Neck, Back & Leg Pain
Relieving Back Pain
Important Note: Do not give aspirin to children or teens.
Back pain is a common problem. You can strain back muscles by lifting too much weight or just by moving the wrong way. Back strain can be uncomfortable, even painful. And it can take weeks to heal. To help yourself feel better and prevent future back strains, try these tips:
Ice reduces muscle pain and swelling. It helps most during the first 24 to 48 hours after an injury.
- Ice helps most during the first day or two after an injury.
- Wrap an ice pack or a bag of frozen peas in a dishcloth. (Never place ice directly on your skin.)
Place the ice where your back hurts the most.
Don't ice for more than 20 minutes at a time.
You should use ice several times a day.
Over-the-counter pain relievers include aspirin, acetaminophen, and ibuprofen. They can help ease discomfort. Some also reduce swelling.
Tell your doctor about any medications you are already taking.
Take medications Â only as directed.
After the first 48 hours, heat can relax sore muscles and improve blood flow.
- A warm shower can relax sore muscles.
- Try a warm bath or shower. Or use a heating pad set on low. To prevent a burn, keep a cloth between you and the heating pad.
Don't use a heating pad for more than 15 minutes at a time. Never sleep on a heating pad.
Back Pain (Low): Self-Care
Most people have low back pain now and then. In many cases, it isn't serious and self-care can help. Sometimes low back pain can be a sign of a bigger problem. Call your doctor if your pain returns often or gets worse over time. For the long-term care of your back, get regular exercise, lose any excess weight and learn good posture.
Take a Short Rest
Rest your back for a day or two to begin healing. Use a firm mattress or the floor. Have your lower back firmly supported with a small pillow or towel. Keep your knees slightly bent, with another pillow under them. Every few hours, get up and walk as much as you can.
Reduce Pain and Swelling
Cold reduces swelling. Both cold and heat can reduce pain. Protect your skin by placing a towel between your body and the ice or heat source.
For the first few days, apply an ice pack for 10-15 minutes every hour while you're awake.
After the first few days, try heat to ease pain.
Over-the-counter medications can help control pain and swelling. Try aspirin or an aspirin substitute, such as ibuprofen.
Exercise can help your back heal. It also helps your back get stronger and more flexible, preventing any reinjury. Ask your doctor about specific exercises for your back.
Use Good Posture to Avoid Reinjury
When moving, bend at the hips and knees. Don't bend at the waist or twist around.
When lifting, keep the object close to your body. Don't try to lift more than you can handle.
When sitting, keep your lower back supported. Use a rolled-up towel as needed.
Call Your Doctor If:
You're unable to stand or walk.
You have a temperature over 101.0Â°F.
You have frequent, painful, or bloody urination.
You have severe abdominal pain.
You have a sharp, stabbing pain.
Your pain is constant.
You have pain or numbness in your leg.
You feel pain in a new area of your back.
You notice that the pain isn't decreasing after more than a week.
Possible Causes of Low Back or Leg Pain
The symptoms in your back or leg may be due to pressure on a nerve. This pressure may be caused by a damaged disk or by abnormal bone growth. Either way, you may feel pain, burning, tingling, or numbness. If you have pressure on a nerve that connects to the sciatic nerve, pain may shoot down your leg.
Pressure from the Disk
Constant wear and tear can weaken a disk over time. The disk can then be damaged by a sudden movement or injury. If its soft center begins to bulge, the disk may press on a nerve. Or the outside of the disk may tear, and the soft center may squeeze through and pinch a nerve.
Pressure from Bone
As a disk wears out, the vertebrae right above and below the disk begin to touch. This can put pressure on a nerve. Often abnormal bone (called bone spurs) grows where the vertebrae rub against each other. This can cause the foramen or the spinal canal to narrow (called stenosis ) and press against a nerve.
Relieving Tension in Your Back
Make time to relax. Start by setting aside 5 minutes daily.
Being relaxed helps keep your mind healthy and your back ready to move. Take short breaks often. Walk around. Stretch. Switch tasks. Also give the following a try.
When deep breathing, let your stomach expand.
Deep breathing is a simple way to reduce stress. You can do it almost any time you need to relax.
Inhale slowly through your nose. Let your lungs and stomach expand.
Hold your breath for 2-3 seconds.
Exhale slowly through your mouth until your lungs feel empty. Repeat 3-4 times.
Common trigger points
Muscle tension can create tender spots called "trigger points." The tips below may help relieve muscle tension.
Press the trigger point if you can reach it. If not, lie on a soft tennis ball, or ask a friend to press the spot. Use steady pressure for 10-15 seconds. Breathe deeply. Repeat a few times.
Massage trigger points with ice for 2-5 minutes. Press lightly at first. Slowly increase firmness.
Torticollis (Wry Neck)
Torticollis occurs when muscles on one side of the neck contract (tighten). This causes the neck to twist or tilt to the side. The muscles may also be quite sore. It affects mainly children and young adults, often appearing overnight. It can also affect infants who develop tight neck muscles on one side.
What Causes Torticollis?
Causes of torticollis include:
Damage to the neck muscles from an accident or other trauma
Side effect of certain medications or drugs
Infection of the airways, such as a sore throat
When to Go to the Emergency Room (ER)
All neck problems should be checked by a healthcare provider within 24 hours. Seek emergency care if you can't reach your doctor or these symptoms are present:
Trouble breathing or swallowing
Numbness or weakness in the arms and legs
Trouble walking or speaking
What to Expect in the ER
The neck will be examined, and questions about any current or former medical problems will be asked. X-rays of the neck may be taken to check for broken bones.
The goal in treating torticollis is to relax the neck muscles. The best approach will depend on the cause of the problem. In most cases, one or more of the following may be given:
Medications to help relax the muscles and reduce swelling
Hot and cold compresses to help ease muscle tightness
Botulinum toxin (Botox) injections to prevent further muscle spasms
A soft neck collar to ease discomfort and help healing
Physical therapy to help stretch and relax the muscles
Depending upon the cause, torticollis often goes away on its own. Follow up with your healthcare provider as instructed. If symptoms become worse, call your doctor or return to the ER.
Causes of Lumbar (Low Back) Pain
Low back pain can be caused by problems with any part of the lumbar spine. A disk can herniate (push out) and press on a nerve. Vertebrae can rub against each other or slip out of place. This can irritate facet joints and nerves. It can also lead to stenosis, a narrowing of the spinal canal or foramen.
Pressure from a Disk
Constant wear and tear on a disk can cause it to weaken and push outward. Part of the disk may then press on nearby nerves. There are two common types of herniated disks:
Contained means the soft nucleus is protruding outward.
Contained herniated disk
Extruded means the firm annulus has torn, letting the soft center squeeze through.
Extruded herniated disk
Pressure from Bone
An Unstable Spine
With age, a disk may thin and wear out. Vertebrae above and below the disk may begin to touch. This can put pressure on nerves. It can also cause bone spurs (growths) to form where the bones rub together.
Stenosis: Stenosis results when bone spurs narrow the foramen or spinal canal. This also puts pressure on nerves.
Slipping vertebrae can irritate nerves and joints. They can also worsen stenosis.
Spondylolisthesis: In some cases, vertebrae become unstable and slip forward. This is called spondylolisthesis.
Sciatica is leg pain often due to pressure on a nerve in your low back that connects to the sciatic nerve. This pressure may be caused by a damaged disk or by abnormal bone growth. You may feel pain, burning, tingling, or numbness that shoots down your leg.
Pressure from a Damaged Disk
Constant wear and tear on a disk can cause it to weaken. Part of the disk may push outward (herniate). Part of the disk may then press on nearby nerves. If this nerve leads to the sciatic nerve, you may feel pain down your leg.
Pressure from Bone
A disk can wear out and thin with age. This can cause the vertebrae above and below the disk to touch, putting pressure on a nerve. Abnormal bone growths called bone spurs can also form where the bones rub together. These can narrow the spinal canal and press on nerves.
Pain felt in the front of your lower leg is often called "shin splints." One common cause of this pain is tendinitis-inflammation of tendons (tough, cordlike bands of tissue that connect muscle to bone). When the tendons of the muscles near the shinbone become inflamed, the pain is felt along the shin. Shin splints often affect athletes and runners, and are commonly due to overuse.
Symptoms of Shin Splints
Symptoms of shin splints often start as a dull ache that gets worse over time. Resting your legs often relieves the symptoms. Later, the pain may become continuous with almost any activity.
Your doctor will ask you questions about your activities and your health history. Be sure to tell your doctor about possible injuries. There are no tests for shin splints, but your doctor may want to do some tests to rule out a stress fracture in your shinbone. These tests may include an x-ray, bone scan, or MRI (magnetic resonance imaging) test.
Treating Shin Splints
Follow these and any other instructions you are given.
Rest: Cut down on running and high-impact sports, or avoid them completely to allow your legs to rest and the injury to heal.
Ice: Put ice on the painful areas. Use an ice pack or bag of frozen peas. Put a thin cloth between the cold source and your skin. Ice for 15 minutes every 3 hours.
Medications: Take nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen, as directed by your doctor.
Preventing Shin Splints
To help prevent shin splints in the future:
Warm up before you run. Perform gentle stretching exercises.
Be careful not to overtrain.
Avoid running on hard surfaces.
Be sure you are using running shoes with good support and cushioned soles.
Neck Problems: Relieving Your Symptoms
The first goal of treatment is to relieve your symptoms. Your healthcare provider may recommend self-care treatments. These include resting, applying ice and heat, taking medication, and doing exercises. Your healthcare provider may also recommend that you see a physical therapist, who can teach you ways to care for and strengthen your neck.
Ice brings down swelling.
Heat relaxes sore muscles and helps relieve spasms.
Pain can end quickly or last awhile. Either way, you'll want relief as soon as possible. Your healthcare provider can tell you which treatments to do at home to help relieve your pain.
Lying down for a short time takes pressure from the head off the neck.
IceÂ and heat can help reduce pain. To bring down swelling, rest an ice pack wrapped in a thin towel on your neck. To relax sore muscles, apply a warm, wet towel to the area. Or take a warm bath or shower.
Over-the-counter medications, such as ibuprofen, aspirin, naproxen, and acetaminophen, can help reduce pain and swelling. Use these only as directed.
Exercises can relax muscles and prevent stiffness. To prepare, drape a warm, wet towel around your neck and shoulders. Remove the towel. Then do any exercises recommended to you by your healthcare provider.
If self-care treatments aren't helping relieve neck pain, your healthcare provider may suggest one or more sessions of physical therapy. Physical therapy is performed by a specialist trained to treat injuries. Your physical therapist (PT) will teach you how to strengthen muscles, improve the spine's alignment, and help you move properly. Treatment methods used in physical therapy may include:
Heat. A special heating pad called a neck pack may be applied to your neck.
Exercises. Your PT will teach you exercises to help strengthen your neck and improve its range of motion.
Joint mobilization. The PT gently moves your vertebrae to help restore motion in your neck joints and reduce neck pain.
Soft tissue mobilization. The PT massages and stretches the muscles in your neck and shoulders.
Electrical stimulation. Electrical impulses are sent into your neck. This helps reduce soreness and inflammation.
Education in body mechanics. The PT shows you ways to position and move your body that protect the neck.
If physical therapy doesn't relieve your neck pain, your healthcare provider may suggest other treatments. For example, medications or injections can help relieve pain and swelling. In some cases, surgery may be needed to treat neck problems.
Protecting Your Neck: Posture and Body Mechanics
Protecting your neck from injuries and pain involves practicing good posture and body mechanics. This may mean correcting bad habits you have related to the way you hold and move your body. The tips below can help you improve your posture and body mechanics.
What Is Posture and Why Does It Matter?
Posture is the way you hold your body. For many of us, this means hunching over, thrusting the chin forward, and slouching the shoulders. But this kind of poor posture keeps muscles from properly supporting the neck and puts pressure on disks, ligaments, and joints in your neck. As a result, injury and pain can occur.
How Is Your Posture?
Use a full-length mirror to check your posture. To begin, stand normally. Then slowly back up against a wall. Is there space between your head and the wall? Do you slouch your shoulders? Is your chin pointing up or down? All these can cause neck pain and injury.
Improving Your Posture
Follow these steps to improve your posture:
Pull your shoulders back.
Think of the ears, shoulders, and hips as a series of dots. Now, adjust your body to connect the dots in a straight line.
Keep your chin level.
What Are Body Mechanics and Why Do They Matter?
The way you move and position your body during daily activities is called body mechanics. Good body mechanics help protect the neck. This means learning the right ways to stand, sit, and even sleep. So do what's best for your neck and practice good body mechanics.
To protect your neck while standing:
Carry objects close to your body.
Keep your ears and shoulders in a line while standing or walking.
To lower yourself, bend at the knees with a straight back. Do this instead of looking down and reaching for objects.
Work at eye level. Don't reach above your head or tilt your head back.
To protect your neck while sitting:
Set up your workstation so your monitor is at eye level. Also, use a document holder when viewing papers or books.
Keep your knees at or slightly below the level of your hips.
Sit up straight, with feet flat on the floor. If your feet don't touch the floor, use a footrest.
Avoid sitting or driving for long periods. Take frequent breaks.
To protect your neck while sleeping:
Sleep on your back with a pillow under your knees, or on your side with a pillow between bent knees. This helps align the spine.
Avoid using pillows that are too high or too low. Instead, use a neck roll or pillow under your neck while you sleep.
Sleep on a mattress that supports you, with a pillow under your neck.
Understanding Neck Problems
If you suffer from neck pain, you're not alone. Many people have neck pain at some point in their lives. Problems such as poor posture, injury, and wear and tear can lead to neck pain. Your healthcare provider will work with you to find the treatment that's best for your neck.
Types of Neck Problems
Pain and injury in the neck can be caused by the following problems:
Strains and sprains: Strains (stretched or torn muscles) and sprains (stretched or torn ligaments) can cause neck pain. Strains and sprains can occur during an accident or when the neck is overused through repetitive motion. They can also cause muscles and ligaments to become inflamed (swollen and painful).
Whiplash and other injuries: Whiplash can result when an impact throws the head, forcing the neck too far forward (hyperflexion), then too far backward (hyperextension). When combined, the two motions can cause a painful injury to different parts of the neck, such as muscles, ligaments, or joints. The most common cause of whiplash is a car accident. But it can also happen during a fall or sports injury.
Weakened disks: A simple action, such as a sneeze or cough, can cause a disk to bulge (herniate). A herniated disk can put pressure on the nerve and cause pain. Over time, disks can also thin out (degenerate). Flattened disks don't cushion vertebrae well and can cause vertebrae to rub together. Rubbing vertebrae can pinch nerves and cause pain.
Weakened joints: Aging and injury can cause joints to slowly degenerate. Thinned joints can also cause vertebrae to rub together. This can cause abnormal growths of bone (bone spurs) to form on vertebrae. Bone spurs put pressure on nerves, causing pain.
If you have a neck problem, you may have one or more of the following symptoms:
Muscle tension and spasm: You may not be able to move your neck, arms, or shoulders comfortably if you have muscle tension or stiffness in your neck. If your symptoms aren't relieved, you may experience muscle spasms, or knots of contracted tissue (trigger points) in areas of your neck and shoulders.
Aches and pains: Dull aches in your head or neck, sharp pains, and swelling of the soft tissue of the neck and shoulders are common symptoms. If there's pressure on the nerves in your neck, you may feel pain in your arms or hands (referred pain).
Numbness or weakness: If the nerves in your neck are injured, you may experience numbness, tingling, or weakness in your shoulders, arms, or hands. These symptoms arise when disks or bone spurs press on the nerves in your neck.