Neck and Back Pain

 

Symptoms relating to problems in the neck and back are by far the most common reasons for a person to present for physiotherapy treatment. We successfully treat these conditions daily at our clinic. The neck and back areas are comprised of an intricate network of different structures, which adds to the complexity of these conditions. The vertebrae, which form the boney structure of the spine, protect the spinal cord. The joints between the vertebrae and their supporting ligaments, muscles and tendons allow multi-directional movement. The discs in between the vertebrae act as shock absorbers and further facilitate movement. Therefore correct identification of the tissue or structure that is causing the problem and accurate diagnosis is essential to ensure that the most effective treatment plan is put in place. Following the assessment process, the physiotherapy treatment for back and neck problems may include:

• Manual joint mobilisations
• Spinal manipulations
• Mechanical or manual traction
• McKenzie exercise programmes
• Electrotherapy modalities
• Trigger point dry needling
• Soft tissue techniques and massage
• Prophylactic management (postural and ergonomic advice, manual handling instruction, flexibility and core musculature conditioning programmes, back care advice and self management)

The common causes of neck and back pain can include strains of the joints between the vertebra due to ligament strain, muscular strains and spasms, disc lesions including bulges and herniations/prolapses, sciatica arising from pressure on or irritation of the sciatic nerve roots by a disc lesion, poor posture, degenerative changes of the joints or discs due to general ‘wear and tear’, traumatic injuries such as whiplash or vertebral fractures, and acquired conditions and diseases such as osteoarthritis, rheumatological conditions (such as Rheumatoid Arthitis and Ankylosing Spondylitis), osteoporosis and structural problems such as scoliosis (a sideways curvature of the spine). Whilst acquired conditions which cause neck and back pain cannot be ‘cured’ by physiotherapy, physiotherapy intervention, through a combination of reducing pain and improving movement and strength, can significantly improve function and thus quality of life. In this way, patients can more effectively manage their condition, continue to remain active and minimise the effect on their everyday life.

Whilst most types of back and neck pain respond well to conservative or non-surgical intervention, microscopic back surgery is indicated for a small category of patients with severe back or leg pain and/or neurological symptoms due to a prolapsed disc that does not resolve with conservative measures (physiotherapy, medication and rest). We aim to identify this small percentage of patients early, to ensure that valuable time and expense is not spent pursuing this course of action and that they are referred promptly back to their GP for further investigations and onward management. For this patient group, the most important aspect of their physiotherapy management is their post-surgery rehabilitation, to ensure that the best outcome is achieved and that they return to their pre-morbid status speedily.