Amanda Rausch, PTA, offers advice for dealing with back and neck pain while at home.

During this time of lock down, many people are finding themselves in a more sedentary lifestyle than they lived before the COVID-19 outbreak. After many weeks of confinement and immobility, they may start to experience restricted movement and stiffness that can easily lead to back and neck pain. That’s why it is so important to intersperse periods of movement throughout the day. The more you move, the better your body mechanics and posture, and the more control you will have over neck and back pain.

PAIN OVERVIEW

Eight out of ten people will suffer from some form of pain at some point in their life. Pain is the body’s way of protecting itself and alerting you to the fact that something is wrong. Back and neck pain can range from a mild, dull, annoying ache, to persistent, severe, disabling pain. Spine pain can restrict your mobility and interfere with your normal functioning and quality of life.

Pain in your back or neck area can be acute, meaning it comes on suddenly and intensely, lasting for a few days to a couple weeks. Chronic pain tends to increase over time, lasting for weeks, months, or even years. This type of pain can be continuous or intermittent. Consult with your healthcare provider or an ONS spine specialist if you experience persistent or increasing pain for more than few weeks.

UNDERSTANDING SPINE PAIN

Anatomy of the Spine

The spine has natural curves creating an “S” shape. These curves allow the spine to act like a coiled spring to absorb shock, maintain balance, and facilitate full range of motion through the spinal column.

The muscles that support and maintain the spinal column fall into two groups, lexors and extensors. The flexor muscles are on the front side of the spine and include the abdominals. The extensor muscles are in the back of the spine.

Both groups perform different functions for the spine. Flexors allow you to bend forward and flex. They also assist when you lift objects to stabilize the low back. Extensors allow you to stand up straight and they assist with lifting objects as well. When both muscle groups work together, they stabilize the spine.

SOME CAUSES OF BACK AND NECK PAIN

Even with today’s technology, the exact cause of back and neck pain is difficult to determine. In most cases, the cause includes any of the following:

• Overuse, strenuous activity, or improper use, such as repetitive or heavy lifting
• Poor muscle tone
• Muscle tension or spasm
• Sprain or strain
• Ligament or muscle tears
• Trauma, injury, or fractures
• Infection
• Abnormal growth, such as a tumor or bone spur
• Obesity, which places increased pressure on your spine, and discs
• Joint problems, such as arthritis
• Smoking
• Dehydration
• Protruding or herniated (slipped) disk and pinched nerve
• Osteoporosis and compression fractures
• Congenital (present at birth) abnormalities of your vertebrae and bones
• Abdominal problems
• Degeneration of vertebrae, often caused by stresses on the muscles and ligaments that support your spine, or the effects of aging
• Emotions: Stress, Depression, Anxiety, etc.

SYMPTOMS ASSOCIATED WITH PAIN IN THE BACK 

Symptoms associated with back pain may include:

• Dull, burning, or sharp pain in the back.  The pain can be confined to a single spot or cover a large area
• Leg numbness or tingling above or below your knee from any side
• Stiffness or achiness that occurs anywhere along your spine (from your neck to your tailbone)
• Sharp, shooting pain that radiates from your low back to your buttocks, down the back of your thigh, and into your calf and toes
• Consistent ache in the middle or lower part of your back, especially after standing or sitting for an extended period

Loss of bladder and bowel control, with weakness in both legs, are symptoms of a serious condition that requires immediate medical attention.

SYMPTOMS ASSOCIATED WITH NECK PAIN

• Headaches, Migraines
• Shoulder pain
• Arm numbness or tingling than can radiate part way down the arm or all the way to the finger tips
• Sharp shooting pains or a dull ache in your neck that can radiate the length of the neck or down the upper back

BACK AND NECK PAIN SELF-TREATMENT

If you experience acute back or neck pain, it may simply improve with some rest. Over-the-counter medicines can also help with the discomfort. It may seem counter intuitive, but you should try to move gently during this time to avoid stiffness and lose mobility. It becomes more difficult to decrease pain when you stop moving for too long.

If you have acute or chronic pain of your back and neck, there are several remedies you can try that may help. These include:

• Hot or cold packs; for better results it’s best to alternate hot and cold. However, wait for the affected area to return to your normal body temperature before alternating packs
• Specific exercises to strengthen muscles and ease pain, such as stretching, extending and flexing
• Mild aerobic exercise such as walking at a normal pace
• Certain anti-inflammatory medications or muscle relaxants may be used, with your Doctor’s supervision

MANAGING PAIN IN THE BACK AND NECK

Acute back pain usually resolves on its own. Acetaminophen, such as Tylenol®, or ibuprofen, such as Aleve®,will decrease the pain and help you rest. Surgery and special exercises are generally not used with acute pain.

For severe, disabling, or chronic back and neck pain, a physical therapist can develop a program designed specifically to meet your needs and lifestyle goals. The type of program will depend on the type and severity of your pain, injury, or disease.

The goal of back and neck rehabilitation is to help you manage the pain, return to your highest level of functioning and independence possible, while improving your overall quality of life. The focus of physical therapy is to relieve pain and improve mobility (movement). Surgery is always the last option for treatment of pain relief.

To help reach these goals, back and neck rehabilitation programs can 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
• Pain management techniques (breathing exercises and mindful awareness)
• Gait (walking) and movement retraining
• Stress management
• Ergonomic assessments and work-related injury prevention programs
• Body Mechanics and Posture training
• Proper lifting techniques: avoid heavy lifting; when you do lift something, bend your legs, keep your back straight, and then slowly lift your body and the object
• Ergonomics for telephone and computer use and other equipment
• Correct posture while sitting, standing, and sleeping

BREATHING AND MINDFULNESS EXERCISES

It’s always important to remember to breath when doing exercises especially when having pain. I always suggest starting with breathing exercises before doing any other physical exercises. It will help you build a better tolerance when going for a walk or doing the neck or back exercises. You can do these exercises laying down or sitting. It’s important to have your back be fully supported while seated or your spine  straight when laying down.

You may be self-conscious if you are new to these types of exercises, but it’s important to be fully relaxed.  Allow your stomach to expand and contract without resistance for best results. Try to visualize your breathing cycle and how it affects your body while completing these exercises.

BREATHING BEST PRACTICE

When first starting to work on breathing exercises, you can either place one hand on your chest and one on your stomach or you can place both hands on your stomach, whichever is most comfortable for you.

With any exercise, if you start to feel pain going down the arm or leg stop immediately and rest.

Posture and Transfers

If you have increased pain in the back or neck, supporting the spine is very important with transfers and with posture.

Getting out of Bed: The proper transfer is the log roll. Turn to the side without rotating or twisting the spine then put legs over the edge before pushing yourself up.

Bed positioning– If you sleep on your back, support your neck with a neck pillow and place a second pillow under your knees to support your low back.  If you tend to sleep on your side, use a neck pillow to support your neck and place a second pillow between your knees. This helps to relieve the pressure from your hips and low back.

Sitting posture: Working or reading while sitting. You want your computer screen at comfortable eye level and keyboard lowered to comfortable level using an extra keyboard if needed to keep straight neutral posture. When reading, don’t slouch and hold the book higher to eye level.

When looking at your phone, keep in mind that for every inch that your head flexes forward, you add 10 lbs of pressure to your neck. The pressure from the head going forward leads to compression on the nerves in the back of the neck and can start causing pain down the neck and into the arms and upper back.  Looking at your phone for long periods can also contribute to disc degeneration and neck arthritis.