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Back & Neck pain

 

Neck pain

 

Neck (or cervical spine) pain is a common problem in our society, with up to 67% of the population suffering from it at some point in their lives. Physiotherapists are able to treat the signs and symptoms of neck pain through a combination of hands on therapies (including mobilisation/manipulation and soft tissue massage) and postural exercises.

The neck itself is a very complex structure consisting of bones, muscles and ligaments that act to support the weight of the head as well as acting as a passageway for the spinal cord and nerves, blood vessels, airways and oesophagus.

Given the complexity of the area it is easy for things to go wrong, leading to pain or reduced movement in the neck.

Symptoms that you may experience if you have issues with your neck can include:

Headaches:

Usually a dull aching type of headache, rather than sharp, shooting pain. Most commonly the headaches will be felt at the back of the head, however the pain may also radiate to the sides, and even the front of the head.

Muscle Ache:

The neck muscles are sore and may have hard knots (trigger points) that are tender to touch. Pain can be felt up the middle of the back of the neck or it may ache on one side or both sides of the neck.

Stiffness:

Tightness in the muscles or joints of the neck can lead to a reduction in the ability to move the neck in a certain direction.

Nerve Pain:

Issues with the neck can lead to a 'pinching' of nerves in the spine. This can result in pain in the neck that can also radiate down the arms. You may also feel a sensation of pins and needles or tingling in your arms, which can be accompanied by numbness, burning or weakness. This pain is typically worse at night.

Muscle Spasm:

A spasm is a sudden, powerful and involuntary contraction of muscles. The muscles feel painful, stiff and knotted. If you have neck muscle spasms, you may not be able to move your neck at all in a certain direction due to significant pain. This condition is referred to as a 'wry neck' and responds very well to hands-on physiotherapy.

There are many different causes of the above symptoms. Some of the more common ones include:

Facet Joint sprain:

The facet joints are small joints on either side of the spine which join the vertebrae together. 

These joints can be sprained or become locked when placed under stress such as with extreme movements beyond the normal range or with poor posture or when adopting an unusual position of the neck (eg. falling asleep in the armchair)

When one of these facet joints is strained or locked, it will result in restriction of movement (often in only one direction) and pain. This pain is often worse with movement and may be associated with muscle spasms and restriction of back movements.

A common condition is "wry neck" which often occurs in the morning when first getting out of bed or when drying oneself after the shower. It can be quite painful and debilitating and the most common symptom is an inability to turn the head to one side.

Muscle Strain:

Ongoing overuse of your neck muscles (which can be caused by a poor neck position during everyday activities, particularly computer work) can trigger neck muscle strain, causing chronic neck pain and stiffness. The pain is often worse with movement and may be associated with headaches, muscle spasms and restriction of neck movements.

Herniated (Bulging) Disc:

If the tough outside layer of one of the cervical discs tears, the soft, fluid-like centre may bulge outwards - this is known as a herniated disc. Herniated discs can put pressure on nerve roots as they leave the spinal cord causing pain in the neck as well as pain, numbness and weakness in the arms.

Whiplash:

Typically this type of injury will occur in a car accident, but can also be seen on the sporting field. In these instances, the neck is thrust forwards then backwards rapidly, before the muscles of the neck have a chance to control the movement of the neck. This will lead to damage to all of the structures in the neck, including the muscles, ligaments and bones. Due to the potential for ongoing problems after a whiplash injury, physiotherapy treatment is always recommended.

Degenerative Changes (Arthritis):

As we grow older, the soft gelatinous centre of the shock-absorbing discs in our spines dries out. This causes the discs to become narrowed and the distance between the vertebrae to decrease. The development of bone spurs often accompanies this degeneration of the spine. Bone spurs, also known as osteophytes, are small outgrowths of bone tissue that are formed when the cartilage covering bone is worn away and bone starts to rub on adjacent bone. Unfortunately, the bone spur can sometimes pinch or press upon the nerve roots as they leave the spinal canal. Symptoms associated with arthritis in the neck include neck pain and stiffness that often improves with rest. The pain may radiate to the shoulders or between the shoulder blades. If there is nerve root compression, there may be numbness, pain or weakness in the arms.

Poor posture:

As mentioned previously with muscle strain of the neck, poor or prolonged sitting posture can place unnecessary stress on the spinal column, leading to inflammation in the joints of the neck. Usually the pain would worsen as the day or activity goes on and can sometimes be relieved by stretching or exercising. Poor posture can be corrected, but only through specific postural exercises.

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Back pain

 
Back pain can be broken down into two categories:
  1. Lower Back (lumbar spine) pain
  2. Middle Back (thoracic spine) pain

Low back pain is very common with roughly 40% of the population suffering from it at some point in their lives, while middle back pain is also fairly common.

Physiotherapists are able to treat the signs and symptoms of back pain through a combination of hands on therapies (including mobilisation/manipulation and soft tissue massage) and exercises (including stretching, strengthening and Clinical Pilates).

The back is required to undergo many different stresses and strains throughout a normal day and it is for this reason that it is susceptible to injury. Injuries to the back can range from very minor to very severe but can always lead to long-term problems if not addressed correctly.

Symptoms you may experience if you have issues with your back include:

Muscle Ache:

The muscles either side of the spine are sore and may have hard knots (trigger points) that are tender to touch. Pain can be felt up the middle of the back or it may ache on one side or both sides of the spine.

Stiffness:

Tightness in the muscles or joints of the spine can lead to a reduction in the ability to move the back in a certain direction.

Nerve Pain:

Injury to the back can lead to 'pinching' of the nerves as they exit the spinal cord, causing referred pain away from the spine. A common term for this in the lower back is Sciatica.

Muscle Spasm:

Certain conditions of the spine can cause the muscles either side of the spine to go into spasm, which can cause severe pain and restriction in the spine. Muscle spasm will usually occur as a result of injury to a deeper structure of the spine and thus assessment as to why the muscles are spasming is essential.

There are many different causes of the above symptoms. Some of the more common ones include:

Herniated (Bulging) Disc:

If the tough outside layer of one of the thoracic or lumbar discs tears, the soft, fluid-like centre may bulge outwards — this is known as a herniated disc. Herniated discs can (but not always) put pressure on nerve roots as they leave the spinal cord causing pain in the spine as well as pain, numbness and weakness in the legs. Painful muscle spasms are also a very common symptom felt with herniated discs.

Facet Joint sprain:

The facet joints are small joints on either side of the spine which join the vertebrae together. There are facet joints all the way from your upper neck down to your lower back and these joints allow your spine to move.

These joints can be sprained or become locked when placed under stress such as with extreme movements beyond the normal range or with poor posture or poor lifting technique.

When one of these facet joints is strained or locked, it will result in restriction of movement (often in only one direction) and pain. This pain is often worse with movement and may be associated with muscle spasms and restriction of back movements.

Degenerative changes (Arthritis):

Given the amount of stress our spines go under during our lives, it is common to develop arthritic changes in it. This can be in the form of thinning of the protective, shock-absorbing discs or wearing out of the joints of the spine (or both). Symptoms associated with arthritis in the spine include back pain and stiffness that often improves with rest. The pain may radiate to the arms or legs (depending on where the problem exists). If there is nerve root compression, there may be numbness, pain or weakness in the legs.

Poor Posture:

Prolonged sitting in poor postures is a very common cause of back pain in office workers. Sitting in a poor posture can actually put twice the amount of stress through the lower back compared to standing and so those that sit for long periods of the day are at risk of back injuries. Usually the pain would worsen as the day goes on and can sometimes be relieved by stretching or exercising. Poor sitting posture can be corrected, but only through specific postural exercises.

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Treatment:


Both neck and back pain are routinely treated by physiotherapists, who have the skills to identify the cause of the pain and then treat these issues appropriately. Common forms of therapy for these conditions include massage, joint mobilisation, joint manipulation, specific postural exercises/stretches, dry needling and Clinical Pilates exercises. Different people respond to different forms of treatment, hence it is imperative that you have a proper assessment by a physiotherapist to determine what treatment is most appropriate for your specific problem.
 

For more information on the conditions we treat and services we offer, or to book an appointment please call (03)9790 4266 or email: info@think-physio.com.au

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We are happy to answer any questions you have. Call us on (03)9790 4266 or email: info@think-physio.com.au
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