Neck and back pain strikes men and women of all ages regardless of ethnicity, employment or medical history. Chronic back pain is so common, in fact, it has been identified as the leading cause of disability worldwide, according to the American Chiropractic Association.

Back and neck pain leads to millions of lost work days each year and is the most common reason for calling in sick. This leads to lost wages and productivity, with repeated absenteeism also posing a barrier to advancement in employment, reports the chiropractic association.

Almost all people experience significant back pain at some time in their lives, explains Steve Mayer, a back specialist with MountainStar Comprehensive Spine Center. Mayer says many patients endure back pain for years without finding relief.

A serious medical condition

Some believe back problems are primarily a matter of discomfort rather than a serious medical issue. But Mayer notes for many patients, the pain can be chronic and debilitating. Furthermore, a Swedish study published by the National Institutes of Health (NIH) looked at 4 million Swedes and found “an increased risk of premature death among both women and men . . . because of musculoskeletal diagnoses” involving neck and back pain.

And a Spanish study found that “Those who reported frequent pain in the neck and low back were 44 percent more likely to be absent for more than 30 days in the past year than those who did not report these symptoms.”

Back and neck pain comes from diverse causes

These high numbers of back and neck pain sufferers indicate a serious problem worldwide, but with no easy solution. The causes of pain are so varied that it can be difficult to differentiate each cause from another, diagnose the principal contributor and treat the problem. Often, the cause of the pain can come from more than one source with some sources being more serious than others.

"My job is to evaluate each patient thoroughly and to then determine the cause of the pain," Mayer says. "If we can find a source for the discomfort, then we have a much better chance of finding a solution. Sometimes finding the right treatment or combination of treatments is all that is needed to get back on track and start the healing process."

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A variety of treatment options

Many who suffer from spinal problems mistakenly believe the only treatment options are painkillers and surgery. In reality, effective treatments vary depending on the source and severity of pain and on the specific patient.

"I often have patients who work with a skilled physical therapist while also receiving spinal injections. Other times the combination might be muscle relaxers and massage therapy. Combining therapies can create a synergy effect, meaning one plus one equals five," Mayer says. "Lifestyle changes can also be quite helpful. Many patients have developed habits that actually intensify their symptoms. Sometimes I act as a coach to help patients be the best version of themselves."

Here are some common causes of neck and back pain and possible solutions.

Poor posture

How a person sits or stands can strain soft tissues and increase muscle tension.

Solution:

• The UK National Health Service recommends strengthening the muscles that help maintain a proper posture. Practice exercises that strengthen your core, buttock and back muscles. Avoid leaning on one leg or hunching your back when texting or typing. When you use a computer screen, adjust it so it is at the right height, allowing you to look straight ahead at it and not up or down.

Sleep problems

A pillow that is too thick or too flat will cause you to sleep in uncomfortable positions. “A pillow is supposed to position your head so that it’s in a healthy, neutral position,” the National Sleep Foundation (NSF) explains. “That means your nose is in line with the center of your body or spine.”

Stomach sleeping is another cause of nighttime neck pain. “When you sleep on your stomach, you have to twist your head and neck to the side, which can put pressure on nerves,” the foundation states. “Converting yourself to side or back sleeping may help you wake up pain-free.”

Sometimes, neck pain at night may be caused by arthritis. This is a chronic condition that requires care from a physician. Studies have shown that people affected by rheumatoid arthritis have more sleep problems than healthy adults and “sleep disruptions may increase a person’s likelihood of experiencing enhanced sensitivity to pain,” according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Solution:

• Try different pillow and mattress combinations. Your doctor can also suggest techniques for managing your pain and improving sleep quality.

Injuries

Neck and back pain may be related to sports injuries or physical trauma. Sports injuries are often the product of overuse, improper technique, lack of conditioning or stretching and trauma.

Whiplash is another common trauma that may cause neck or back pain. It occurs as a result of an action that causes the head to whip forward or backward suddenly (as in a car accident). The symptoms of whiplash might not be evident until a day or more after the initial trauma, according to WebMD. When pain begins, it may involve stiffness, headaches, dizziness, fatigue or shoulder pain, but because it is an injury to soft tissues, it cannot be seen on standard x-rays.

Solutions:

• Education is the first step in preventing and treating sports-related neck and back pain. People who play sports or participate in other physical activities should warm up before play, learn proper body mechanics for their sport, pay attention to aches and pains and stop before they become over-tired.
• When an injury occurs, the North American Spine Society recommends rest, followed by gentle exercise. “Initially, ice and medications such as nonsteroidal anti-inflammatories can be used. For persistent symptoms, particularly those associated with muscle spasm, heat may also be very helpful,” the Society explains.
• A more serious cause of back pain in athletes may involve defects in the spine (spondylolysis) or the slippage of vertebra (spondylolisthesis). These injuries can be treated with physical therapy and targeted exercises that strengthen abdominal and back muscles, according to WebMD. Pain that worsens or does not resolve over time may require a surgery that immobilizes the joint by fusing it with adjacent bones.

When symptoms are more serious

There are many other sources of back and neck problems that can only be diagnosed by a doctor. Your doctor will want to know if your pain suddenly worsens or slowly worsens over time with no improvement, if it doesn’t respond to treatment or if you feel tingling or numbness.

"Because I have had the experience of working with a neurosurgeon, I recognize certain red flags that come up during the examination," Mayer says. "Two of the most common conditions that require surgery are a compressed nerve that could lead to nerve damage or spinal instability. These conditions are not necessarily easy to determine without a thorough examination. If I am worried about the possibility of nerve damage, I will send the patient out for a neurosurgical consult."

Even when patients experience chronic, severe pain or show indications of nerve damage, that doesn't mean surgery is necessary. Mayer says he always starts with more conservative treatments before considering more invasive procedures.

"Ultimately, knowledge is power. When we gather information from the exam and possibly other tests, then we can discuss the problem and begin to focus on solutions," Mayer says.

For fast back pain relief, you can be seen at a MountainStar Comprehensive Spine Center within 1-2 business days.

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