Neck /Back Pain
The cervical spine comprises of the first 7 vertebrae. It supports the weight of the head and allows its smooth movement. Neck pain refers to pain or discomfort resulting from abnormalities or injuries to any of the structures in the neck including the muscles, ligaments, nerves, bones and vertebral joints. Neck pain is one of the most common health problems experienced by individuals, at some point of their life.
Neck pain can either be a dull constant pain or a sudden sharp pain and is usually aggravated by movement. Apart from pain you may also experience muscle spasms, clumsy hand movements, gait and balance disturbances, numbness or tingling sensation, stiff neck, and swelling and tenderness over the affected region. Neck pain may also be associated with headache, dizziness, jaw pain, ringing sensation in the ears, and rarely bowel or bladder problems.
Neck pain may either be localized to the neck or may radiate to the shoulders, upper back, or arms. Cervical radiculopathy refers to the pain that originates in the neck and radiates to the arms.
Neck pain can result from muscle strain or sprain, trauma, poor posture and body mechanics, degenerative diseases, nerve compression, osteoarthritis of the cervical spine, infection of the cervical spine, and spinal tumors.
The diagnosis for neck pain is based on the medical history along with a physical examination and neurological examination. Your doctor will test your sensations, reflexes, and the strength of the muscles. Other imaging tests such as an X-ray or CT scan may also be may be used to confirm the diagnosis and detect any spinal fractures.
In most of the cases, neck pain can be resolved without a surgery. Conservative treatments such as activity modifications, anti-inflammatory and pain medications, muscle relaxants, spinal injections, physical therapy, braces, and chiropractic care may help alleviate pain and associated symptoms. Your doctor may recommend combining two or more therapies to maximize the chances of a successful treatment outcome.
You can prevent or improve your neck pain by following these simple steps:
- Perform relaxation exercises to reduce the undesirable stress on the neck muscles.
- Stretching exercisesshould be performed before and after exercise.
- Maintain a good posture.
- If you work at a computer adjust the monitor to your eye level. Stretch your neck frequently.
- If you use the telephone often, use a headset.
- Use a pillow that keeps your neck straight.
- Wear seat belts and use bike helmets to reduce injuries while driving or riding.
The incidence of back pain has drastically increased. Approximately 90% of Americans experience back pain at different stages of their life. In America, the annual expenditure for the treatment of back pain is approximately $50 billion. Back pain is not a disease; rather it is a symptom due to an underlying pathology.
Pain in the lumbosacral region (lower back) is the most common type of back pain. Back pain may have a variable presentation.
- Pain localized to the lower back or pain radiating down the front, side or back of the legs
- Worsening of the pain with physical activity
- Aggravation of the pain at night or by sustained sitting posture such as long drives
- Numbness or weakness in the legs, which may result in difficulty to stand or inability to perform upward and downward movements of the foot
The common causes of back pain are as follows:
- Abdominal disorders such as appendicitis, kidney diseases, aneurysms, bladder infection, kidney infection, pelvic infection, and ovarian disorders
- Conditions such as pregnancy, due to stretching of ligaments and irritation of the nerves
- Spinal disorders such as herniated disc, spinal stenosis, cauda equine syndrome, fibromyalgia, osteomyelitis and spondylitis
- Inflammation of the spinal nerves
- After back surgery
The diagnosis of the back pain includes medical history, physical examination and use of imaging techniques such as X-rays, MRI scan, CT scan and electromyogram or EMG. In some cases, blood tests such as sedimentation rate and complete blood count (CBC) may be also be ordered.
Management of back pain comprises of rest, improvement in sitting or standing posture and medications. Different classes of medications such as NSAIDs, opioids analgesics, muscle relaxants and steroids may be prescribed.