Five Main Causes of Neck & Back Pain

By Hunter Tam
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:

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.

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.

Neck Anatomy
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.

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.

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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