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Neck and Low Back Pain

Neck pain may occur from muscle strain or tension from everyday activities including poor posture, prolonged use of a computer and sleeping in an uncomfortable position. Low back pain is often a common symptom of many disease conditions and the back pain may range from simple or dull pain to sudden and sharp pain. 

Neck Pain

What is Neck Pain?

Neck pain may occur from muscle strain or tension from everyday activities including poor posture, prolonged use of a computer and sleeping in an uncomfortable position.

Cervical Anatomy

The first 7 vertebral bones of the spinal column form the cervical spine in the neck region. The neck bears the weight of the head, allows a significant amount of movement, and is less protected than other parts of the spine. All these factors make the neck more susceptible to injury or other painful disorders. 

Causes of Neck Pain

The most common cause of neck pain is injury to the soft tissues (muscles, ligaments or nerves) or prolonged wear and tear. Traumatic accidents or falls and contact sports can cause severe neck injuries and pain. Neck pain can also occur from infections, tumors or congenital abnormalities of the vertebrae. The common conditions producing neck pain include:

  • Rheumatoid arthritis: It is an autoimmune disease in which the body's immune system attacks healthy joints, tissues, and organs. The condition occurs most often in the upper neck area, causing inflammation of the lining (or synovium) of joints, and resulting in neck pain, stiffness, swelling, and loss of function.
  • Cervical disc herniation: disc herniation is the bulging or rupture of the soft fibrous disc that cushions the vertebrae. The soft central portion called nucleus pulposus bulges out through the tear in the capsule. Cervical disc herniation refers to the herniation of the discs in the cervical spine region or neck region. The condition can be caused by normal aging or by traumatic injury to the spine. The condition results in painful, burning, tingling or numbing sensations in the neck. 
  • Cervical spondylosis: Cervical spondylosis refers to the abnormal degeneration of the cartilage and bones in the neck region. The condition results in neck pain radiating to arms or shoulder and neck stiffness that gets worse over time.
  • Cervical stenosis: Cervical stenosis refers to the narrowing of the spinal canal that protects the spinal cord and its branching nerves. The condition causes neck pain radiating to your arms and hands. 
  • Degenerative disc disease: Degenerative disc disease refers to the gradual deterioration of the disc between the vertebrae and is caused due to aging. As people age, intervertebral discs lose their flexibility, elasticity and shock absorbing characteristics, resulting in neck pain. 

Diagnosis of Neck Pain

The diagnosis of neck pain is made with a review of your history, physical examination and other imaging techniques including electromyography (EMG), X-ray, MRI scan, CT scan, blood tests, and bone density assessment. 

Treatment Options for Neck Pain

The treatment options for neck pain may include rest, ice application, use of a soft neck collar and neck immobilization using a splint, cast or sling. Medications such as anti-inflammatory drugs, analgesics, and muscle relaxants may be prescribed to reduce pain and inflammation. Certain stretching and strengthening exercises may be recommended to strengthen the neck muscles. 

Surgical treatment by anterior cervical discectomy with spinal fusion is typically recommended only after non-surgical treatment methods fail to relieve the pain. An anterior cervical discectomy is a surgical procedure performed to remove a herniated or degenerative disc in the cervical (neck) spine. Spinal fusion may be performed to provide stability to the spine. 

Prevention of Neck Pain

The following steps may help you prevent or improve your neck pain:

  • Practice relaxation exercises to prevent undesirable stress and tension to the neck muscles.
  • Perform stretching exercises for your neck before and after exercise.
  • Maintain good posture if you work at a computer and adjust the monitor to your eye level. Stretch your neck frequently. 
  • If you use the telephone a lot, use a headset. 
  • Use a pillow that keeps your neck straight.
  • Wear seat belts and use bike helmets to reduce injuries.

Low Back Pain

Low Back Pain

Low back pain is often a common symptom of many disease conditions and the back pain may range from simple or dull pain to sudden and sharp pain. If the pain persists for a few days, it is acute pain whereas if it continues for more than 3 months, it is considered as chronic pain. In most cases, low back pain may resolve without any treatment, however, if it persists for more than 3 days, medical intervention is necessary.

Low back pain may be a common symptom in various conditions such as appendicitis, aneurysms, kidney diseases, kidney and bladder infections, ovarian disorders, pregnancy, nerve root syndromes such as sciatica, herniated discs, spinal stenosis, musculoskeletal problems, osteomyelitis, spondylitis, tumors, spine injuries, fractures, and many more.

Low back pain can be alleviated with rest and RICE (Rest, Ice, Compression, and elevation) treatment, pain relievers, non-steroidal anti-inflammatory drugs, corticosteroids, and physical therapy. However, certain conditions causing severe pain may require surgical treatment. Treating the underlying conditions offers relief from back pain.

Causes of Low Back Pain

One of the common causes of low back pain is a low back strain. Low back strain or lumbar strain occurs when the muscle or the tendon in the lower back gets stretched or torn. It is caused by lifting heavy objects or overload, sitting or standing for a longer time, direct blow over the area, or sports such as basketball, baseball, or golf that involve sudden twisting of the lower back, can also lead to strain.
The risk factors such as excess low back curvature, weak abdominal muscles, and forwardly tilted pelvis can increase the risk of this injury. The common symptoms include low back pain that radiates down to the buttocks; inflammation of the soft tissues that surround the muscles; stiffness in the lower back; restricted movements; inability to maintain correct posture; muscle spasms; and pain which continues for a longer period.

Diagnosis of Low Back Pain

Your doctor will perform a physical examination and take a brief medical history to diagnose your child’s condition. Other additional tests such as X-ray and MRI scan may be required to confirm the injury and provide necessary treatment.

What are the Treatment Options?

Conservative treatment methods include:

  • Rest: Your child should take complete rest for 1-3 days, as more damage could result from putting pressure on the back. Prolonged bed rest should also be avoided as it leads to loss of muscle strength and makes the muscles stiff which will aggravate pain and discomfort. Hence bed rest should not be continued for more than 48 hours.
  • Ice packs can be applied to the injury which will help to diminish swelling and pain.; Ice should be applied over a towel to the affected area for 15-20 minutes four times a day for several days. Never place ice directly over the skin.
  • Braces or belt might be used to support the back while the healing happens.
  • Medications that may be prescribed include non-steroidal anti-inflammatory drugs to reduce pain and inflammation. Other medicines such as muscle relaxants control muscle spasms. These medicines often cause sedation; therefore, consult your doctor to discuss the type of muscle relaxants for your child.
  • Your doctor may also suggest a rehabilitation program for your child. It consists of stretching and strengthening exercises, pelvic traction, gentle massages, and ice or heat therapy to improve your child’s condition. It helps to control the pain, strengthen the abdominal muscles, and also speeds up the recovery which allows your child to return to the weight-bearing activities.

Prevention

Some of the preventive measures which can help prevent back strain in children include:

  • Doing warm-up exercises before the start of any physical activity or sports and taking short breaks in between the activity.
  • Ensure that your child uses correct lifting techniques such as squatting to lift a heavy object.
  • Ensure that your child maintains a proper posture while sitting and standing.
  • If your child is overweight or obese, it can strain the back muscles. Hence, it is advised that your child lose some weight and maintain a healthy diet.
  • Encourage your child to exercise every day as it improves spine stability and also prevents extra stress on your child’s back.
  • Texas A&M University
  •  Harvard Medical School
  • University of Texas Medical Branch
  • Loma Linda Medical Center
  • Baylor College of Medicine
  • University of Washington Medical Center
  • Mischer Neuroscience Institute
  • UT Health
  • North American Neuromodulation Society
  • International Association for the Study of Pain
  • American Academy of Pain Medicine
  • Harris County Med Society
  • Texas Medical Association
  • Texas Pain Society
  • Spine Intervention Society
  • American Socieyt of Interventional Pain Physicians
  • American Society of Regional Anesthesia
  • Memorial Hermann
  • International Neuromodulation Society
  • American Society of Pain & Neuroscience