Our backs and necks are perhaps two of the most neglected areas of our bodies. Statistics show that more than 80% of people will suffer from back and neck pain at some point in their lives – a number too high to ignore. Charlene Yared-West talks to the experts about what to do about it and how to avoid it.
In the hustle and bustle of today’s society, people tend to ignore their neck and back pain until they get to a point where it is unbearable,” says Michelle Ferreira-Teixeira, occupational therapist at Rehab Worx at the Little Company of Mary Hospital in Pretoria.
“Stress plays a major role in back and neck pain, and even though it is not the root cause of pain, it undoubtedly brings out underlying pains in the back and neck areas. People lead very unbalanced lifestyles and hardly ever take time out to relax and de-stress.”
Deevya Vasson, hatha yoga instructor at Phoenix Wellness Studio (phoenixwellness.co.za), adds that not breathing properly also plays a role. “When we stress, we hold our breath and tense up the shoulders, clenching the jaw,” says Vasson. “And if you are constantly under stress, your body makes a habit of assuming this pose every time you are in a stressful situation.”
The denial of pain can lead to a number of serious complications, says Dr Martin Krüger, chiropractor at The Spine Clinic (spineclinic.co.za) in Johannesburg. “People often don’t come in for pain relief until it has progressed and interfered with something they value,” he says, citing an example of a mother who was experiencing severe back pain, but only came in when she could no longer pick up her child.
“The way we have been raised is to address our health issues only when there is a crisis, but often when the crisis has occurred, there has been more damage to the tissues of the body as a result of neglect, which was avoidable in the first place,” he explains.
Dr Guy Ashburner, Cape Town osteopath , agrees. “Long-term or chronic pain is very debilitating, and can eventually encompass every part of your life and all aspects of your health. Chronic pain will dictate the way you move, the way you think and your state of mind, stop you from doing things you want to do in your life, such as caring for your children or realizing your ambitions, and affect your energy levels, and your susceptibility to illness and disease,” he says.
“There are so many implications with chronic back and neck pain which can gradually lead to chronic fatigue syndrome, fibromyalgia and other serious health problems, so see a health professional before your pain gets the better of you.”
Getting the right diagnosis
“If you are in pain – no matter where it is located in your body – always seek out the advice of a qualified professional to get to the root of the problem,” says Ashburner. “This is essential for neck and back pain, because even though a massage may offer temporary relief, the massage therapist is not always qualified to give you a diagnosis.
“An osteopath will sit down with you and, after writing up your case history, do a complete clinical physical examination to ascertain the root cause of the problem or problems, and assess what needs to be done. This does not only mean looking at your back or neck, where the pain resides; rather, treatment will take the form of a holistic approach to health. The person’s whole life will be looked at – from how you sit, your posture and your sleeping to habits that inadvertently cause pain, such as a lack of exercise or inappropriate exercise.”
Krüger agrees. “There is no point treating someone with rheumatoid disease in the same way as you treat a sports injury, so diagnosis is key to ascertaining the appropriate treatment.”
Ilse du Plessis, physiotherapist at Life Rehabilitation Centre at Vincent Pallotti Hospital in Cape Town, notes that without the correct diagnosis, you can easily become addicted to pain medication, which can cause complications and further stress on the body and mind.
“Once you have been assessed by a professional healthcare practitioner, you will be advised of the correct treatment for your particular back and neck pain issues, and this treatment will vary among individuals,” she says.
Krüger adds that the best approach is a multidisciplinary setup, where a variety of practitioners can help assess and treat the cause of a person’s problem.
A multidisciplinary approach
To assess your problems, you can see a qualified osteopath, chiropractor or physiotherapist, who will be able to consider the appropriate and specific treatment to alleviate your back and neck pain. Many people also swear by inversion therapy, shiatsu, hydrotherapy, aromatherapy, reflexology, yoga and acupuncture, among other treatments, as ways of alleviating the symptoms of neck and back pain. However, Ashburner recommends first seeing a qualified specialist before engaging in any alternative modalities, to ensure that the modality is safe for your specific neck and back pain, which differs from person to person.
“A shiatsu treatment for neck and back pain places the client on a futon on the floor and allows the practitioner to use body weight to apply the necessary pressure, as opposed to a normal massage, which takes place on a therapy bed,” says Markus van der Westhuizen, shiatsu practitioner at Healthy Choice (healthychoice.co.za) in Cape Town.
“The practitioner applies pressure to the appropriate trigger points/acupoints on the body to allow the muscles to relax, which includes the back and neck areas. Pain can be caused by daily stress on the muscles or energetic blocks, and by applying pressure to these areas, blockages are removed and the muscles relax. Releasing this energetic build-up (emotional or mental) may cause the client to experience a variety of reactions, such as crying, laughing, joy or stillness, and these indicate that the body is breaking through old energy patterns which are causing the pain.”
According to Van der Westhuizen, a qualified shiatsu practitioner can show you a few locations on the back and neck area where you can also administer pressure for some relief from pain. “I still recommend that the person see a professional first, and use the self-massage techniques only to keep things in place and to help relieve pain between treatments,” he says.
Michele Shenker, polarity therapist specialising in inversion therapy at Backswing for Health (backswing.co.za) in Cape Town, says many forms of back and neck pain are caused by pressure on the spinal discs due to the force of gravity on an already compromised spine. As gravity forces the vertebrae to exert pressure on your discs, they lose moisture and, as a result, flatten and harden over time.
“Inverted, your spine gently extends, the spaces between your vertebrae widen, and discs are given a chance to absorb moisture, including fresh oxygen and nutrients, from surrounding blood vessels. Like sponges, they expand and regenerate,” she says. “Inverting regularly, you can gain up to 5cm in height, which is what astronauts gain when they go into weightless space.”
A study carried out in 1978 showed that patients who received inversion therapy experienced a 35% decrease in pain levels almost immediately. Another study revealed that over 80% of patients who had undergone just eight treatments were able to return to work and normal everyday activities. The most recent study confirmed that just over 70% of patients who were scheduled for back surgery were able to cancel their surgeries.
Getting back to basics
“We appear to be too busy to get the basics right. Other mammals on the planet move with ease and have an innate ability to know the correct management of their musculoskeletal systems. We live in a convenience culture, where it is easy to just take a tablet, have an injection or strap it up to deal with the symptoms, without really addressing the cause of the problem,” says Ashburner.
“How about looking after your posture, doing regular, appropriate exercise and getting enough sleep? All of the body’s systems affect one another, so when our spine and musculoskeletal systems are out of alignment, the nervous, circulatory, lymphatic, respiratory and gastrointestinal systems go out of sync as well.”
He explains that the stiffer we are in our musculoskeletal system, the more energy it takes to maintain the status quo in our bodies, which places greater stress on our overall wellbeing.
“Not only is the reduction in pain an important aspect of the treatment, but so is the correct retraining of muscles,” says Du Plessis. She also suggests that patients do appropriate exercise and stretching, which will help in the prevention and treatment of neck and back pain.
“Care needs to be taken with heavy weight-lifting and repetitive rotational activities in the presence of a back or neck injury,” she says. Other “unilateral sports” such as golf, tennis, bowls and cricket, may load muscles on one side of the body more than the other, which could cause compensatory reactions in other areas, and lead to discomfort, pain and loss of flexibility.
Says Shenker: “Inversion helps re-align the spine, which enhances the body’s performance and wellbeing.”
Avoiding back and neck pain
Ensuring correct back hygiene: “Proper seating is important for good posture. The best kind of chair is firm and provides support up and down the entire spine, but allows a small space at the curve of the lower back,” says Ashburner. “Good sitting posture is as follows: Sit on the chair. Bend forwards, then wriggle your bottom back as far as possible until your spine meets the back of the chair. Then sit up. You will find that your lower back is concave, and the remainder of the curves of your spine are well supported and automatically relaxed. Most importantly, you will find it difficult to slouch!”
Ferreira-Teixeira adds that, in addition to maintaining good posture, lifting heavy objects correctly is important too. “Bend your knees when lifting heavy objects, so that you don’t place too much strain on your back muscles,” she says.
Get some exercise, make time for yourself and stress less: “Exercising will improve blood flow and relieve muscle tension in all areas of the body, including the back and neck. It will also alleviate built-up stress,” says Ferreira-Teixeira. “Participate in leisure activities and find something you enjoy that will take your mind off everyday stressors. This is very important, in order to balance out work, work, work! Make time for yourself and you will see improvements in your overall wellbeing.” She adds that this includes broadening the ways you manage your stress levels, such as relaxation therapy, coping strategies, assertiveness training, improving emotional insight into your condition, and even meditation.
Ashburner adds that exercise is fundamental to maintain optimum health. “After all, ‘movement is life’, says Aristotle. If you are in pain, always consult your healthcare practitioner before continuing. If it doesn’t feel right, don’t do it and avoid extreme abnormal postures.”
Do some yoga: Vasson explains how yoga helps the body work through its pain, and release it through certain positions and postures. “Getting reacquainted with the breath is number one, as focus on the breath takes the mind off stressful situations, which inadvertently cause pain in the neck and back areas. Secondly, I would recommend some poses to ease the neck and the back,” she says.
She suggests the “cat cow” pose: “Get on to all fours, knees underneath the hips, hip-distance apart, and wrists underneath the shoulders, shoulder-width apart. When you inhale, look up towards the ceiling, arching the spine. The tailbone moves up towards the ceiling too, and then exhale; round the spine, tuck in the chin, look towards your belly-button and draw in the belly. Repeat a few rounds. Don’t jerk your head up towards the ceiling if you’ve got tension in your neck; just look straight ahead instead.”
Sleep support: “Make sure that your neck is fully supported when you sleep, and that your pillow provides that support adequately,” says Ferreira-Teixeira. “This ensures that your spinal column is in alignment and your weight evenly distributed.” Ashburner emphasises the importance of sleep, as it is the vital time that the body needs to restore and repair itself into its natural state of equilibrium.
Try hydrotherapy: According to Du Plessis, hydrotherapy has been proven successful in the treatment of back and neck pain. “The buoyancy of water reduces loading on joints and often assists in relieving pain and muscle spasm. Hydrotherapy also offers psychological benefits from the induced relaxation,” she says.
Learn a few self-massage techniques: “Knowing where the tension spots are and how to release them can really help you deal with on-the-spot back and neck pain,” says Van der Westhuizen. “A qualified shiatsu practitioner will be able to show you a few spots and how to administer the pressure. Alternatively, he recommends a book on trigger-point therapy that can help: Acupressure’s Potent Points – A Guide to Self-Care for Common Ailments by Michael Reed Gach.
Take supplements: “Get checked for vitamin D levels,” says Krüger. “Low levels of vitamin D have been associated with inflammation and joint pain. And, take a high-quality omega-3 oil. The oil should have a high content of EPA, which aids in controlling inflammation in the body, hence helping alleviate neck and back pain.” However, Ashburner adds that taking supplements should not be the first port of call. “The underlying problem should be addressed first, where further examination takes place, followed by treatment or referral if necessary,” he says.
Seek professional help: To get to the root of your problem, see your local osteopath, chiropractor or physiotherapist. “Understanding the problem completely will empower you towards getting back to good health,” says Ashburner. “Armed with diagnosis and a good management plan, there usually is a solution to your pain.”
What are those achy knots I feel in my neck, shoulder and back areas?
“These are called adhesions, which are a sign of a chronically contracted muscle,” says Ashburner. “In a normal functioning muscle, the fibres that make up a muscle glide over one another during contractions; however, with muscle tension and repetitive strain, this gliding action becomes limited, and often small, painful bumps are palpable in the muscle. They are a sign of a chronically contracted muscle and can be treated effectively through osteopathic treatment, which includes deep massage, myofascial release and postural management.”
According to Du Plessis, these muscle spasms prevent the normal sliding of muscle fibres, and a muscle may lose its ability to lengthen as well as contract optimally. “It is very important to treat the underlying cause of muscle spasms and not only the symptoms,” she says. “Pure symptomatic treatment, like going for a massage only, may aid in temporary relief, but the pain will soon return if the cause is not treated as well.”
Source: Longevity Magazine