Tuesday, January 26, 2021

Back and neck pain

Back and neck pain is a common condition that affects all age groups. It is estimated that back and neck pain affect 80% of the population at some time of their life. It is more common in industrialized and modern societies while it is much less prevalent in agricultural and primitive societies because of the difference in life style. In some estimates, the direct and indirect cost of back pain diagnosis and management to the American society is up to 100 Billion U$ annually.

Back and neck pain can start with or without injury, sudden movement or excessive activity. It can be in the cervical (neck) region, dorsal region, and lumbar or sacral (lower back) area. It can radiate from the neck region to the head, shoulders, and upper extremities. It can radiate from the lumbar (lower back) region to the buttocks and to the lower extremities.

CAUSES of back and neck pain can be due to worn out spine discs and joints, muscle spasm, nerve pinching, slipped disc or vertebra. It can also be due to simple causes like weak muscles and poor posture with lack of fitness. Risk factors for back and neck pain include lack of physical fitness, weak muscles, overweight, smoking, and sitting on office chair for long durations. Operating or driving certain machines or vehicles (like trucks or SUVs) can also be a risk factor. Most women in last months of pregnancy will have lower back pain.

PRESENTATION is usually there is limitation of movement with pain, tenderness and muscle spasm weakness or numbness

DIAGNOSIS (identifying of the causes) of back and neck pain is by  carful history taking, clinical examination, and  x-ray, MRI, and sometimes other tests like nerve testing and blood tests.

TREATMENT of back and neck pain depend on the clinical diagnosis and test results. Most of the treatment initially is conservative (non-surgical), which include rest, pain medications and reevaluation. If the pain is severe, associated with muscle weakness, numbness in the upper or lower extremities, further treatments are needed. This includes injections or surgery. If the patient is having weakness in the extremities or loss of bowel or bladder control, then they should immediately seek medical care because this indicates that there is severe nerve compression and will need emergency treatment.

PREVENTION is by avoiding and minimizing the risk factors above, exercise regularly, maintain normal weight and proper sitting position.

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