Back and neck pain is very common, and can be severe and debilitating either in acute episodes, or as a chronic pain suffered over a long period of time that is both uncomfortable and fatiguing.

Why does back pain occur?

There are many different reasons for back pain, and if prevention and treatment is to be most effective it is important to have a good understanding of the cause. The onset can often be traced to an accident or trauma, even one that occurred many years previously.

Accumulation of stresses in the body.

Back pain often does not arise immediately after an injury because the body is very good at adapting to injuries and accommodating strains and stresses. However, the disruption to spinal mechanics causes strain to build up over a period of time and symptoms begin, often insidiously.

Episodes of pain may be triggered by events such as physical exertion, emotional stress or illness. Sometimes a minor strain may give more pain and take longer to heal than expected. This may be because the body has reached the limits of its ability to cope with the combined effects of past injuries, and any new demand is 'the final straw'.

In treatment, it is often necessary to release the retained stresses from past traumas in order to relieve the current back pain, and reduce the chances of it recurring.

Other symptoms.

Stresses within the body often cause problems in other areas as well as the back. Common associated symptoms are; nerve entrapment (sciatica), undue fatigue, mood swings or depression, disturbed sleep, headache, period problems, digestive problems, vulnerability to infections due to a depleted immune system. Many of these improve during a course of osteopathic treatment.

Common types of trauma and injury.

There are certain types of accident that are common contributors to back pain, even if they did not cause pain at the time. The most common ones are described here, but it is by no means a comprehensive list.

Occupational strain.

Habitual bad posture such as poor position at computers can place strain on areas of the spine and lead to back pain. The seating position should be improved, you should get up and move about regularly, as well as using osteopathic treatment to release ingrained spinal stresses.

Lifting strains.

Lifting heavy or awkward weights including babies, children and shopping can cause back strain, especially if not done correctly. If the spine is already under stress due to another cause, it may only take a small lifting strain to cause a significant injury, usually occurring at the weakest point of the spine.

Car accidents.

In any car accident, even at relatively slow speeds, the body is subjected to sudden deceleration forces and can be thrown around violently in many different directions. Osteopaths are often able to feel components of directional stresses locked into the body tissues after a whiplash accident. The whole body is affected, not just the neck, and unless these strains are treated they are present for life.

Common findings after whiplash accidents:

Neck: Overstrain of the neck muscles and ligaments. This often causes persistent neck pain and headaches, and may lead to arthritis.
Low Back: The sacrum or the tail bone at the base of the spine often becomes wedged down into the pelvis, leaving it rigid and immobile. This is one of the most important consequences of whiplash injury to treat, because it can disturb the function of the whole spine.
Rib cage: Twisting and compression through the rib cage from the seat belt often leads to shoulder pain, indigestion, heartburn, gall bladder problems, and chest complaints (pain or shortness of breath).


The spine is often jerked or twisted during falls, and parts can become quite impacted or compressed. Sit-down falls such as falling on ice or a slippery surface are particularly damaging because in addition to the direct impact on the base of the spine, the impact of the head onto the top of the spine causes strain at the top of the neck. Headaches and neck problems are very common after this type of injury.

Direct injury.

Any direct injury, for example kicks or blows to the spine can create local area disruption of normal spinal mechanics. Problems may gradually develop over a period of time, even if the back seemed uninjured at the time.

Blows to the head

Blows to the head can disrupt the normal minute movements of the bones of the skull, a situation that has far reaching effects on the whole of the body. Posture may be modified by blows to the head as the spine adapts to the injury, which can cause areas of strain.

Childbirth strains

During childbirth, the mother's pelvis can become distorted as the baby's head descends. In many cases the distortion corrects itself, but if severe, it can remain for many years and disrupt spinal and pelvic mechanics. This can cause very diverse symptoms including backache, constipation, stress incontinence, headaches, disruption of periods when they start again, and even postnatal depression.

Self help for back sufferers.

Whilst every person is different, there are a few general rules to observe to help reduce or prevent back pain:

Consult your osteopath if you are in pain regularly or for more than a week or two. After an acute episode of back pain, check with your osteopath about when it is advisable for you to resume work or exercise.
When lifting, stand straight in front of the object to be lifted and hold the weight close to your body. Bend the knees, and keep your back as straight as possible.
Do not slouch in chairs with your lower back unsupported. Push your bottom well back into the seat of the chair and sit tall.
Be sensible with physical exertion. If you are unfit then muscles fatigue easily and injury is more likely. Short bursts of heavy activity should be interspersed with more gentle tasks.
If it hurts, stop! Pain is natures way of telling you something is wrong. If you heed the early warning signs, and get help, it is often possible to prevent the situation getting worse. Painkillers mask the pain, so take extra care if using them.
Do whatever is most comfortable, not what is most convenient!
Gentle exercise helps improve flexibility and muscle strength. If you are new to exercise, try a small amount of activity the first time, and see what effects it has if any the following day. If all is well, a little more of the chosen exercise can be done next time. Concider seeking expert advice at a gym or health club.

Back and Neck Pain

Terry Rulten Brentwood Osteopath