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Introduction
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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