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UR Medicine


Back Pain

For more information, please visit our Integrated Spine Care site or our Neuromedicine Pain Management Program site

What is low back pain?

Low back pain can range from mild, dull, annoying pain, to persistent, severe, disabling pain in the lower back. Pain in the lower back can restrict mobility and interfere with normal functioning.

What is neck pain?

Neck pain is pain that occurs in the area of the seven cervical vertebrae in the neck area. Because of its location and range of motion, the neck is often left unprotected and subject to injury.

Pain in the back or neck area can be acute, which comes on suddenly and intensely, or chronic, which can last for weeks, months, or even years. The pain can be continuous or intermittent.

What causes back and neck pain?

Even with today's technology, the exact cause of back and neck pain can be found in very few cases. In most cases, back and neck pain may be a symptom of many different causes, including any of the following:

  • overuse, strenuous activity, or improper use such as repetitive or heavy lifting
  • trauma, injury, or fractures
  • degeneration of vertebrae, often caused by stresses on the muscles and
  • ligaments that support the spine, or the effects of aging
  • infection
  • abnormal growth such as a tumor or bone spur
  • obesity due to increased weight on the spine and pressure on the discs
  • poor muscle tone
  • muscle tension or spasm
  • sprain or strain
  • ligament or muscle tears
  • joint problems such as arthritis
  • smoking
  • protruding or herniated (slipped) disk and pinched nerve
  • osteoporosis and compression fractures
  • congenital (present at birth) abnormalities of the vertebrae and bones

How can back and neck pain be prevented?

The following may help to prevent back and neck pain:

  • practice correct lifting techniques
  • use telephones and workplace computers and other equipment properly
  • maintain correct posture while sitting, standing, and sleeping
  • participate in regular exercise (with proper stretching before participation)
  • avoid smoking
  • maintain a healthy weight
  • reduce emotional stress which may cause muscle tension

Rehabilitation for back and neck pain:

A back and neck pain rehabilitation program is designed to meet the needs of the individual patient, depending upon the type and severity of the pain, injury, or disease. Active involvement of the patient and family is vital to the success of the program.

The goal of back and neck rehabilitation is to help the individual to return to the highest level of function and independence possible, while improving the overall quality of life - physically, emotionally, and socially. The focus of rehabilitation is on relieving pain and improving mobility (movement).

In order to help reach these goals, back and neck rehabilitation programs may include the following:

  • exercise programs to improve range of motion, increase muscle strength, improve flexibility and mobility, and increase endurance
  • help with obtaining assistive devices that promote independence
  • patient and family education and counseling
  • pain management techniques
  • smoking cessation counseling
  • gait (walking) and movement retraining
  • stress management
  • nutritional counseling
  • ergonomic assessments and work-related injury prevention programs
  • vocational counseling

Generally, there are three phases to back and neck pain rehabilitation. These include the following:

Phase I: Acute Phase During this initial phase, the physiatrist and treatment team focus on making a diagnosis, developing a treatment plan, and starting treatment to reduce the pain and inflammation. This may include some of the items listed above and possibly the utilization of ultrasound, electrical stimulation, or special injections.
Phase II: Recovery Phase Once the initial pain and inflammation are reduced, the rehabilitation team then focuses on helping the patient restore function. This includes returning the patient to normal daily activities, while starting an exercise program that is designed to help the patient regain flexibility and strength.
Phase III: Maintenance Phase The goal of this phase is two-fold: educating the patient on ways to prevent further injury and strain to the back and neck, and helping the patient to prevent further injury by improving strength and endurance.

The back and neck rehabilitation team:

Back and neck rehabilitation programs can be conducted on an inpatient or outpatient basis. Many skilled professionals are part of the back and neck rehabilitation team, including any/all of the following:

  • orthopaedist/orthopaedic surgeon
  • neurologist/neurosurgeon
  • physiatrist
  • internist
  • rehabilitation nurse
  • registered dietitian
  • physical therapist
  • occupational therapist
  • social worker
  • exercise physiologist
  • psychologist/psychiatrist
  • recreational therapist
  • case manager
  • chaplain
  • vocational counselor