Up to 80% of the population experiences neck and/or back pain some time in their lives. However, most of this pain is of a benign mechanical nature. This usually results from persistent and prolonged stress or loading on certain parts of the spinal from bad posture. The pain is not necessarily a consequence of injury or disease.
This issue starts a series on neck and back pain that will include: common causes and myths, how to control neck and back pain,.
You CAN control your neck and back pain. Just stay tuned!

Types of Back Pain

The most common type of back pain originates from the discs. This kind of pain (Let’s call it Type I) is felt most prominently in the low back and buttocks. It may also be felt in one or both legs but the important thing is that the pain is worse in the back and buttocks rather than in the legs.
It is aggravated by bending forward, especially if you have to remain in that position or repeat it many times at work or play. If you have Type I Back Pain, you will feel worse with bending over to brush your teeth, put on your socks, cut your toe nails, or retrieving a golf ball from the cup. You will also feel worse after sitting for prolonged periods of time, such as long car rides or engaging in desk work all day. Doing knee-to-chest exercises, sit-ups, and working out at the rowing machines will also aggravate this pain. The pain can usually be reduced by straightening up, bending backward, walking around and lying down, especially if you lie prone.
When I indicated that the disc is the origin of the pain, I am not trying to paint a picture of a prolapsed disc. The causes of disc-generated pain can range from simple uneven distribution of pressure, to mild bulging, to cracking of the annulus. Discs, like other body parts, will undergo healing. So do not be frightened by the prospect of an injured disc.
People with Type I Back Pain usually respond very well to appropriate treatment.

Loading Your Spine

In most cases, pain in the back and neck occurs not as the result of one specific, isolated incident but as a result of prolonged, sustained and repetitive strain or “loading” on certain parts of the spine. If you can relate the onset of pain to one incident, the latter was probably the proverbial “last straw”. The process started long before that.
To understand this concept of loading, just stick out your left thumb and slowly to pull it back over you left wrist with your other hand. Pull it back until you feel discomfort at the base of the thumb. We are now “loading” this joint. We can increase the loading at this joint and sooner or later cause pain. Another way we can cause pain is to apply only mild pressure but don’t let go for a long time.

If you think about it, this is exactly what we subject our spinal joints to, everyday of our lives, by bending, twisting and assuming bad postures. Some of these movements and postures are required in our work but some are just bad habits. It is no wonder that our neck and back hurt.

The good news is that when we can unload the patient’s painful joint in treatment, relief is surprisingly rapid. It sure is better than taking a pill or lying in bed feeling sorry for yourself. The crucial thing, however, is that your therapist must recognize the type of pain you are experiencing and apply the correct unloading treatment.

Myths About Neck and Back Pain

Despite its commonplace occurrence, there are many myths or misconceptions surrounding common back pain. Here are three examples:

  1. There is no such thing as a “slipped disc”. This commonly used term is simply incorrect. The disc may crack or bulge. This is itself can cause pain. If the crack is severe, the internal core material may be squeezed out and this is then called a prolapsed disc. Yet discs do not slip in and out of place like slippery bars of soap. Be wary of modes of treatment which claim to be able to pop your disc back in place.

  2. In most cases, X-rays offer no valuable information regarding common back pain. Normally, degenerative changes in our spine start occurring in our 20s’, and 95% of people by age 50 show degenerative changes on X-rays. It is incorrect to assume that in all cases, these incidental X-ray changes are causing our back pain. Magnetic Resonance Imaging (MRI) has been overused in attempting to diagnosis common back pain. One research study revealed that only 36% of 98 normal volunteers had completely normal MRI! It is a sophisticated technology which should be used before surgery and to diagnosis non-mechanical back pain.

  3. Less than 10% of neck and back pain sufferers actually have a pinched nerve. The fact that your back pain radiates down to your leg does not automatically mean you have a pinched nerve or sciatica. The pain may simply be what doctors call referred pain. This means that the location of pain is not the location of the source or cause of the pain. A common example is when somebody has a heart attack, the pain can be felt in the neck and down the left arm away from the chest, which is the location of the heart. If it is a pinched nerve, the pain will be most disabling in you legs and arm, not your back and neck. If you find this confusing, don’t worry. As long as your therapist understands and is able to sort out the type of pain you have, he or she can institute effective treatment.

Anatomy of Spine

Back pain is usually associated with the discs, facet joints, nerves, fibres and ligaments of the spine. Muscular pain and spasms are often secondary symptoms. Traditional “passive” therapies such as heat, electrotherapy and massage only offer short-term help, as they do not deal with the primary cause of the pain. If the problem is only muscular then the pain will normally subside within a matter of days.
Discs act as shock absorbers but aging causes them to dry out. Cracks appear and they start to absorb force unevenly, causing bulging and prolapse. It is the resulting pressure on surrounding tissues that causes pain. When there is pressure on the nerves, pain can be felt all the way down to the feet.
Different types and causes of back pain can be identified by examination and for the patient’s history. While most cases do not require sophisticated and expensive investigation, it is of paramount importance to recognize these different patterns of pain in order to initiate proper treatment.