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CAUSES OF PAIN
As stated earlier, many people
experience neck and back discomfort at sometime in their lives.
Problems can occur suddenly after an accident or injury, or
may occur as the result of a slow, gradual process due to lack
of exercise or poor posture. Incorrect posture throws the head
forward and puts a tremendous amount of stress on the muscles
in the back of the neck and upper shoulders. Muscles in this
position maintain a constant state of contraction, resulting
in injury and subsequent discomfort. Poor sleeping habits, poor
work habits, and tension can all contribute to this problem.
While tension is not often the primary cause of back and neck
pain, it can certainly worsen pain and make you more prone to
injury.
Also, as outlined in the exercise
section of this brochure, failure to exercise opposing muscle
groups can also result in neck and shoulder pain. The imbalance
of muscle strength can cause chronic or sporadic tension and
tightness in these areas. Some other specific conditions that
can lead to muscle deterioration and pain may include a sedentary
lifestyle, obesity, and general lack of muscular tone. A healthy,
pain-free neck also depends on the condition of your upper back.
Because the neck and upper back share the same muscles, the
strength and flexibility of the shoulders and upper back muscles
are important for keeping the neck balanced.
Pain is also generated when muscles
go into spasm. While such a spasm may occur as a protective
reflex, it intensifies discomfort by reducing circulation and
setting up an inflammatory response. Stress of any kind, physical
or emotional, may cause spasms in underexercised muscles. Lastly,
pressure or "pinching" of the nerves in the spine
can cause severe pain that can radiate (travel) down the back
and leg.
SERIOUS SYMPTOMS
While dull aches can be annoying
and even ignored, severe pain or pain accompanied by other symptoms
may indicate a serious underlying disease that requires medical
attention. If you have any of the following symptoms associated
with pain in your neck or back, you are urged to seek medical
assistance:
- Fever — May indicate an
infection.
- Frequent, painful or bloody
urination — May indicate a kidney problem.
- Leg pain traveling down to
or below the knee — May indicate a possible disc problem.
- Numbness, tingling, weakness
or loss of bladder or bowel control — May indicate a
nerve or disc problem.
- Persistent pain that hasn't
improved and can not be relieved — May indicate a serious
back disorder or injury.
SEEKING HELP
If you have any of the symptoms
listed above or have other concerns about your neck or back,
you are encouraged to consult with a medical provider. Evaluation
of your problem may include a discussion and review of your
medical history, a physical examination and diagnostic tests.
To be a better health care consumer,
you should prepare for your appointment in advance. You may
want to make a written, chronological history of your problem
with accurate descriptions of your symptoms. You may also want
to prepare a list of questions in advance. By letting your provider
know you have prepared these, it may help ensure that you have
an exchange of communication and that all of your concerns and
questions are addressed.
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Your provider should let you know
the advantages and disadvantages of all recommended tests, procedures
and treatments and give you an idea (or prognosis) of outcomes,
especially if extensive drug therapy, physical therapy or surgery
may be required. If your provider refers you for tests or additional
consultation, you should also be aware of the financial obligations
you may incur. Talk with the provider's office or your insurance
company, if you have coverage, about filing a claim or payment
expectations.
SELF-CARE
Self-care and treatment can be
responsibly done under the consultation of a medical provider.
The following are some safe and effective methods, but remember,
if your back still hurts after a week of self-treatment, seek
medical advice.
Application of heat or ice
Apply heat and/or ice in a way
that makes you most comfortable. To relieve initial pain, you
may want to apply ice packs wrapped in towels for 10 minutes
every two hours for the first one or two days. Then you may
apply heat or ice. Always make sure you have a cloth of some
type between your skin and the ice, to prevent freezing the
skin and frostbite. It is not recommended that you lie on an
ice pack. Since back sprains and strains don't usually cause
much swelling, some people find moist heat, such as a hot shower,
tub bath, wet towels, or hot water bottle, to be more effective
than ice. Limit heat to 15-20 minutes every few hours. Too much
heat can make you feel drained and tired, rather than relaxed.
Massage
Massage helps increase the blood
flow to your muscles, improves muscle tone and helps your muscles
to relax. Classes are often offered for massage training and
there are resources such as books and handouts available to
teach proper massage technique.
Medication
Pain relievers, such as acetaminophen,
ibuprofen and aspirin can help reduce pain. Be aware that products
such as these can cause stomach irritation for some people.
Take all medications in the dosages and time schedules recommended
on the label.
Rest
Try to lie comfortably in a well-supported
bed. The best position for your back is on your side with the
knees bent. A pillow between the knees may also help increase
comfort. Another good resting position is on your back with
a pillow underneath your knees. Lying on your stomach or flat
on your back with your legs straight out are not recommended
positions.
Exercise
Once your pain subsides, do the
exercises outlined in this brochure. A bit of initial discomfort
is normal, but if you avoid exercise for too long, your muscles
will stiffen and weaken and may cause you more problems in the
future. If you experience any significant pain, stop immediately
and seek medical attention. Gradually increase the amount, intensity
and frequency of exercise as tolerated. Do not perform any exercise
with pain that is increasing or not improving.
Stress and Tension Management
Techniques, such as progressive
muscular relaxation, exhalation breathing, meditation and guided
imagery can help create a more relaxed body that is receptive
to healing. You might want to seek out a class or book on one
of these topics. Soothing music played on a stereo or radio
and resting your body and mind may also be beneficial.
Recreational Activities
Some activities can be helpful
in toning and stretching muscles while reducing the possibility
of further injury. Swimming, walking, and water walking are
recommended. Conversely, some activities can cause problems
if done before symptoms are gone and strength, flexibility and
conditioning are restored. Avoid tennis, golf, bowling, racquetball,
diving, high-impact aerobics, and other activities that combine
sudden bending and twisting.
SUMMARY
You are not alone if you suffer
from back and neck pain and related problems. Restoring your
body to optimal conditioning with proper exercise and prevention
measures will help ensure an active life. Consultation with
a medical provider may be necessary for some individuals. The
staff of McKinley Health Center hopes that you will be safe,
happy and healthy while you are a student at the University
of Illinois. We encourage you to come to the health center and
learn about the services available to you. And, we hope that
you do not have any serious back or neck problems or injuries
while here; but if you do have a need for assessment or care,
do not hesitate to visit us.
- REFERENCES:
- American College Health Association.
(1990). Oh, my aching back! Rockville, MD: Author.
- Instructions for patients,
4th edition. H. Winter Griffith, M.D. W. B. Saunders Co. Philadelphia,
PA: 1989.
- Back pain prescription: Out
of bed and into the gym. The Physician and Sports Medicine,
Vol. 17, No. 9. September, 1989.
- Posture perfect performance.
The Physician and Sports Medicine, Vol. 14, No. 6. June, 1986.
- Kennedy, C., and Legel, D.
Anatomy of an exercise class: An educator's handbook. Sagamore
Publishing. Champaign, IL: 1992.
- Phillips, G., and Clippinger-Robertson,
K. Has the bend been banned? Aerobics and fitness. January/February,
1987.
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