Discussion:

The prevalence of low back pain in the United States is approximately 80 percent.  At any given time, 31 million Americans will suffer from lower back pain. In the United States, low back pain is second only to the common cold as the reason patients cite for seeking medical care. The estimated cost of medical care for patients with low back pain exceeds $8 billion annually.

Neck pain along with related disorders such as cervical radiculopathy and headache, is very common. It is estimated that 30-50% of adults will experience some form of significant neck pain in any given year. Further, work limitation due to neck pain occurs in 11-14% of individuals each year.

A common cause of back and neck pain is muscle strain or tension.  Activities such as performing several hours of deskwork, having poor posture while watching TV or reading, placing your computer monitor too high or too low, sleeping in an uncomfortable position, or twisting and turning the body in a jarring manner while exercising, all contribute to what is known as mechanical back and neck pain.  These everyday postures lead to overuse syndromes of the musculature surrounding and directly attaching to the spinal column.  With respect to neck pain, research has reported that chronic muscle tenderness and tightness is the most common clinical finding in adults with self-reported neck pain.  Muscle groups that commonly contribute to neck pain are the upper trapezius, levator scapulae, sternocleidomastoid, scalenes, neck extensors, and the suboccipital muscles to name a few.  Examples of muscle groups that commonly contribute to lower back pain are the erector spinae, quadratus lumborum, gluteal musculature, hip flexors, and the hamstrings.

Another common cause of back and neck pain is vertebral joint restriction.  The joints that make up the vertebral column have one purpose, to move in attempt to help distribute load on the spine as a whole.  Certain areas of the spinal column are more mobile than others and conversely, there are areas of the spine that become restricted much easier due in part to changing joint orientation and alignment.  Areas of the spine that commonly experience a loss of motion are known as transitional areas.  Throughout the regions of the spine containing freely moveable bones (cervical, thoracic, lumbar), the alignment and orientation of the vertebrae is consistent.  When one region transitions to another (Ex: cervical – thoracic  or thoracic-lumbar), the joint orientations change, slowing the flow of load distributed from one region to the next.  As time goes by, marked joint restriction builds up in these transitional areas leading to joint stiffness and immobility.  Just like muscle tightness and restriction, joint restriction is also a common generator of pain and discomfort.