Back and Neck Pain

Virtually everyone will experience some form of neck or back pain in their lifetime. You are not alone. The pain may occur suddenly and go away within a few days or weeks, or it may go and come back in episodes over many years. It may also spread into the arm or leg. Back and neck pain may have a major impact on the regular activities of your daily life.

You may have pain with:

• Sitting at the computer
• Rising from a chair
• Turning in bed
• Bending or twisting with yard work
• Standing or walking
• Swinging a golf club
• Lifting and playing with your kids

What causes it?

People are often puzzled by the cause of their back or neck pain. For many people, back pain can be caused by poor posture and bad habits. The accumulated wear and tear our bodies experience on a day-to-day basis puts us at risk of experiencing back pain, regardless of occupation. This increases with age as the spine begins to lose its flexibility. You don’t have to fall off a ladder or lift 50 kg to hurt your back. At least 70% of back and neck injuries begin with normal daily repeated activities.

The two main causes of back and neck pains are:

• poor posture
• poor body mechanics with for example: lifting, bending, pushing and pulling

Other important causes include muscle strains, disc injuries and arthritis.

Poor Posture

The human spine (neck, mid-back and low-back) has three natural curves to it when viewed from the side. There is a small curve (lordosis) in the neck towards the throat, a curve backwards in the mid-back, and a curve forwards towards the abdomen (lordosis in the low-back). If your neck or back is not positioned in these natural curves, pain will develop sooner or later.

In order to understand pain that arises in your neck or back from poor posture, try the following experiment: bend your finger backwards until you feel a stretch. There is no pain now, but hold it there for a minute or two, and pain or discomfort will occur. Pain is a warning signal by your body, and if you allow it to continue, damage will occur. Pain often develops as a result of strain and stretch on muscles and ligaments over time.

If you are seated in a poor, slouched posture, then your low-back has lost its natural curve or lordosis, your neck has an increased curve forwards, and your mid-back has an increased curve backwards. A slouched posture puts the muscles, ligaments, and discs of your spine on an abnormal stretch, just as you tried in the experiment above. Pain can develop in a short time (minutes), or it can take months. The pain can also spread to your head in the form of headaches. Often the pain is relieved when you change position, but as time goes on, if nothing is corrected, then the pain will persist in any position. If the posture is not corrected, (in sitting or standing) eventually the muscles and ligaments will shorten and become tighter, and you lose flexibility in your neck and back. A loss of flexibility is also a cause of back and neck problems.

Poor Body Mechanics with Bending and Lifting

The second most common cause of neck and back pain is repeated bending, lifting, and stooping. The discs of your lower back can become damaged from poor posture and poor lifting technique. The outer wall of the disc can develop small tears in it, which allows the gel-like center to bulge backwards. If the bulge is large enough, it will push on the nerve behind it called a "pinched nerve".

The key to prevention is keeping the normal curves in your neck and back while lifting, stooping, and bending. It is especially important to position your low back arched inwards (lordosis) when lifting. This is the strong position for your back. In the strong position, the muscles and ligaments are in a perfect position to perform at their maximum.

A physiotherapy program has to address the above causes for a person to improve. If the mechanical cause of the pain is removed (poor posture or poor body mechanics) then the pain improves. Successful treatment comes with teaching a person about their back and how to lessen strain and stress on their neck and back. Treatment also focuses on special exercises to reduce strain, stretch tight muscles, strengthen and create faster healing. Physiotherapists are skilled in the management of back injuries. A physiotherapist will provide a comprehensive assessment of your back to determine the source of the problem, and to develop an individualized program to treat your symptoms.

To help ease the pain, the physiotherapist may also use hands on treatment like massage to help the back move and stretch easier. They may use their hands to apply gentle pressures to the lower back to help reduce the bulge in the disc and therefore get to the root of the problem. To help reduce pain and promote healing, they may also use many proven treatments like ultrasound, heat, acupuncture, and gentle electrical therapy. They will also teach you special movements to reduce pain, and heal a bulging disc.

Physiotherapy focuses on long term solutions as well as short term pain relief. Patients are taught ways of easing the pain at home or at work, such as using a proper support for sitting and how to use the lower back at work or during sports, without injuring it further. Teaching self-treatment and promoting independence is a very important part of physiotherapy treatment.

Recent studies indicate that the most important factor in avoiding back injury may be your general physical conditioning. This suggests that regular aerobic exercise, such as walking or swimming, may provide the conditioning a back needs to stay healthy. However, a specific exercise program to mobilize and strengthen the spine can also be effective in preventing a recurrence of back pain. Strong back and stomach muscles are necessary to support your spine properly, and a physiotherapist can provide guidance on the appropriate exercises to tone and strengthen these muscles.