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Triggers and Treatments for Neck and Back Pain

Doctor Q&A

Pain Specialist with the Shawnee Mission Center for Pain Medicine

Does your job have you at your workstation most of the day? If so, you may be at risk for neck or back injury over time. Many people underestimate the importance of ergonomics in the workstation until they experience pain. Neck or back pain can seem to creep in out of nowhere and can be a result of how you’ve been sitting at work over a long period of time.
When your pain is severe or long lasting, it’s time for a diagnosis—and a complete treatment plan.

Pain Triggers

There are numerous types of neck and back pain—and just as many possible triggers. The symptoms can range from nagging to debilitating and often originate from lifting something too heavy, twisting or stretching your back or neck muscles, or straining your posture by using the computer, watching TV, or reading a book for extended periods of time.

Where’s the pain coming from?

About 40 – 50 percent of the workforce has missed work because of axial lower back pain. The axial region involves your head and spinal column, where many of your body’s sensory nerves reside.
Axial neck or back pain can result from a torn muscle or a stretched or partially torn tendon. The pain can come from anywhere in the neck and vertebral column and could include the disc, facets, vertebral body end plates, or muscles. Although mechanical problems, such as compression fractures, have an inflammatory component, they’re different from inflammatory conditions, such as arthritis, and are usually easier to treat. Mechanical pain is also different from sciatica, which causes pain to radiate to the arms or legs.
In some cases, axial pain is inherited and can stem from both genetic and lifestyle predispositions such as posture, activity levels, and nutrition. Carrying stress across your neck and shoulders can cause axial pain, and depression may play a role as well. In fact, physicians and psychologists at the Center for Pain Medicine often identify and treat depression as a contributing factor for neck and back pain.

How’s the pain treated?

Some neck and back pain can be healed at home with rest, ice, and time; other pain may require medical attention. If you have a minor muscular injury, it should begin feeling better within a week or two, but if your pain lasts longer than three weeks, there may be underlying chronic reasons for your pain, which should be assessed by a physician.
If conservative treatments such as stretching, exercise, and physical therapy don’t help, your doctor may recommend an over-the-counter pain reliever or prescribe pain treatment. If you have a particular muscle injury, small trigger-point injections and local anesthetic can be used to break up muscle spasms and help relax the tight areas. Flexibility exercises, strength training, heat, ultrasound, massage, and yoga to increase circulation to the injured area may also help to reduce pain.

Why is help important?

The long-term goal is twofold: Relieve immediate pain and resolve chronic pain before it can lead to permanent changes in your central nervous system. Contrary to what you might think, chronic pain doesn’t make you less sensitive to pain; it makes you more sensitive to it. Research has shown that constant pain to the central nervous system can cause structural changes. Untreated chronic pain can cause your spinal cord to grow additional neuro-connections, which amplify the pain response.
After successful treatment, the focus is on preventing a recurrence of the pain through strength and flexibility training, activity modification, and ergonomic education.

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