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It’s not a matter of whether you’ll tweak your back or neck; it’s a matter of when. According to the National Spine Health Foundation, more than 100 million Americans report back and neck pain annually, with one in five cases progressing from acute to chronic pain—defined as pain lasting longer than 12 weeks.
“You have to realize that your back is precious,” says Dr. Andrew Will, founder and medical director of Twin Cities Pain Clinic. “One of the most vulnerable parts of our body is our spine, and you don’t really appreciate it until you know what it’s like to hurt it…. It only takes one bad day.”
That one bad day—perhaps the result of overdoing it while bending over to pull weeds in your garden, fixing household appliances in awkward positions, or lifting heavy objects using power generated by your back instead of your legs—can sometimes be the inciting incident for further back and neck pain. But Will says there are other factors at play when it comes to spinal injuries, including age, genetics, and autoimmune conditions. “Eventually, time catches up with us,” Will says. “You have to be willing to change, and you can’t always do the same stuff at 60 that you could do at 20.”
So how do we care for our spine and prevent pain conditions that debilitate our everyday motion? Ahead, experts divulge some of the top causes of back and neck pain, innovative treatments and technologies, and the best ways to prevent injury.
Photo courtesy of Twin Cities Pain Clinic
Dr. Andrew Will, Twin Cities Pain Clinic
“A lot of people are blessed to live long lives these days, and they realize that having a quality of life and not being in miserable pain all the time is important.”
–Dr. Andrew Will, Twin Cities Pain Clinic
Unraveling the Knots
10 of the most common causes of back and neck pain.
The neck and lower back are especially sensitive segments of the spine, experts say, since they’re the most mobile, making them more susceptible to injury and pain. But back and neck pain have a number of culprits. Here are some of the most common causes of that pesky pain.
Muscle and ligament strain
Something as simple as sleeping on an unfamiliar mattress or twisting your back into an unusual position can put strain on your spine. “Most of the time, it can be a muscle strain that gets better on its own,” says Dr. Leslie Hillman, a physical medicine and rehabilitation physician at HealthPartners.
Posture-related strain
Slouching, slumping, and sitting with your neck pushed forward (we’re looking at you, chronic computer users!) can cause pain in the lumbar and cervical spine, causing rounded shoulders, body aches, muscle fatigue, and headaches.
Ruptured or pinched disks
Human spines contain 25 disks (seven cervical, 12 thoracic, five lumbar, and one sacral), which act as cushions between our bones, says Dr. Cody Foster, a pain management doctor at Nura Pain Clinic. “Soft material in those disks can bulge out or rupture and press on nerves, which can cause pain,” Foster says. When this happens to a disk specifically in the lumbar spine, it may pinch spinal nerve roots, causing sciatica, shooting pain in your lower back, tushy, and legs. Other causes of sciatica include a herniated disk and bone overgrowth (AKA bone spurs).
Compression fractures
As we age, our bones weaken, making them more prone to osteoporosis and breakage. A not-so-fun fact: Vertebral compression fractures are almost twice as common as other osteoporosis-linked fractures, such as broken wrists and hips, according to the American Academy of Orthopaedic Surgeons. Compression fractures are most common in the thoracic and lumbar spine.
Arthritis
Spinal arthritis—involving the deterioration of cartilage between the facet or sacroiliac joints between the spine and pelvis—may be caused by a number of conditions, including general wear and tear, autoimmune disorders, and genetics, and it leads to inflammation, pain, and stiffness.
Spondylolisthesis
“This is a condition that occurs when one vertebra slips either forward or backward from the one above or below it,” Foster says, “which can cause pain in some of the joints in the back as well as can cause some of that narrowing—that spinal stenosis.”
Spinal stenosis
Any condition involving the narrowing of spinal or nerve root canals in the cervical, thoracic, or lumbar spine is defined as spinal stenosis. This spinal narrowing compresses nerves, mostly as a result of age-related and arthritis-induced wear and tear, causing weakness, cramps, and pain in the mid and lower back. Spinal stenosis with neurogenic claudication can cause your back to curve forward in what experts call the “shopping cart sign.” “When you lean forward, it opens a space for the nerves,” says Dr. Todd Jackman, a board-certified orthopedic spine surgeon at the Midwest Spine and Brain Institute. “As nerves get pinched, your spine naturally leans forward and tries to relieve that pain.” Treatments including the MILD, Vertiflex, and Minuteman procedures can effectively treat spinal stenosis using minimally invasive techniques.
Radiculopathy and peripheral neuropathy
A pinched or inflamed nerve (AKA radiculopathy) can cause tingling, numbness, weakness, and pain. Neuropathy, or peripheral neuropathy, results from damage to nerves in the peripheral nervous system, including in diabetic neuropathy, chemotherapy-induced neuropathy, autonomic neuropathy, and focal neuropathy. Earlier this year, Abbott received U.S. Food and Drug Administration (FDA) approval to use spinal cord stimulation to treat diabetic peripheral neuropathy. Its application to peripheral nerves advances avenues for migraine and complex regional pain syndrome relief.
Herniated disk
The disks in your spine have two parts: a marshmallowy center (nucleus) and a rubbery exterior (annulus). When the nucleus pops through a tear in the annulus, it causes pain, numbness or tingling, and weakness.
Sacroiliac joint pain
“The sacroiliac joint is where your pelvis and your spine come together,” says Dr. Louis Saeger, a pain management specialist at Premier Spine and Pain Clinics and senior instructor of the Spine Intervention Society. “It’s an area that can produce, literally, a pain in the butt.” Individuals who’ve had previous spinal fusions in their lower back often develop a sacroiliac joint problem later as a result of increased mechanical forces that are absorbed by that joint, leading to arthritic changes. “That’s an area that can be overlooked,” Saeger says.
Learn the Terms
A look at your spine and the different areas that can cause concern.
Illustration by Shutterstock
Spinal terms
This Is a Pain in the…Back?
How to tackle back and neck pain.
So you’re experiencing some back and neck pain. What do you do? Who do you call? Don’t panic! Here’s how experts recommend addressing the pain.
Ice, heat, and anti-inflammatory painkillers
If your pain isn’t a result of an emergency situation (such as in the case of motor vehicle accidents, which are a common cause of back and neck pain), start with conservative treatments, including ice/heat, rest, and anti-inflammatory painkillers, such as ibuprofen or naproxen, Hillman suggests.
Acupuncture or massage
Sometimes, back and neck pain may be a result of muscle aches and strains. If painkillers aren’t helping, consider alternative approaches, such as acupuncture or a massage.
Physical therapy
For more than a decade, Minnesota physical therapists who have been licensed for at least a year have been able to accept self-referrals for appointments regarding back and neck pain, making them a great resource for pain lasting more than a couple of weeks. “Most people would do better if they start with physical therapists, because they can actually assess them, give them some treatment, then rule out red flags and figure out if they need a doctor, and then touch base with a doctor,” Hillman says.
Digital imaging scans
If pain persists for more than four to six weeks, it’s time to make an appointment with your doctor, who may recommend digital imaging scans, such as X-rays or magnetic resonance imaging (MRI) scans, to determine the best course of treatment.
Interventional pain specialists
Based on diagnostic workups, your general practitioner may refer you to an interventional pain specialist, whose expertise rests with treating long-lasting, chronic pain. “That’s my goal, is to listen to the patient, figure out the specific source of pain,” Saeger says.
Photo courtesy of Premier Spine and Pain Clinics
Dr. Louis Saeger, Premier Spine and Pain Clinics
“The sacroiliac joint is where your pelvis and your spine come together. It’s an area that can produce, literally, a pain in the butt.”
–Dr. Louis Saeger, Premier Spine and Pain Clinics
Aching Body, Weary Mind
How to address the mental—and physical—consequences of pain.
Pain has profound impacts on physical health, but it also can take a toll on mental health. According to the American Psychiatric Association, 35 to 45 percent of people with chronic pain experience depression, and they’re more than three times as likely to develop an anxiety disorder. “A lot of people are blessed to live long lives these days, and they realize that having a quality of life and not being in miserable pain all the time is important,” Will says.
Cognitive behavioral and biofeedback therapies can help patients alter their pain perception, improve their coping strategies, and control their response to stress. At many pain clinics, such as Nura, pain therapy is an essential part of the healing process.
“It’s really the holistic, that multimodal approach, that has been shown to be the most effective way to treat chronic pain,” Foster says.
Photo Courtesy of Nura Pain Clinic
Dr. Cody Foster, Nura Pain Clinic
“It’s really the holistic, that multi-modal approach, that has been shown to be the most effective way to treat chronic pain.”
–Dr. Cody Foster, Nura Pain Clinic
Strengthen Your Spine
How to prevent back and neck pain in the first place and find freedom in mobility after spine injuries, procedures, and treatments.
Foremost spinal anatomist Frank Willard points out that in American culture, there’s a four-letter word that many people avoid: W-A-L-K. “We do everything we can to avoid walking,” Saeger says. We park as close to the supermarket entrance as we can. Office workers are more sedentary than ever. Driving has largely replaced biking. “Walking is an exercise that the human body is designed to do,” Saeger emphasizes.
Like most doctors advise, it’s important to maintain a healthy weight, a healthy diet, and healthy habits. “Smoking is bad for many aspects of your health,” Foster says, “but it also reduces blood flow to your lower spine and can cause your disks to degenerate more quickly [compared] to nonsmokers.”
In addition to moving your body regularly, experts recommend working to strengthen your core (including abdomen and back muscles) and to gain more flexibility by regularly stretching.
Simple everyday exercises, such as crunches and planks; prioritizing “motion as lotion” by regularly walking; and being gentle with how you treat your back and neck can ensure your spine stays strong for years to come.
This article originally appeared in the September 2023 issue of Mpls.St.Paul Magazine.
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Twin Cities Pain Clinic, Multiple Twin Cities locations, twincitiespainclinic.com
Nura Pain Clinic, Edina, nuraclinics.com
