Neck pain is a common problem, with two-thirds of the population experiencing neck pain at some point in their lives.
Neck pain, despite being felt in the neck, can be cause by other numerous spinal problems. These may includepostural abnormalities, muscle tightness originating in the neck or upper back, deep neck muscle weakness or pinching of the nerves emanating from the cervical vertebrae. Joint disruption in the neck creates pain, as does joint disruption in the upper back.
Neck pain may also occur secondary to injury, other health problems, or be referred from other areas or structures of the body.
Physiotherapy is commonly sought out when neck and shoulder pain strikes which can be successfully treated by this approach. The physiotherapist will investigate the pain and determine its cause. There are many different causes of neck pain.
Physiotherapy is very successful at treating the following problems and their causes:
- Postural neck pain
- Shoulder dysfunction/injuries leading to neck pain
- Pinched nerves
- Headaches referred from the neck
- Tension related neck pain and headaches
- Muscular strains
- Acute wry neck (often after waking with a sore, stiff neck)
Treatment of neck pain depends on the cause, but may include:
- Soft tissue massage
- Soft tissue and muscle mobilisation
- Joint mobilisation
- Specific exercise programs
- Postural re-education and ergonomic advice
- Electrotherapy such as TENS and ultrasound
Studies have shown between 60-80% of the general population experience back pain at some point in their lives. Pain can be categorised into neck pain, upper back pain, lower back pain or tailbone pain. It can be a dull ache, a sharp pain, a piercing pain, or a burning sensation.
Non-specific acute back pain with no serious underlying pathology is diagnosed in approximately 98% of back pain patients.
Secondary back pain accounts for ~2% of cases and includes underlying pathologies such as abscesses, metastatic cancer or referred abdominal organ pain. Whilst these pathologies are not the most common underlying cause of back pain
If you are experiencing any of the following symptoms you should consult your doctor immediately:
- Bowel and/or bladder incontinence
- Progressive weakness in the legs
- Difficulty walking
- Severe back pain (such as pain bad enough to interrupt sleep) with other signs of severe illness(i.e. fever, unexplained weight loss, immunosuppressive symptoms)
- Back pain after trauma, such as a car accident or fall may indicate a bone fracture or other injury
- Patients with back pain who have a high riskfor a spinal fracture (i.e. long history of steroid use, osteoporosis, rheumatoid arthritis, or multiple myeloma)
- Patients with back pain with a history of cancer (especially cancers known to spread to the spine such as: breast, lung, and prostate cancer) to rule out metastatic disease of the spine
Physiotherapy and Back Pain
If you do not fall into the above categories it is most likely you are suffering from non-specific acute back pain, which physiotherapy can assist with. Back pain can arise from various structures in the spine
- Muscle tissue including muscles strains (pulled muscles), muscles spasm and muscle imbalances
- The joints of the spine (zygapophyseal/facet joints)
- Spinal disc
Physiotherapy can also help individuals managing other causes of back pain including, sciatica (nerve pain into the leg), spondylolisthesis, osteoarthritis (degenerative joint disease), post surgical back rehabilitation and spinal stenosis.
Treatment for managing back pain may include joint mobilisations, soft tissue mobilisation, massage therapy, heat, ice, electrotherapy, exercise therapy, core stability exercises, Pilates, hydrotherapy, stretches, manipulation if appropriate, and/or neural mobilisation techniques.