General Neck and Back Pain

Image of the side of the spinal column showing the cervical curve, the thoracic curve, the lumbar curve, the sacrum and the coccyx

Both neck and back pain are usually caused by injury to the muscles or ligaments of the spine. Sometimes the disks that separate each bone of the spine may cause pain by pressing on a nearby nerve. Back and neck pain may appear after a sudden twisting or bending force (such as in a car accident), or sometimes after a simple awkward movement. In either case, muscle spasm is often present and adds to the pain.

Acute neck and back pain usually gets better in 1 to 2 weeks. Pain related to disk disease, arthritis in the spinal joints, or narrowing of the spinal canal (spinal stenosis) can become chronic and last for months or years.

Back and neck pain are common problems. Most people feel better in 1 or 2 weeks, and most of the rest in 1 to 2 months. Most people can remain active.

People have and describe pain differently.

  • Pain can be sharp, stabbing, shooting, aching, cramping, or burning

  • Movement, standing, bending, lifting, sitting, or walking may worsen the pain

  • Pain can be limited to one spot or area, or it can be more generalized

  • Pain can spread upward, downward, to the front, or go down your arms or legs

  • Muscle spasm may occur.

Most of the time mechanical problems with the muscles or spine cause the pain. It's usually caused by an injury, whether known or not, to the muscles or ligaments. Pain without an injury is not common. But it can sometimes be caused by a health problem such as kidney stones or an infection. Pain is usually related to physical activity such as sports, exercise, work, or normal activity. Sometimes it can occur without an identifiable cause. This can happen simply by stretching or moving wrong, without noting pain at the time. Other causes include:

  • Overexertion, lifting, pushing, pulling incorrectly or too aggressively.

  • Sudden twisting, bending or stretching from an accident (car or fall), or accidental movement.

  • Poor posture

  • Poor conditioning, lack of regular exercise

  • Spinal disc disease or arthritis

  • Stress

  • Pregnancy, or illness like appendicitis, bladder or kidney infection, pelvic infections

 Home care

  • For neck pain: Use a comfortable pillow that supports the head and keeps the spine in a neutral position. The position of the head should not be tilted forward or backward.

  • When in bed, try to find a position of comfort. A firm mattress is best. Try lying flat on your back with pillows under your knees. You can also try lying on your side with your knees bent up towards your chest and a pillow between your knees.

  • At first, don't try to stretch out the sore spots. If there is a strain, it's not like the good soreness you get after exercising without an injury. In this case, stretching may make it worse.

  • Don't sit for long periods, as in long car rides or other travel. This puts more stress on the lower back than standing or walking.

  • During the first 24 to 72 hours after an injury, apply an ice pack to the painful area for 20 minutes and then remove it for 20 minutes over a period of 60 to 90 minutes or several times a day. 

  • You can alternate ice and heat therapies. Talk with your healthcare provider about the best treatment for your back or neck pain. As a safety precaution, don't use a heating pad at bedtime. Sleeping with a heating pad can lead to skin burns or tissue damage.

  • Therapeutic massage can help relax the back and neck muscles without stretching them.

  • Be aware of safe lifting methods and don't lift anything over 15 pounds until all the pain is gone.

Medicines

Talk to your healthcare provider before using medicine, especially if you have other medical problems or are taking other medicines.

  • You may use over-the-counter medicine to control pain, unless another pain medicine was prescribed. Talk with your doctor first if you have chronic conditions like diabetes, liver or kidney disease, stomach ulcers, gastrointestinal bleeding, or are taking blood thinner medicines.

  • Be careful if you are given pain medicines, narcotics, or medicine for muscle spasm. They can cause drowsiness, and can affect your coordination, reflexes, and judgment. Don't drive or operate heavy machinery.

Follow-up care

Follow up with your healthcare provider, or as advised. You may need physical therapy or further tests.

If X-rays were taken, you will be told of any new findings that may affect your care.

Call 911

Call 911 if any of the following occur:

  • Trouble breathing

  • Confusion

  • Very drowsy or trouble awakening

  • Fainting or loss of consciousness

  • Rapid or very slow heart rate

  • Loss of bowel or bladder control

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Pain becomes worse or spreads into your arms or legs

  • Weakness, numbness or pain in one or both arms or legs

  • Numbness in the groin area

  • Trouble walking

  • Fever of 100.4ºF (38ºC) or higher, or as directed by your healthcare provider

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