Research indicates that, on any given day, approximately
10% of adults must cope with neck pain. When young
adults develop acute neck pain it is usually the
result of turning awkwardly during the night, or
playing a sport which requires quick neck movement
such as squash. Lifting things improperly can also
cause neck pain. Middle aged people are more likely
to develop neck pain as a result of the normal degenerative
changes of the discs and facet joints of the cervical
spine.
There are five main causes of neck &
back pain:
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| 1.
Strains and/or sprains account for the majority
of neck & back problems. |
| If
you are suffering from a strain and/or sprain you
will likely have reduced mobility in one or more
directions. Positions that demand extreme ranges
of motion - particularly rotation - will increase
your pain. So will any kind of jarring move. Usually,
there are no neurological signs which means no nerves
are damaged. The majority of back pain is caused
by strains and/or sprains of the back's muscles,
ligaments and tendons. Because so many of us lead
inactive lives, our muscles become lax and lose
their ability to support the spine properly. After
time, the ligaments and tendons can also lose
their ability to function properly. If you've
ever doubted how much pain muscle strain can cause,
try holding a very heavy dictionary in your outstretched
arm for five minutes!
Poor posture over many years, especially for those
of us who spend a lot of time sitting, puts enormous
strain on the spine. In some cases, a person bends
over to pick something up and the sudden exertion
sends the muscles into spasm. But just as often,
back pain creeps up slowly. You may suffer from
backache after strenuous activity. Or in the morning.
Or after sitting, or standing in one position
for an hour or more. In these cases, poor posture
is generally as much to blame as an inactive lifestyle.
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| 2.
Disc problems are most common in Neck & Back
pain patients under the age of 40. |
| If you have
a disc problem, flexion, and rotation toward the
side on which the disc is bulging, or herniated,
most often causes the most pain. On rare occasions,
however, a disc will bulge, or herniate, centrally
rather than to one side; in this case, rotation
will not increase the pain. In extreme cases,
a centrally herniated disc may effect bowel or
bladder function. This is a medical emergency,
which may require immediate surgery.
The discs between the vertebrae can also be involved
in back pain. Two things can happen. Most commonly,
the disc's outer casing, called the annulus, weakens.
When this happens, the disc bulges, irritating
a nearby nerve. Less often, the centre portion
of the disc actually bursts, or herniates, through
a tear in the annulus and pinches a nearby nerve.
This may cause severe leg pain if the herniation
occurs in the lower portion of the spine. This
is often called sciatica. In fact, patients with
herniated discs are far more likely to complain
of leg pain than back pain. Most people who suffer
from a herniated disc are under the age of 40.
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| 3.
Patients suffering from spinal stenosis are most
often over the age of 45. |
| Spinal
stenosis patients generally find that extension
- prolonged extension in particular - aggravates
their back problem. In general, spinal stenosis
causes chronic rather than acute pain. Many people
find it difficult to walk any distance unless they
learn how to adjust their posture so that they do
not walk with their low back extended. This can
be done by assuming the pelvic tilt position as
a normal walking posture. As we age, the discs
begin to dry out slightly and become thinner.
This natural process is sometimes called disc
degeneration. When this occurs, other problems
sometimes arise: the space in the vertebrae through
which the nerves exit can become narrow, causing
the nerves to be irritated. This condition is
called spinal stenosis. Most people with spinal
stenosis are over the age of 40.
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| 4.
Facet joint problems are more difficult to categorize
in terms of age but most often, these patients are
over the age of 40. |
| Prolonged
extension tends to increase facet joint problems.
Most people tend to suffer from chronic rather than
acute pain. If they do experience an acute flare-up,
however, rotation usually increases the pain dramatically.
The onset can often help distinguish facet joint
syndrome from stenosis although further diagnostic
testing may be required. As we age, our facet
joints may also become slightly misaligned, especially
if our posture has been poor for many years. When
this happens, they can eventually become worn.
This condition is known as facet joint syndrome.
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| Osteoarthritis
patients are generally over the age of 45. |
| If
your problem fits into the category of osteoarthritis,
itís likely that extreme ranges of motion
will increase your pain. So will vibration and compression
- for example, jumping up and down. The onset is
often different, however. For example, strains and
sprains usually hurt immediately after an injury
occurs. The pain caused by osteoarthritis generally
develops more slowly. Sometimes, it is not felt
until the next day. As the wearing process described
above continues, our bodies try to compensate
to make our spines more stable once again. For
instance, where a disc is attached to the vertebra
above and below it, osteophytes - little growths
of bone - begin to form. Similarly, osteophytes
often appear around the facets joints. When this
happens, the condition is called osteoarthritis,
which is very different from other, more severe
types of arthritis that sometimes leave people
crippled. In fact, by the time we reach middle
age, most of us have mild osteoarthritis that
causes some backache from time to time. Eventually,
however, osteophytes make the spine more stable,
although less flexible, and the pain tends to
subside.
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