If you are experiencing a medical emergency, please call 911 or seek care at an emergency room.
The human spine is a miraculous, elegantly balanced system, the foundational support of the entire body. Gently curved in an S-shape, the spine balances the neck, chest, lower back, and pelvis to keep the head, trunk, and legs in alignment.
It provides a protective sheath for the spinal cord—the main conduit of the nervous system—and for some internal organs as well. It provides us with the support structure to maintain an upright posture. And it flexes to allow freedom of movement; in fact, every movement we make engages the spine.
What Causes Back or Neck Pain?
The spine is a stack of 33 vertebrae connected and cushioned by cartilage and connective tissue. These vertebrae are linked by facet joints that, like other joints in the body, can experience inflammation, degradation, and pain. Pain in the back or neck can occur when vertebrae, facet joints, or other spinal components feel the long-term impact of injury, poor posture, inactivity, too much sitting, or certain diseases.
Over time, just about everyone will develop a spinal issue. By age 25, one in four people show some level of degeneration within the discs, pads of cartilage that separate the vertebrae and act as shock absorbers. Two-thirds of adults age 40 show disc deterioration; by age 60, 90 percent are affected.
This progression is a normal side effect of aging and gravity over the years. And, although most adults are affected, not everyone shows symptoms of this degeneration. Often, it only becomes painful once it reaches a severe stage.
But if you’ve ever experienced back or neck pain in any form, or know someone who has, you’ve seen its potential impact on quality of life. With even mild or moderate pain in the back or neck, an individual may have to forgo certain activities, can become increasingly sedentary, or might even have difficulty doing their job. At its most severe, spinal pain may even require a visit to the emergency room. And long-term pain can also spur depression, downheartedness, and other forms of psychological distress.
Most typically, back and neck aches result from muscle strain, weakness, and lack of tone and conditioning due to inactivity, or from the opposite extreme—over-use or over-exertion. Fortunately, when it comes to addressing these more common complaints, a patient can frequently improve back or neck pain by following a simple program of targeted therapy.
Although physical activity and exercise generally benefit good health, most of these activities do not specifically work to strengthen and condition the back. For patients who have sustained a neck or back injury, or who regularly feel some degree of pain and discomfort after certain activities, the best approach to improving their back health is a regular course of physical therapy.
The therapist initially works with the patient to strengthen, stretch, and relax the area and relieve any discomfort from injury or overuse as quickly as possible. Then the patient is counseled on how to continue the regimen at home to keep the back in good condition.
Recommended exercises and other physical movements are simple and constructive, typically requiring only a good exercise mat and a few resistance bands. For regular exercisers and the serious athlete, we may advise an additional level of targeted exercise, to protect and strengthen the neck and back for more specific activities.
Most patients with neck and back pain do not need surgery: targeted therapy can improve their condition. 10 tips for a healthy spine from orthopedic spine surgeon Oliver Tannous, MD. https://bit.ly/3x5SzM9 via @MedStarWHC
10 Tips for Maintaining a Healthy Spine
1. Stretch and strengthen the back
Motivated patients often maintain a steady regimen of targeted stretching and strengthening, which is key to long-term success in managing and controlling spine pain.
2. Maintain a healthy weight
Excessive weight can place undue physical stress on the spine. Also, excess weight can often result in additional diseases or physical conditions that may further impair the spine or intensify existing issues.
3. Don’t Smoke
Nicotine is a vasoconstrictor—it tightens blood vessels, reducing blood flow and limiting oxygen and nutrition to the spine. Vasoconstriction can accelerate inflammation and degradation within the spine and throughout the body.
4. Reduce or eliminate inflammatory foods
Avoid a diet of inflammation-causing dairy, red meats, refined sugar, and other processed foods. Opt instead for healthy anti-inflammatory food choices, such as plant-based foods that are also naturally low in calories and help to discourage excessive weight gain.
5. Take care with heavy lifting
The act of bending to lift a heavy load places a large strain on the spine. Use correct technique when lifting: Keep the back straight, bend the knees, and recruit the power of the legs to complete the lift.
6. Stay in motion
Remaining in one position for an extended time is hard on the spine. Keep the spine activated—for example, if you must sit for long periods at work, take frequent breaks. Move around, walk, and occasionally exercise or stretch to keep your back flexible and limber.
7. Stand whenever possible
Constant sitting makes it nearly impossible to maintain neutral spine alignment—and that can contribute to spinal stress. Standing is frequently the better option. Many of my patients appreciate their stand-up desks. Another alternative: sitting on a large workout ball rather than an office chair, to engage the core and encourage the back to remain erect.
8. Try yoga
Yoga is a highly beneficial activity that can both strengthen and stretch muscles. Beginners should start slow to avoid aggravating any possible existing conditions with the back or neck. The yoga instructor can recommend any necessary modifications that will protect your spine while helping you get the most from each pose.
9. Get into the water
Water therapy can play a very helpful role in alleviating back issues, especially for older patients or those who experience severe discomfort with a land-based approach. Water exercise can be an effective way to build strength and confidence, and pave the way for eventual land therapy.
10. Seek a doctor’s advice
It makes sense to seek medical attention when neck or back pain is persistent—if it flares regularly or never fully dissipates. Your primary care provider will check for numbness, tingling, sciatica, or any other indicators of nerve involvement.
Be assured, in most instances, back or neck pain will not require surgery. Your doctor may refer you to an orthopedic surgeon for further examination, or to a physiatrist, a doctor specializing in pain management.
Comprehensive Care for Your Spine
MedStar Washington Hospital Center features a superb, integrated program for spine health. Our specially trained providers focus primarily on non-surgical approaches to treating and managing back and neck pain.
Our affiliation with the MedStar National Rehabilitation Network gives us access to some of the best physical therapists in the region. For most patients, we can tailor a program of physical therapy that works quickly to improve their condition.
If you’re experiencing persistent neck and back pain, keep in mind that it typically won’t go away on its own. Follow our tips and remember: targeted therapy remains the most effective way to prevent and relieve most neck and back pain and to start you on the path to more pain-free living.