Clearing's Chronic Pain Blog


Chronic Back and Neck Pain: Symptoms, Causes, and Treatments

Jacob R. Hascalovici MD, PhD
Jacob R. Hascalovici MD, PhD

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Do you suffer from chronic back or neck pain? If so, you are not alone. Back and neck pain are widespread occurrences. In fact, an estimated 60 to 80 percent of adults will experience back pain. Plus, 20 to 70 percent of adults will have neck pain severe enough to interfere with their daily activities at some point during their lives. Uncomfortable, frustrating and at times, seemingly hopeless, it’s tough to work through this kind of pain.  

However, there is some good news. And yes, some not-so-good news. The good news is that because the problem is so pervasive, it has been well-researched. The not-so-good news is that there is no easy, one-size-fits-all solution.  

That being said, if you’re frustrated by the treatment options that don’t seem to work for you, take a deep breath and keep reading. We’re here to give you the information you need to understand your symptoms and find the best treatment methods for you.

Chronic back and neck pain symptoms

While you may feel symptoms anywhere along the spine, the lower back is by far the most common area. The type of pain you feel can cue you in as to what is causing the pain. For some, it could be shooting pain that comes and goes. For others, it may be a dull, nagging pain that can be irritating. 

Deep, aching pain and morning stiffness are common symptoms of spinal arthritis. A sharp shooting pain and electric sensations radiating from the back to the legs may be caused by a pinched nerve, also known as sciatica or radiculopathy. Pinched nerves can sometimes be accompanied by tingling or numbness in the arms or the legs, which is called paraesthesias.

Neck pain can be associated with shoulder pain and headaches. As with back pain, some people with neck pain will experience dull aches, while others may feel sharp, shooting pain. 

Causes of chronic back and neck pain

There are many conditions that can cause chronic pain, which can make treatment a little tricky. Here are just a few of the common causes of back and neck pain:

  • Muscle tension or strain, which is a pulled muscle
  • Spinal joint strain, which is when a joint swells after an injury
  • Spinal arthritis or Spondylosis, which is joint wear and tear
  • A herniated disc, which is a disc bulge causing a pinched nerve
  • Degenerated disc, which is the wear and tear of spinal discs
  • Spinal stenosis, which is a narrowed spine
  • Spondylolisthesis, which is the misalignment of the spine bones
  • Compression fracture, which is a broken bone in the spine
  • Scoliosis, which is a twisted spine
  • Osteoporosis, which is the thinning of bones
  • Fibromyalgia, a condition causing generalized muscle and joint pain

Mild back or neck pain can often be easily and safely managed at home. However, if the pain lasts longer than a week, or if you have other symptoms, such as nausea, vomiting, weakness, numbness or changes in your bowel and bladder function, seek medical help immediately. 

Though rare, you want to ensure that the cause of your back or neck pain will not lead to permanent neurological damage. Plus, the earlier you start treatment, the faster you may see results.

Treatments for back and neck pain

There are a variety of treatment options for neck and back pains, ranging from at-home remedies to surgery. 

Here are a few of the most common treatment methods:

  • Conservative therapies: physical therapy, acupuncture, yoga
  • Behavioral health: mindfulness, cognitive-behavioral therapy
  • Topical therapy: prescription-strength topical pain cream, CBD creams, menthol-based botanicals
  • Oral Medications: anti-inflammatory medicine (ibuprofen, naproxen), muscle relaxer medications, nerve pain medications, pain interventions, cortisone injections, nerve block injections
  • Surgery
  • Electroceuticals: Electrical stimulation of the muscles (TENS), spinal cord stimulation

As you can see, there are quite a few options for treatment. Don’t lose hope if one treatment doesn’t seem to work out. There are plenty of other methods to try, and chronic pain sufferers typically respond best to a multimodal treatment strategy, which means using several treatment options at the same time.  

Various chronic back and neck pain management methods

Keep in mind that simple changes can go a long way towards treating your back and neck pain. 

For example, if your pain is caused by poor posture and positioning, you can:

  • Avoid sitting or standing in the same position for long periods of time 
  • Practice good posture and/or buy an ergonomic chair for work
  • Refrain from cradling the phone between your shoulder and your ear
  • Use a special pillow to support your neck at night
  • Add simple stretches and exercises to your daily routine

If your pain is caused by something more serious, then these at-home treatments or behavior modifications may not be enough to manage your pain. Although they may alleviate your pain, they may not be strong enough to get rid of it. 

Certain pain medications can be a practical next step in the management of your symptoms, as they can provide a short-term solution for pain as a result of an injury or strain and may be available without a prescription at your local pharmacy. Once the cause of your pain heals, the need for painkillers should subside. However, painkillers are not a good long-term solution because even mild over-the-counter pain medications can damage your body if overused. 

Physical therapy, including stretching and exercise programs, has been proven to be an effective treatment for most people with back pain, and the earlier you start physical therapy, the better. Researchers have shown that patients who receive physical therapy within four weeks of experiencing back pain symptoms are less likely to need to see a doctor. They are also less likely to get spinal injections or have surgery.

Unfortunately, many people find physical therapy to be impractical or inconvenient. Trying to get to a therapist’s office once or twice a week for your sessions can be quite a challenge in terms of time, travel and cost. 

To address this issue, digital health companies are bringing home exercise right into your living room. Digital telehealth solutions and digital home exercise programs make it easier than ever to access the individualized care you need. 

Choose the multimodal approach

Since there are pluses and minuses to any form of treatment, an individualized, multimodal treatment plan tends to be best for most people. Multimodal simply means using two or more forms of treatment at the same time. Studies have shown that multimodal care for back pain treatment leads to decreased disability and lower pain scores. Instead of prescribing a few pain pills, a multimodal approach is far more thorough. 

For instance, combining pain pills with nutraceuticals, which are science-backed dietary supplements, can help promote joint, nerve and muscle health, address dietary deficiencies and help control inflammation. You may combine this with at-home stretches, exercises, or full-blown physical therapy, depending on your needs. Furthermore, prescription-strength topical pain cream or a natural CBD topical cream can also be used in combination with pain pills or a home exercise program.

In other words, a multimodal treatment plan addresses your pain symptoms and causes from many different angles. 

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Avoid opioids 

You may be wondering: Why would I go through all this work to develop an alternative treatment plan, when I could just take an opioid instead? Unfortunately, this “one size fits all” attitude has arguably spawned the modern-day opioid epidemic. From 1999 to 2018, nearly 450,000 deaths occurred due to opioid overdoses, some of them related to misusing prescription pain medication. In fact, in 2015, the CDC issued guidelines suggesting that opioids should not be routinely prescribed as a first-choice therapy to treat chronic pain.

Going back to the question above: why not just take pain medication? The simple answer is that opioids, in most cases, do not have a role in the treatment of chronic pain because they are addictive and can cause more harm than good. Even those with the best intentions may find themselves in an unfavorable relationship with pain medication over time. It’s better to avoid these opioid medications as much as possible.

Why a customized treatment plan is best

The most critical takeaway is that not everyone's pain is the same. A cookie-cutter approach to treatment for your back and neck pain will only be effective for some individuals. That’s why a customized, multimodal treatment plan is your best weapon in the fight against chronic pain. Make sure your healthcare providers have advanced training in pain management and hold a deep commitment to aiding you in your chronic pain journey. 

Existing treatment options require you to manage pain alone. Fortunately, at Clearing, we’re building a comprehensive centralized platform to help you get the relief you need. Leveraging technology, clinicians on the Clearing platform can help you manage your symptoms, through home exercises, physical products and medications delivered directly to your door. Click the button below to learn more!

FAQ

Activity, including stretching, isn’t always comfortable. Some discomfort is manageable, but pain that reaches the level of agony isn’t normal. Anytime you’re feeling very challenging pain, back off the stretches or exercise you’re doing. If you need more guidance, consult a physical therapist.

If you are wondering about devices like massage guns or TENs units, you can always speak to a doctor for more in-depth feedback. Many people find relief with devices like these…as long as they’re not hurtling you, they could be worth trying.

Start with what is bothering you most. While you might not be able to completely get rid of the pain, you can likely discover a few different ways to control it. You could, for example, pick three areas of pain management to work on, like anti-inflammatory eating, applying a pain cream and using CBT techniques. If those three areas are manageable and work well together for you, you could expand them. If not, you could shift to different areas.

This article is for informational purposes only and does not constitute professional medical advice. Always seek the advice of your healthcare professional with any questions or concerns you may have regarding your individual needs and medical conditions.