Back and Neck Pain
Low back pain can range from mild, dull, annoying pain, to persistent, severe, disabling pain. Pain in the lower back can restrict mobility and interfere with your normal functioning. Low back pain is one of the most significant health problems. Consider these statistics from the National Institutes of Health (NIH):
- Seventy to 85 percent of all people have back pain at some time in their life.
- Back pain is the most frequent cause of activity limitation in people younger than 45 years old.
Neck Pain occurs in the area of the seven cervical vertebrae. Because of its location and range of motion, the neck is often left unprotected and subject to injury. Pain in the back or neck can be acute, which comes on sudden and intensely, or chronic, which can last for weeks, months, or even years.
Even with today's technology, the exact cause of back and neck pain is usually unknown. In most cases, back and neck pain may be a symptom of different sources, including any of the following:
- Overuse, strenuous activity, repetitive lifting.
- Trauma, injury, or fractures
- Degeneration of vertebrae, often caused by stresses on the muscles and ligaments that support the spine, or the effects of aging
- Abnormal growth such as a tumor or bone spur
- Obesity due to increase weight on the spine and pressure on the discs
- Poor muscle tone
- Muscle tension or spasm
- Sprain or strain
- Ligament or muscle tears
- Joint problems such as arthritis
- Protruding or herniated (slipped) disc and pinched nerve
- Osteoporosis and compression fractures
- Congenital (present at birth) abnormalities of the vertebrae and bones
Preventing Back and Neck Pain
The following may help to prevent back and neck pain:
- Practicing correct lifting techniques
- Maintainging an ergonomic workplace
- Utilizing correct posture while sitting, standing, and sleeping
- Participating in regular exercise (with proper stretching prior)
- Maintaining a healthy weight
- Reducing emotional stress which may cause muscle tension
Rehabilitation for Back and Neck Pain
A back and neck pain rehabilitation program is designed to meet the needs of the individual patient, depending upon the type and severity of the pain, injury, or disease. Active involvement of the patient and family is vital to the success of the program.
The goal of a back and neck rehabilitation program is to help the individual to return to the highest level of function and independence possible, while improving the overall quality of life. The focus of rehabilitation is on relieving pain and improving mobility (movement).
In order to help reach these goals, our physical therapy programs may include the following:
- Exercise programs to improve range of motion, increase muscle strength, improve flexibility and mobility, and increase endurance
- Patient and family education
- Pain management techniques
- Gait (walking) and movement retraining
- Stress management
- Ergonomic assessments and work-related injury prevention programs
Generally, there are three phases to back and neck pain rehabilitation:
Phase I: During this initial phase, the physical therapist and treatment team focus Acute Phase on making a diagnosis, developing a treatment plan, and starting treatment to reduce the pain and inflammation. This may include gentle joint mobilization, ultrasound, electrical stimulation, and taping techniques.
Phase II: Once the initial pain and inflammation are reduced, the physical therapist Recovery focuses on helping the patient restore normal function. This includes Phase returning the patient to normal daily activities, and starting an exercise program that is designed to help the patient regain flexibility and strength.
Phase III: The goal of this phase is two-fold: educating the patient on ways to Maintenance prevent further injury and strain to the back and neck, and phase strength and endurance.
Low Back Pain Conditions
Herniated Disc ("Slipped Disc")
A herniated or "slipped disc" is a frequent cause of mild or moderate low back or leg pain. The soft flexible discs separate the bones in the spine. The discs, which have a rigid outside rim and a soft gel-like center, act as shock absorbers to protect the spinal cord. Activity, stress, or a mechanical problem in the spine can cause a disc to bulge. The damaged or bulging disc may pinch or irritate a nerve root, which can cause leg pain.
Another common disorder of the lower spine is disc degeneration, or osteoarthritis is in the spine. As the body ages, the discs in the spine dehydrate or dry out, and lose their ability to act as shock absorbers. The bones and ligaments that make up the spine also become less flexible and thicken. Degeneration in the discs is normal and is not in itself a problem. But pain occurs when these discs or bone spurs begin to pinch and put pressure on the nearby nerve roots or spinal cord.
The sciatic nerve, is composed of several lumbar nerve roots and can become irritated with a herniated disc. Each of the major branches of sciatic nerve travel through the pelvis and buttocks, down the hip, and along the back of the thigh to the foot. The pain of sciatica ranges from a mild tingling to a sharp ache.
Lumbar spinal stenosis
Degeneration of the spine also can result in lumbar spinal stenosis (LSS). This disease involves a narrowing of the canal that houses the spinal cord and nerve roots. A narrowed spinal canal may compress nerve roots in the lower back, resulting in low back pain, and weakness in the legs. Patients often find relief by sitting or standing in a hunched over position, such as leaning on a shopping cart. Symptoms of LSS do not usually occur until after the age of 50.
Degeneration in the spine also can lead to spondylolisthesis, a condition characterized by the slippage of a vertebra in the spine. One vertebra slips forward over another, stretching or pinching the nerves and causing low back pain.