To explore all about neck and back pain I will try to answer the following questions: What is neck and back pain? What causes neck and back pain? What causes stiff neck and back pain? Can neck and back pain cause Headaches? Can neck and back pain cause vertigo? Are neck and back pain connected? Why do I have neck and back pain? Why do I have pain in my neck and back when looking down? Why do I have neck and back pain when sleeping? Who do I see for neck and back pain? How to relieve neck and back pain?

According to Physicians Weekly , “it is generally believed that about $90 billion is spent on the diagnosis and management of low back and neck pain each year. An additional $10 to $20 billion annually is attributed to economic losses in productivity”. This is, therefore nothing new to most Americans and certainly not to me given the nature of my specialty being Chiropractic, Postural Neurology and Developmental Kinesiology (Functional Movement). These are essentially what most of my patients ask me and this blog should cover most if not all of your questions bear in mind that the cause of almost all neck and lower back pain is muscle-skeletal so keep that in mind as this blog will be all about that!

What is neck and back pain?

As you suspected, it is pain in the neck and back and your back is not just your lower back. While your neck and lower back are at the opposite end of your spine, they are actually connected. Let me ask you something! Stand up right now and make sure you are straight! That means do not slouch, nor stick your chest out. Now I want you to naturally bring your neck forward as if you are slouching; do you see how you shifted your pelvis so your stomach sticks out?

So you can see that the position of your neck, plays a role in your center of gravity (brings it forward) and therefore positions your lower back differently. So in essence, one leads to the other and it does not have to start with the neck causing the lower back pain. Obviously, your neck and upper back are connected and you can’t have an issue in one without causing stress on the point, muscles and alignment and posture of the other; it is only a matter of time before one leads to the other!

What causes neck and back pain?

The causes of neck pain vary and depends on the individual but the list can start from previous injuries, sports or other types of accidents, lifestyle (sitting behind computer or devices, or just sitting jobs), habits such as sleeping or ending the day watching TV, propping the head to read or look at the laptop to navigate social media, laying on the couch to watch TV and so much more. It can be a combination of any of what I listed. One thing to remember is that the day your neck and back pain came is not the day the neck and back pain started! This is the number one mistake that most people make.

What causes stiff neck and back pain?

Generally speaking, stiffness has to do with arthritic changes BUT here is the newsflash: Arthritis is NOT a by-product of aging but a direct result of misalignment! That means, you don’t have to be old to have arthritis and the general notation of arthritis being age-related had to do with the fact that in the old days, older people would go to the doctors, get x-rays and we would see arthritic changes on the x-ray.  BTW, this has to do with the most common type of arthritis, Osteoarthritis, Degenerative Joint Disease, or DJD. There are other types of arthritis that are hereditary such as Gout, Psoriasis, Rheumatoid Arthritis which can be found from blood work up while showing signs on the x-rays.

So the conclusion was that arthritis is seen in the elderly because back in those days, we would not see younger people with issues!! Now, that is a different story! The age of our patients is getting younger and younger and that is when we realized we were mistaken all along!!

• What is the cause of Arthritis?

Let me answer this by giving you an example but keep in mind, we are talking about the most common type of arthritis here: you have a door that is hanging on its frame; what happens if it is hanging croocked? It can be only 6 months old but as you open and close it, the upper part of it, let’s say, hits that jam so it is fair to say that after a short while of use, you start seeing wear and tear in that area. Now the same door can be 100 years old but sitting on its frame properly and all you see is the aged wood of the door, right? Also, how is it that only a part of your spine is aged and other others? How is it that only one knee has arthritis and not the other? Is one knee younger than the other?!! That is the question that would get me in trouble in this college years but I am glad at least, my curiosity started at a young age.

• What are the signs and symptoms of arthritis?

The common symptom of arthritis is pain and stiffness in the joint. Ligaments and joints involved in the arthritis joint become rigid and there is a loss of flexibility. Once again, reminding you that we are talking about the most common type of arthritis in this blog. The signs of Osteo-arthritis are typically seen on the x-ray and include, decrease joint space, uneven surface of the bones in the joint, decrease or loss of alignment of the bones, bony proliferation (bone spur) in the joint.

Of course, while stiffness, in general, can be the beginning phase of arthritis, it is impacted by other factors such as the length of time a joint is not used; for instance, you may have mild arthritis in your neck but if you stare at your computer for a long time, the degree of stiffness may change. It is reasonable to say that stiffness and lack of mobility come before the pain in arthritis joints.

Can neck and back pain cause Headaches?

The most common type of headaches is Cervicogenic Headache, Sub-occipital or Tension headache. In the blog called: Why do I get headaches, I explain the different types of headaches and the things that can be done about them. In brief, Tension headaches has to do with the tension in the back of the head muscles called Suboccipitals. This tension initiates trigger points that are Lactic Acid build-up. Trigger point, as the name implies, triggers pain elsewhere and when it comes to the Suboccipital muscles, the pain typically goes to the head, in the back of the head, in a band-like pattern around the head or any part of this ‘imaginary’ band.

Tension Headaches can cause sensitivity to light and noise, can be piercing just like Migraine Headaches so look at Tension Headaches as a clue that you are ‘abusing’ your neck and a subtle clue to look into this issue more seriously.

Let me walk you through how your neck can cause headaches. In the x-ray below you can see a normal curvature in the neck. Now imagine having tension in the back of the head where the neck is connected to the head. Is it reasonable to say that there will be a shift toward the area of pull? What does that do the alignment of the neck curve? As I mentioned in the door example above, now you are setting yourself up for the arthritic changes that take place as a result of long term mis-alignment. It is also reasonable to end up with Tension headaches because of the undue stress of those muscles I talked about.

Why do I have pain in my neck and back when looking down?

By now you can probably answer this question yourself. Something to know is that an average head weighs about 12 lbs. That means the supportive structures to hold the head, the neck bones or vertebra are designed to withstand that much weight continuously throughout the day and the ‘normal’ daily routines. This means when looking at your side view posture, your ear hole, the center of your shoulder, the center of your hip and the bone on the outside of your ankle all line up. This is called the Plumb line.

Now, the vertebrae are able to withstand more weight occasionally but not continuously or too much. The moment you look down at let’s say looking at your cellphone or your glide your neck forward to stare at your computer, the undue stress on the vertebrae begin. The same 12 lb head ends up putting up to 60 lbs of pressure on the vertebra which means the beginning of the stress and damage. So why do you get pain in the neck and back when looking down? It is your body’s way of telling you it does not like it. It is like someone politely but firmly telling you to back off. It is amazing how we are so courteous to others asking us to back off but fully ignore our own body when it asks for help!!

Why do I have neck and back pain when sleeping?

Now when it comes to sleeping and pain, this means your problem is more complicated! Remember how your body tries to communicate to you its likes and dislikes? If you have a problem sleeping due to pain in your neck and back, you have not been listening to ‘it’ for a while!!

Typically having a hard time finding a comfortable position is the sign that you need to urgently look into your neck and mid back. I remind you once again that there are many conditions that can cause difficulty sleeping but if you have pain in the neck and back, it is reasonable to say that your issue is musculoskeletal (has to do with muscles and bones). If you ignore this phase, you may end up with numbness in one or more fingers on one side or the other. The alignment or misalignment in the neck and upper mid back spine plays a huge role in your difficulty finding a comfortable position to fall asleep. Your issue is more than likely posture related and therefore, the postural correction and avoiding what led to the postural decline are the solution. One of those contributory factors is your use of pillow; here is a video of how to use your pillow which plays a big role in the proper neck positioning while sleeping.

Who do I see for neck and back pain?

That is a great question and billions of dollars are spent in the US on answering it. I invite you to use your common sense reading what I am about to explore!

Given that the most common cause of neck and back pain are muscle-skeletal and posture related, it makes sense to get rid of the things we do that alter our ideal posture. Ideal posture is not what we see in the media, with the hour-glass figure or a six-pack ab! In fact, both of those presentations limit the amount of oxygen we are able to hold in our abdomen, between the abdominal diaphragm and the pelvic diaphragm.

Proper breathing faculty is fundamentals to living and proper posture. Who would have thought that their breathing is not even okay!! Have you noticed how new born babies have a big tummy? It is not because they are fat but because at birth, we are born with what it takes to do it ‘right’!

Now, due to lifestyle, habits, and injuries, we start developing wrong patterns of movement which in turn, impact our posture. These can be from playing one-sided sports as a child, to sitting behind our computer playing video games or working, then playing basketball or working out at a gym when our muscles and body are too tired from the daily abuse we call in-office work. It is reasonable to say that our chances of injuries go up. Typically soon after, many take medicine as if that is going to make the source of pain go away. When either you or your Primary Care physician get tired of going back with the same problem, you get referred to a physical therapist.

The Physical therapist (PT) will examine and based on her findings, starts treating the area of pain. It feels good, you gain strength and go off to do the same things you were doing maybe or maybe not but for some ‘odd’ reason the pain comes back or your injure something else!! You try a different PT but essentially the same pattern of the problem follows.

Now you hear that Chiropractic works and go see one. You get adjusted, feel great but have to keep going back. Is the adjustment working? Yes but even with the improvement you still have the ache and pain.

Now you try Acupuncture. That may or may not work but at this point, you need something done. Does this sound familiar?

This is an often-heard story all of us are too aware of. The issue is we are moving creatures. If we remove the cause of our issues AND address fixing the problem, it is reasonable to say that we will NOT see the problem again, right? Then why don’t we do just that? Why don’t we spend the time learning about the do’s and don’ts of our body when it comes to general healthy things. We do that about our ‘objects’ in life. If you are into racing, you learn how to race better, you learn what can go wrong so you avoid them, you learn how to maintain your car so you get to enjoy the very thing you like doing, right?

If the brain controls everything we do, if there is a map in the brain for movement and sensation and then there is a body part but its cooperation with the rest of our body – in movement- plays a huge role, then why do we stop at the site of pain and thing working on that is going to make the problem go away?!!

As I explained in my blog on Layered Syndrome: ” If the movement was a concert, your brain is the conductor, the map of movement and sensation called Homunculus is the music notes for the conductor to conduct and the body parts are the musicians. As our lifestyle, injuries and previous issues take place, the music notes change so the map of movement and sensation is subjected to the changes. If the notes change, the conductor will conduct the new notes and the musicians knowing their musical instruments will play. The concert is everything coming together and the musicians chiming in when they are supposed to. If that very part of when to chime in gets changed, the concert is no longer the best concert”. With postural decline leading to chronic pain, and re-injuries, the biological patterns of movement have changed and just as any time you change the natural design of anything, issues arise, the pain in your neck and back are there as a clue.

As a Chiropractor who has done chiropractic and physical therapy I can assure you that the combination of the two is great but not a complete answer. Only through Postural Neurology, where the brain’s weaknesses when it comes to posture are determined, we know if our ‘musical notes’ are correct; it is only through Developmental Kinesiology such as Dynamic Neuromuscular Stabilization (DNS) we can complete the solution. Why reinvent the wheels and try to come up with a new method of correcting wrong patterns of movement when every single baby on this planet follows the same patterns of movement milestones. If it works on every single case and we automatically do it as babies, it MUST be the perfect match to what we are ‘wired’ to do, right?

This is how every single musculoskeletal problem gets addressed in my office and how I see the whole path of movement (and deviation from ideal) issues are addressed in my practice.

Remember, you are the Designer and the Director of your own life so design and direct your life the way you wish to see it.

Dr. Shakib