UNDERSTANDING NECK AND LOWER BACK PAIN

Everything you wanted to know about neck and lower back pain, as explained by Dr.Alan Cheung of International Orthopaedic Clinic – from the do’s and don’ts to the best way to treat and manage it.

What are the most common causes of neck and lower back pain that we should know of?

Spine pain is commonly caused by a prolapsed or ‘slipped’ disc. In between the bones (vertebra) of our spinal column we have a fibrous disc, which can tear when subject to certain forces. This tear is painful and worsened when the softer inner layer bulges out, irritating and sometimes pressing on surrounding nerves. Slipped discs can sometimes occur through a sudden forceful activity, such as lifting weights at the gym, but are more often due to damage accrued over time, bad posture, and working habits and weak muscles around the spinal column.

Another very common cause of spinal pain is pain from the facet joints which help stabilize the spine. These tend to cause a more localized pain which is worse on rotational movements.

Meanwhile, nerve compression can cause a pain in the neck which radiates to the shoulder or down the arm, or in the lower back characterized by a pain that radiates to the buttock and down the back of the leg. If the disc prolapse is severe, sometimes you may feel a ‘pins and needles’ sensation or numbness, and weakness in your limbs.

Is it true that this type of pain is more apparent when you get older?

Most people, at some point in their lives, will experience lower back pain. As we age, the structures in our spine unfortunately degenerate and you are more likely to have chronic spine pain as you get older. However, spine pain can commonly affect adults of all ages, from the young athlete who is trying to deadlift 160kg, to the office worker who spends 12 hours a day in a slouched position in front of their screen.

By instinct, we sometimes try to stretch and “crack” the pain away. Does this help?

If you have severe spinal pain, I wouldn’t recommend trying to cure it by yourself. Currently, most medical doctors would refer patients with back and neck pain to a manual therapist, such as a physiotherapist or osteopath. There is research to suggest that manipulation and mobilization of the spine can help reduce symptoms of spinal pain. If your pain persists, then an MRI scan of the injured area is recommended to exclude uncommon, but sinister causes like a tumor and infection.

Would you recommend going for a massage?

A gentle massage can relieve muscle tension temporarily but does not cure the underlying cause. Usually, the pain will come back again after a few hours or the next day.

At what point should we consider seeing a doctor?

Most people come to see me when the pain is severe, disabling, and has not been relieved by other methods, such as TCM. After asking a series of questions and examining the spine, I will typically arrange an MRI scan and prescribe medication and physiotherapy.

What happens if physiotherapy does not work?

If your pain is due to a severe disc prolapse, then you may need surgery under general anaesthetic to decompress the affected nerve. If the prolapse is less severe, or your facet joints are the cause of the pain, you can undergo various pain management techniques which are performed as a day case under sedation.