What causes neck and back pain?
Most neck and back pain is not a damaged spine. It is a mechanical joint dysfunction: the tissues are intact, but the small joints of the spine and pelvis are not gliding the way they should, so the surrounding muscles spasm to protect them. Think of a car with its wheels out of alignment. The tires are fine, but they wear unevenly and run hot. Your spine works the same way, which is why the pain can be intense even when an X-ray looks normal.
Each of the seven vertebrae in your neck connects to its neighbors through several small joints that rotate and glide so you can look up, down and over your shoulder. When one of them stops moving in its preferred path, the muscles around it tighten into a protective spasm. That spasm is the crick in the neck, the knot at the base of the skull or the ache that spreads across your shoulders. It is also why a traction device only goes so far.
Every movement of your trunk and legs passes through the pelvis first. The SI joint moves in many small directions, and when it gets stuck, the low back, buttock and hip muscles respond with spasm and a false sense of weakness. SI joint problems are one of the most common reasons low back pain keeps coming back after rest, heat and stretching have stopped helping.
Moving a heavy box, picking up a child or twisting awkwardly can push a joint past the range you can control. The joint locks up, protective muscle guarding kicks in, and you wake up the next morning barely able to move. A joint that is mechanically stuck can usually be freed up, and the spasm settles once it moves normally again.
Sitting in the same position for hours lets the joints of your neck and low back stiffen at the edge of their range. Over weeks and months, the muscles that hold you upright tire and tighten. Changing your workstation helps, but the joints that have already lost motion need to be restored before the ache truly lets go.
Herniated or degenerated discs and pinched nerves can send pain, tingling or numbness into an arm or leg. A careful exam separates true nerve involvement, which shows up as numbness, decreased strength and decreased reflexes, from referred pain caused by joint dysfunction and muscle spasm. A tight piriformis muscle crossing the SI joint, for example, can squeeze the sciatic nerve. If true nerve signs remain once the mechanics are fixed, we will tell you and help you find the right next step.
