Tips for Managing Neck and Back Pain

September 29, 2022

Neck and low back pain are common complaints as we age. Increasing use of computers and smartphones can exacerbate these aches and pains.

University Hospitals orthopedic spine surgeon, Christina Cheng, MD, shares her advice for treating and preventing neck and low back pain, and when to call a specialist.

What causes back or neck pain?

Low back and neck pain can come from a number of places. Most commonly, it can be from straining the muscles that support the spine. This can result from heavy lifting or overexertion. Back and neck pain can also come from deeper spinal structures, such as arthritis of the joints, degenerative disc disease or disc herniation, and pinched nerves. Often, back and neck pain are caused by a combination of the above.

How do you diagnose the source of back or neck pain?

Typically, we start with a history of the symptoms and a physical examination. Imaging can also be a valuable tool and may include an X-ray or an MRI. X-ray allows us to visualize your bones to look for fractures or arthritis or scoliosis. An MRI allows us to evaluate the finer anatomy of your spine, such as the nerves and discs.

How can I best manage my back or neck pain?

In many cases back and neck pain resolves with conservative care within a matter of weeks. This may include rest, alternating ice and heat, the use of anti-inflammatory medications (such as ibuprofen) and other medications that help to relax the muscles of the spine. Physical therapy, chiropractic care and massage therapy can also be helpful.

Some people find electrical stimulation and acupuncture to be of benefit as well. In many cases steroid injections under X-ray guidance can also assist in reducing back and neck pain and expedite a return to normal activity. These injections or cortisone-like shots can also help narrow down the cause of the pain in some cases.

Can this pain be prevented?

Yes and no, like many illnesses the cause of back and neck pain can be the result of both our genes and lifestyle. For example, people born with scoliosis (a curvature) of the spine, may be more likely to struggle with spine-related pain over the course of their lives, particularly if this condition is left uncorrected. People who have physically demanding jobs or who are overweight may be at greater risk to develop back and neck pain over the course of their lives.

For many people as they approach their fifth and sixth decade of life, the best way to prevent spine-related back and neck pain is through moderate and consistent low-impact exercise routines. Activities such as yoga, stretching, walking, and swimming can be helpful for some. Other preventive tools include good hydration, a balanced diet and maintaining a healthy weight.

When should I be concerned about needing surgery to help with my pain?

Barring a serious injury to the spine or spinal cord, surgery is typically a treatment of last resort for back or neck pain. Generally, surgery of the spine is indicated for uncontrolled radiating arm or leg pain that is not responding to less invasive treatments. In some cases, surgery is necessary because of the severity of pain and/or the progressive nature of the symptoms or the findings on diagnostic imaging. Some of the other indications for surgery include spinal instability, spinal cord compression and muscle weakness.

For most patients with back or neck pain, the pain can be managed without the need for surgery.