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Symptoms and Remedies: Neck and Back Pain

Posted Dec 20 2008 5:56pm

There are simple ways to bring relief and a few important signs that indicate when it’s more than a simple strain.

What is it?

Most everyone at one time or another develops pain in the neck or in the back. Usually, an activity brings on the pain, and the pain typically improves with rest. There are simple ways to bring relief and a few important signs that indicate when pain is more than a simple strain. Chronic pain usually gets worse despite bed rest, wakes you in the middle of the night, progresses despite medication and interferes with daily activity.

How bad is it?

Pain is a very good messenger. It tells us that something is wrong. The more mysterious it is, the more likely it is to be significant, either by itself or as an indicator of some other condition. Back and neck pain come in all degrees; from a brief, mild ache after a day of painting the ceiling to a crippling years-long misery that defies potent pain-relievers, intense physical therapy and even surgery.

What causes it?

Most back and neck pain is easily recognized as the result of overdoing some activity. It is amazing what the human body can be trained to do, but it is equally amazing how incapable it is of doing something it is not accustomed to.

There are two categories of strain that cause nearly identical pain - acute and cumulative. We all know what weekend warriors feel like on Monday morning, whether they just dug up the garden or began the tennis season. But there is a more insidious type of strain that takes many days or even months to notice. Cumulative stress injuries (CSI) in the workplace are now being recognized as major causes of disability and work loss. The human body is not used to the many activities required of us today. Probably the first CSI to be recognized was the pitcher’s elbow in baseball. Little leagues won’t let children pitch more than a few innings because of the strain it puts on their arm.

Another more common CSI is carpal tunnel syndrome, often the result of hours a day at a keyboard. The back and the neck can suffer similar strains by remaining in certain positions for long periods. The whole science of ergonomics has been developed to prevent these repetitive stress injuries by designing furniture and appliances that place body parts in the optimum position for working.

Not knowing immediately what brought on your current discomfort is the first warning sign to take a pain seriously. Some pains that seem to be coming from the spine are actually referred there from elsewhere inside the body. For instance, a sick gall bladder can masquerade as a strain of the mid-back and usually hurts just beneath the right shoulder blade. Heart attacks can mimic neck pains that pinch nerves going into the left arm.

Other symptoms that accompany the pain are more clues. Some of the most important are related to all nerves that pass through your spine on their way between the brain and the rest of your body. These nerves send feelings in one direction and movement commands in the other. If either of these functions - feeling or movement - is disturbed, something serious is happening. Numbness is the most common failure of feeling, and weakness is the most common disturbance of movement. Certain changes in feeling such as tingling, burning or extreme sensitivity are also signs of nerve problems. Paralysis is the extreme form of weakness. The urinary bladder can also be affected by nerve damage related to back pain. So if your back pain comes with inability to control urinating, there is likely to be a significant relationship between the two.

How do I know I have it?

The important question is: How do you know what is causing it? If your pain is clearly related to what you are doing and has no peculiarities like numbness or weakness associated with it, chances are it’s just mechanical strain. But you should see a doctor for any pain that lasts more than a few days without improving, that has no obvious cause, that gets worse without provocation or that has associated symptoms.

What can I do about it?

If you decide to seek professional care for unusual spinal pain, first get a competent diagnosis from a doctor. This may require X-rays or special scans (CT or MRI) to identify unusual and serious causes such as tumors or bone and joint disease. When nothing beyond mechanical strain can be found, the first and foremost intervention is a good posture and exercise program. Secondly, for the more serious mechanical spinal pains, such as whiplash neck injuries and chronic low back pain that is crippling, a variety of helpful and sometimes controversial treatments are available. Osteopathic/chiropractic manipulations and acupuncture have helped some patients but have also failed in others. The foundation for treatment remains an accurate diagnosis.

Starting new activities

Your body is able to do extraordinary things but not all at once. Remember two things about any physical activity:

  • If you are in generally good shape, new activities will be better tolerated.
  • Begin any activity gradually.

The first point doesn’t require more than common sense - 15 to 30 minutes a day of anything that tires you out is good. Swimming is close to ideal because you use everything at once, without being able to overuse or abuse anything. Water provides resistance without being as hard on the joints like pavement.

When starting new activities, you should start slowly and briefly. But each beginning should be preceded with a warm-up. Jog in place. Stretch the muscles you will be using. Plan your time.

Points to remember

  • Nearly all back and neck pains are because of unwise over-activity.
  • If you pay attention, your pain will tell you how serious it is.
  • Seek medical advice if there is anything unusual about your pain.
  • Stay in good shape and use common sense when beginning new activities.

Updated on 06/25/2008SOURCES: The American Academy of Orthopedic Medicine , American Pain Society

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