Back and neck pain

Back and neck pains are among the most common presentations to a physiotherapy clinic.

Fortunately, most occurrences of back and neck pain resolve within a few days, only a smaller percentage being more serious.

Back injuries can be classed as acute or chronic.

Acute back pain generally lasts a few days or weeks, and is often mechanical in nature and caused by some form of trauma e.g lifting a heavy object, a fall, sports injury or prolonged activities such as gardening or sitting in front of the computer.

Chronic back pain last for a longer period of time, generally more than 3 months, and may be more degenerative in nature.

Common causes of back pain include:

• Disc bulge (sometimes called herniated or ruptured disc)
  The disc between the vertebrae may become damaged and bulge slightly, causing pressure on the surrounding nerves. This can cause symptoms of back pain, leg pain, pins and needles and possible numbness. Physiotherapy treatment is usually indicated, and occasionally further investigations such as an MRI scan may be required.
• Sciatica
  Refers to pain originating from pressure or irritation to the sciatic nerve. This nerve exits the spine in the lower back and travels down the leg. Causes of sciatica may include a disc bulge, muscle spasm or poor posture.
• Ligament or joint sprain and muscle spasm
  May be caused by heavy lifting, prolonged bending or sporting injuries. Pain is usually felt in the lower back, sometimes one sided. Movement is often restricted. Physiotherapy treatment for this type of back injury usually gives good results and can reduce recovery time and prevent ongoing problems.
• Postural back pain
  Poor posture can be one of the most common causes of back pain. Sleeping position, work desk set up and standing posture may all be contributing factors. Back pain and injuries are often caused by weak abdominal and back muscles, contributing to poor posture and reduced 'core strength'.
• Degenerative changes
  Back pain and stiffness may develop from 'wear and tear' to the spinal joints and discs. This can be degenerative in nature, be gradual in onset, and may become chronic. Early morning stiffness and pain with prolonged standing is a common complaint.

Physiotherapy treatment

A physiotherapy assessment for back pain will allow accurate diagnosis of the problem, and a treatment plan to be formulated.

Treatment may involve joint mobilisations, massage, stretches, and exercises.

Physiotherapy rehabilitation for a back injury may involve a graded exercise program to strengthen postural muscles and improve flexibility.

Advice on back care, back injury prevention and a strengthening program is a core part of physiotherapy treatment for back pain.