Treating Your Back & Neck Pain For Dummies

Dr. Loïc Burn is a specialist in musculo-skeletal medicine and a vice president of BackCare. Michael S. Sinel, MD, and William W. Deardorff, PhD, are renowned back specialists.

• Introduction 1About This Book 1Foolish Assumptions 2What You’re Not to Read 2How This Book Is Organised 3Part I: Getting Back to Back and Neck Basics 3Part II: Conventional Treatment Options 3Part III: Complementary Approaches: Are They for You? 4Part IV: Rehabilitation 4Part V: Resuming Normal Activity and Preventing Future Injury 4Part VI: The Part of Tens 5Part VII: Appendixes 5Icons Used in This Book 5Where to Go from Here 6Part I: Getting Back to Back and Neck Basics 7Chapter 1: Ouch! The Problem of Back and Neck Pain 9Defining Back and Neck Pain 10Who experiences back and neck pain? 11What causes back and neck pain? 11Treating Back and Neck Pain 12My back or neck pain can get better, can’t it? 13Who can treat my back or neck pain? 14How is my back or neck pain treated? 16How do I choose a multidisciplinary approach? 18Chapter 2: Introducing the Parts of Your Spine 21Feeling Fine with Help from Your Spine 22Touring Your Splendid Spine 23The spinal column 24The vertebrae: the bones of your back 24The discs 25The facet joints 26The ligaments 28The spinal canal 29The sacrum and the coccyx 29The sacroiliac joints 30The spinal nerves 30The muscles 30The vertebral arteries 33Chapter 3: Examining the Nature and Causes of Back and Neck Pain 35Discovering the Gate Control Theory of Pain 36Understanding Categories of Pain 38Debating the Need to Diagnose: Helpful or Harmful? 39Diagnosing based on an imaging scan 40Recognising the role of psychological and emotional factors 40Understanding the Deconditioning Syndrome 41Considering Conditions That Cause Spinal Pain 41Herniated disc/arm pain/sciatica 42The sprain–strain diagnosis 46Cervical migraine and headaches 48The whiplash neck 48Bizarre (ear, nose, and throat) neck symptoms 48Neck, shoulder, and arm pain 48Stress-related back and neck pain 49Arthritis of the spine 49Degenerative disc disease 50Facet syndrome 50Arachnoiditis 52Spondylolisthesis and spondylolysis 53Coccydynia 54Spinal fractures 55Lumbar spinal stenosis 56Chronic back and neck pain syndrome 57Exploring Other Conditions That Cause Back and Neck Pain 58Discitis 59Fibromyalgia 59Osteomyelitis 60Scoliosis 60Transitional vertebrae 61Osteoporosis 61Chapter 4: Finding Someone to Help with Back and Neck Pain 63Who Treats Back and Neck Pain? 63Primary care doctors 64Specialists 64Pain clinic consultants 65Physiotherapists 65How Well Qualified Is Your Specialist? 65Dealing with Osteopaths, Chiropractors, and Other Complementary Practitioners 66Building a Positive Relationship with Your Health Care Provider 68Chapter 5: Knowing Your Rights and Benefits 69Being Aware of Your Rights 69Seeking a second opinion 70Your right to hospital treatment 70Leaving hospital after treatment 71Checking Out the Alternatives 71Accessing Medical Reports and Health Records 72Getting Around the Benefits Jungle 72Taking time off work: Short-term absence and benefits 73Looking at long-term absence and benefits 73Dealing with disability: The personal capability assessment 73Getting a helping hand 74Getting Personal Advice 75Part II: Conventional Treatment Options 77Chapter 6: Home Remedies: First Aid for Your Back or Neck 79Heading to Your GP 79Using Home Remedies 81Climb into bed – but not for too long! 81Cool down and heat up 85Try anti-inflammatory drugs 86Starting to Move and Returning to Normal Activity 87Chapter 7: Back and Neck Pain under the Microscope: Common Medical Tests 89Appreciating the Importance of Your Medical History and Physical Examination 90Getting personal 90Getting physical 91Examining Your Doctor 92Exploring Your Diagnostic Testing Options 93Plain X-Rays 94MRI (magnetic resonance imaging) 95CT (computerised tomography) scanning 96Myelography 96Bone scanning 97Discography 98Electrodiagnostic studies 98Moving from Body to Mind 99Chapter 8: Going the Conservative Treatment Route 101Analysing Active Therapies 102Exercising healthily 102Understanding pain and functional restoration programmes 107Perusing Passive Therapies 108Hot and cold packs 108Ultrasound 109Massage 109Bed rest 110Water therapy 110Transcutaneous electrical nerve stimulation (TENS) 110Traction 111Corsets, braces, and collars 111Mulling Over Medications 112Analgesics 113Anti-inflammatory medications 114Muscle relaxants 115Sedatives 116Anti-anxiety agents 117Antidepressants 117Investigating Invasive Conservative Treatments 119Trigger point injections 119Facet joint injections 119Spinal epidural steroid injections 120Selective nerve root blocks 120Implantable pain therapies 121Chapter 9: Choosing to Have Surgery 125Choosing to Have Surgery 126Determining When Surgery Is Necessary 126Medically necessary spinal surgery 126Elective spinal surgery 127Addressing Psychological Issues and Surgery 129Getting a Consultation with a Spinal Surgeon 131Understanding the Different Types of Spinal Surgery 132Chymopapain injection or chemonucleosis 132Percutaneous discectomy 133Microsurgical discectomy 133Laminectomy 134Spinal fusion 135Preparing for Surgery 136Looking at the Future of Spinal Surgery 137Part III: Complementary Approaches: Are They for You? 139Chapter 10: Ancient Eastern Wisdom and Contemporary Ideas 141Selecting a Complementary Medicine Practitioner 142Choosing the Best Complementary Medicine Approach for You 143Asking the right questions 143Avoiding quackery 143Considering Specific Complementary Treatment Methods 144Acupuncture: Needling your way to a better back and neck 144Appreciating aromatherapy 148Taking up t’ai chi 149Rebalancing with reflexology 149Bodywork 150Chapter 11: Chiropractic and Osteopathic Solutions for Your Back and Neck Pain 155Understanding the Chiropractic and Osteopathic Ways of Thinking 156Choosing Chiropractic or Osteopathy 156Knowing What to Expect 158Making a diagnosis 158Starting treatment 159Looking at the Side Effects of Manipulation 160Stopping Manipulative Treatment 161Chapter 12: All in Knots: Trying Yoga 163Beginning Hatha Yoga 163Practising yoga postures 164Controlling your breath 164Meditating towards samadhi 166Using Yoga to Treat Back and Neck Pain 166Using yoga exercises for your back and neck pain 167Keeping a daily journal 168Resting and Relaxing 169Chapter 13: Using the Power of the Mind–Body Connection 171Taking Control of Your Thoughts and Emotions 172Recognising automatic thoughts 172Using automatic thoughts to your advantage 173Changing your thoughts 174Using the three- and five-column techniques 175Recognising the Relaxation Response: More than Just Relaxing 178Trying Different Types of Breathing 180Breathing awareness 180Diaphragmatic or abdominal breathing 181Relaxed breathing 182Considering Cue-controlled Relaxation 183Using Imagery Techniques 185Practising imagery 186Trying some standard imagery exercises 188Beginning Biofeedback Training 190Homing In on Hypnosis 191Part IV: Rehabilitation 195Chapter 14: The Importance of Posture 197Sizing Up Static Postures 197Standing up for yourself 198Sitting casually 202Lying down on the job – and anywhere else 205Dealing with Dynamic Postures 207Walking tall 208Looking at lifting and bending 210Chapter 15: Exercising Your Way to a Healthy Back and Neck 217Exercise Tips 218Exercise Warnings 219Your Exercise Programme 219Exercise 1: Pelvic tilt 220Exercise 2: Single leg pull 221Exercise 3: Double knee to chest 221Exercise 4: Pelvic lift 222Exercise 5: Partial sit-up 223Exercise 6: Oblique sit-up 224Exercise 7: Hamstring stretch 225Exercise 8: Gentle press-up 226Exercise 9: Cat and camel 226Exercise 10: Arm reach 227Exercise 11: Leg reach 229Exercise 12: Alternate arm and leg reach 230Exercise 13: Wall slide 231Exercise 14: Side stretch 231Exercise 15: Back arch 232Exercise 16: Head roll 233Exercise 17: Head pull 236Exercise 18: Neck tilt 236Exercise 19: Shoulder shrug 237Exercise 20: Shoulder roll 238Chapter 16: Products to Improve Your Back and Neck Health 241Relaxing at Home 242Everyday chairs for the home 242Massage chairs 243Sleeping Soundly 243Mattresses 243Pillows 244Opting for Office Comfort 244Office chairs and stools 245Changeable-height workstations 246Ergonomic footrests 247Travelling in Comfort 247Staying Fit and Healthy 248Part V: Resuming Normal Activity and Preventing Future Injury 249Chapter 17: Getting ‘Back’ to Work 251Pondering the Purpose of Work 251Identifying Risky Occupations 252Jobs that require lifting and bending 252All shook up: Exposure to vibration 253Sitting down on the job 255Identifying What’s Stopping You from Returning to Work 255Preparing to Return to Work 256Physically reconditioning 256Understanding your limits 257Preparing for flare ups 257Returning to the Office 258Chapter 18: Returning Safely to Your Favourite Sports 263Getting Involved in Sport Safely 264Warming up and cooling down 264Considering competition in your sport 265Knowing the risks 266Playing Sport with Spinal Pain 267Low-risk sports 268Low- to medium-risk sports 269Medium-risk sports 271Medium- to high-risk sports 273High-risk sports 277Chapter 19: Getting Back in the Saddle:Back and Neck Pain and Sex 279Understanding the Vicious Circle of Back and Neck Pain 279Communicating With Your Partner 280Getting in the Mood 283Getting Physical 284Getting Down to It, or Spine-Friendly Sexual Positions 284Getting started 285Outercourse 285The missionary position 286The female superior position 287Doggie style 287Side by side 288Putting It All Together 289Part VI: The Part of Tens 291Chapter 20: Ten Common Questions about Back Pain 293Can I Manage My Herniated Disc Without Surgery? 293What Kind of Practitioner Should I See for My Back Pain? 294Why Do I Still Have Pain When My Imaging Scans Are Normal? 295What about Alternative Treatments for My Back Pain? 296Is My Diagnosis as Terrible as it Sounds? 296When Should I Consider Surgery for My Back Pain? 297Can Stress and Emotion Cause My Back Pain? 298How Can Pain Only in My Legs Be Related to My Back? 298What Makes Up a Good Medical Evaluation for Back Pain? 298Should I Continue Exercising if Doing So Worsens My Pain? 299Chapter 21: Ten Common Questions About Neck Pain 301I’ve had Neck Pain for Years but my Doctor Says Nothing’s Wrong and I Must Live With It Is this True?  301I’m Going Out and Doing Less Because of My Neck Pain. Do You Have Any Advice? 302Why Have I had Three Different Diagnoses for my Neck Pain in as Many Weeks? 302Am I Ever Going to Find a Cure for My Neck Pain? 303What are the Pros and Cons of Neck Surgery? 303I’m Worried that My Family Thinks I’m Malingering What can I do? 304Could My Headaches Originate in My Neck? 304An X-Ray Shows I Have Cervical Spondylosis What does this mean? 305How Should I Deal With Whiplash Following a Car Accident? 305Can Neck Problems Cause Shoulder Pain? 305Chapter 22: Ten Steps to a Healthy Back and Neck 307Stay in Shape 307Do Your Back and Neck Exercises 308Maintain Your Proper Body Weight 308Watch Out for High-Risk Sports 308Foster a Positive Attitude 309Lift and Move Properly 309Don’t Lift and Twist 309Don’t Stand or Sit for Long Periods 309Use a Good Chair 310Avoid Carrying Heavy Luggage 310Chapter 23: (Almost) Ten Reasons to See a Doctor for Your Back or Neck Pain 311You’re Weak in the Legs or Feet 311You Can’t Control Your Bowels or Bladder 312Your Back or Neck Pain Awakens You 312You Have New Symptoms or Excruciating Pain 312You Have a Serious Accident 313You Want to Pursue Complementary Treatments 313You Need More than an Aspirin for Your Pain 314You’re not Seeing any Improvement 314Your Medication Isn’t Working 315Chapter 24: (Almost) Ten Tips for Working Successfully with Your Doctor 317Identify Your Communication Style 318Become an Assertive Communicator 319Plan Your Consultation in Advance 320Prepare Your Medical Fact Sheet 320Check Your Attitude 321Allow the Doctor to Ask Questions First 321Make Sure that You Understand the Conclusions 322Bring a Friend 322Explore Other Sources of Information 323Part VII: Appendixes 325Appendix A: Glossary 327Appendix B: Resources for Additional Information 337Organisations 337Acupuncture 337Alexander technique 337Alternative and complementary medicine (general) 338Ankylosing spondylitis 338Arthritis 338Aromatherapy 338Bodywork 339Chiropractic 339Consumer information and protection 339Drugs, medications, and products 339Fibromyalgia 339Homeopathy 340Hypnosis and hypnotherapy 340Massage therapy 340Meditation 340Mental health 340Naturopathy 341Nutrition 341Osteopathy 341Pain (general) 341Reflexology 342Support groups 342Surgery 342Yoga 343Product Resources 343Index 345