by strains in which the muscles or ligaments become torn. Heavy lifting or improper lifting techniques can strain muscles in the back. Sudden, awkward movements, as in the case of a fall or a car accident can also strain back muscles. Muscle spasms can cause shooting pains in the back or neck.
Structural problems can also cause back and neck pain. The discs in the spine are cushiony tissue designed to pad the bones. If a disc bulges, ruptures, or becomes compressed, it can put pressure on a nerve causing intense pain. Some people with bulging discs feel leg pain if the disc presses upon the sciatic nerve, the large nerve in the lower back that runs down through the buttock and into the leg. Arthritis can cause back pain if there is inflammation of the spine. Osteoporosis can increase the likelihood of incurring compression fractures in the spine, which can be extremely painful.
Any irregularities in the curvature of the spine can lead to back or neck pain as the muscles try to support your upper body. These muscles are designed to support our backs and heads in an upright position, so excessive curving of the spine can push them beyond their natural limits. Some medical conditions, such as scoliosis, lead to an abnormal curving of the spine. Sitting with bad posture can lead to temporary back and neck pain. In much rarer cases, these pains can be caused by spinal infections or cancer (if a tumor presses on a nerve).
Seeking Help for Back and Neck Pain
As mentioned above, back and neck pain normally resolve themselves in a matter of days as the strained or injured muscles repair themselves. If there is no improvement within 72 hours there may be a serious medical problem. If left untreated there is a risk of permanent damage.
Medical attention should be sought for back or neck pain if:
- The pain follows an accident. If there has been any trauma to your head, neck, or spine, you should see your physician immediately as pain could indicate a fracture.
- The pain is very intense or constant, particularly when you lie down. This could indicate pressure on a nerve or nerve irritation.
- The pain is accompanied by any weakness or numbness in the limbs, which could indicate neurological damage.
- The pain causes throbbing in the abdomen or is accompanied by a fever, which may mean you have an infection.
- If bowel or bladder problems are associated with the onset of pain it may indicate a neurological problem.
Conventional Treatments for Back and Neck Pain
The most common cause of back and neck pain is the inflammation that occurs naturally when the muscles are strained. Temporary pain can be treated at home with over the counter pain relievers and proper rest. It is important to allow the muscles to heal themselves before exerting them once again. For more acute pain, prescription pain relievers and anti-inflammatories may also be recommended.
If you seek medical attention for back or neck pain the physician will perform diagnostic tests to check for infections, fractures, tumors, or any swelling that may be causing you discomfort. X-rays, for example, can show the alignment of the bones in your spine, help identify fractures, and help diagnose arthritis. Computerized tomography (CT) scans or magnetic resonance imaging (MRI) can be used to visualize the structures in your back and neck to look for more subtle problems with the tendons, muscles, ligaments, bones, nerves, or discs. The physician can also inject a tracer substance into your body and perform a bone scan to look for compression fractures due to osteoporosis or bone tumors that may be putting pressure on nerves. Any nerve compression can further be tested using a technology called electromyography (EMG), which measures electrical impulses produced by your nerves and tests how your muscles respond.
Depending on what the diagnostics reveal, the physician may prescribe stronger pain medications or muscle relaxants to make recovery more comfortable. Rest with periodic gentle stretching can help loosen up stiff, painful muscles, though medication can potentially provide faster relief for more acute pain. Narcotics (such as codeine) or injections of cortisone may be prescribed in extreme cases. Following recovery, many physicians also suggest abdominal exercises to help strengthen all the muscles that support the back and neck to reduce the risk of future strains. In some cases, patients may need to work with a physical therapist to regain strength and flexibility in their neck and back muscles.
If back pain is being caused by a compressed or ruptured disc, surgery may be necessary for relief. The offending part of the disc may be removed or the entire disc can be replaced with an artificial one. If there is a growth on the spine that is affecting a nerve, a small part of the vertebra can be removed to relieve the pain. If the pain is caused by movements between adjoining vertebrae, these bones can be surgically fused together, though this can increase the likelihood of developing arthritis later.
Numerous practical things can be done to prevent back and neck pain. Regular exercise helps keep muscles in the back strong and flexible, and helps to keep your weight under control. Carrying extra body mass can put additional stress on the spine. There is also evidence that smoking can reduce oxygen levels in the tissues of the spine and hinder healing following minor injuries. This is one more reason among many not to smoke. Proper body mechanics can prevent back and neck pain. Standing up straight and using lower back support while sitting help maintain the spine's normal curvature. The natural tendency is to slouch while sitting for long periods of time, so taking frequent breaks and standing can help. Stretching exercises ensure that muscles stay loose and flexible. It is also recommended that people with neck and back pain not sleep on their stomachs as it can put additional stress on the spinal column.
Patients Medical Treatment for Back and Neck Pain
Our physicians work with you to develop a treatment program for your back and neck pain that will speed up your recovery and help prevent future injuries.
First, we can help tailor a diet and exercise program for your weight and body type. By maintaining good body composition and eliminating extra weight around the waist there will be less stress on the spine and muscles in your back. We will teach you proper techniques for standing and sitting, particularly if you need to do so for long periods of time as part of your job.
Depending on your situation we may recommend chiropractic therapy to improve the alignment of your spine. Acupuncture or acupressure may be prescribed to help relieve chronic pain. Massage therapies can aid in the relaxation of the muscles for relief of neck and back pain.
To prevent future back pain we can make recommendations for your home and work environments to help make them ergonomically correct. Ergonomics aims to better design each element of your environment to make it safer, more comfortable, and easier to use. Learning these fundamentals can help eliminate many of the underlying causes of neck and back pain.
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