back pain

Treatments for back pain from a specialist

Extra treatment from the specialist may be recommended if self-help measures alone do not improve the back pain.

These extra treatments include:

  • group exercise classes where you’re taught exercises to strengthen your muscles and improve your posture,
  • manual therapy treatments, such as manipulating the spine and massage, which are usually done by a physiotherapist, chiropractor, osteopathy,
  • psychological support, such as cognitive behavioural therapy (CBT) if you are struggling to cope with pain.

Surgery is generally only considered in the small number of cases where back pain is caused by a specific medical condition.

back pain


In general, most back muscle spasms occur because of the following reasons:

(1) The muscles are trying to protect themselves from muscle strain

A back spasm can occur after any type of strain or injury to the soft tissues (muscles, tendons or ligaments) in the spine. This type of soft tissue injury typically heals enough within a week or two for the muscle spasms to stop.

(2) The muscles can spasm in response to an underlying anatomical problem

If your back spasm does not get better in 1 to 2 weeks, or it comes and goes overtime in the same area of your back, you may have an underlying anatomical problem in your spine. Some examples of underlying issues that could cause your back to spasm include:

  • Facet joint osteoarthritis
  • Spinal stenosis
  • Degenerative disc disease
  • Herniated disc

When these or other underlying anatomical problems are present in the spine, muscle spasms are likely to keep recurring due to ongoing inflammation or instability. It is important to seek medical attention to treat the underlying cause of your symptoms, rather than just treating the symptoms.

back pain


Common causes of back pain and neck pain can be divided into acute common causes and chronic common causes.


The most common cause of acute back or neck pain is a muscle injury, in which muscle fibres stretch too far and tear. Muscle injury may be caused by overuse, such as from heavy lifting, as well as by repetitive motions that put continual stress on the back or neck muscles.

Most muscle injuries alleviate within 6 weeks using treatments such as over-the-counter pain medicines, heat or ice therapy, or stretching exercises.


  • Lumbar disc herniation. A herniated disc occurs when the soft, gel-like interior of the disc bulges or leaks outward, irritating nearby muscles, joints, or nerve roots. A herniated disc typically causes sharp, stabbing pain down to the back of the legs (sciatica), which is usually more pronounced than low back pain.
  • Lumbar degenerative disc disease. Wear-and-tear on the spinal discs that cause chronic low back pain is called lumbar degenerative disc disease. This condition typically causes chronic, low-level low back pain that intermittently flares up for a few days or weeks before returning to normal.
  • Osteoarthritis. Spinal osteoarthritis consists of wear-and-tear on the facet joints, causing excess friction when twisting or bending the spine. This friction can lead to bone spurs that pinch a nerve root and produce sciatica pain. Other symptoms include stiffness and tenderness around the joint.
  • Sacroiliac joint dysfunction. The sacroiliac joint connects the hip bones (the ilia) to the sacrum, a triangular bone at the base of the spine. When the sacroiliac joint experiences too much or too little motion, it may cause pain in the hips, pelvis, and lower back.
  • Spinal stenosis. Narrowing of the spinal canal due to a bone spur, herniated disc, or another irritant can cause leg pain (sciatica). While back pain may occur with spinal stenosis, it is usually not as severe as the leg pain caused by nerve root irritation.
  • Isthmic spondylolisthesis. A spinal condition occurs when one vertebral body slips forward over the vertebra below it, straining the disc and joints at the spinal segment. Slippage is caused by a fracture in the back of the vertebrae. Low back pain, stiffness, and leg pain, numbness, and/or weakness are common symptoms of Isthmic spondylolisthesis.
neck pain


Back pain can be worsened by undue pressure on the neck and shoulders. This is often caused by a pillow that is too firm, or one that puts the head and neck in an uncomfortable angle. A pillow that relieves pressure will cradle the head and neck and reduce tension.

The best pillow for neck and shoulder pain is firm enough to hold the head at a healthy angle, but soft enough to alleviate pressure points. Most sleepers find success with a memory foam pillow as this material offer the best balance of support and pressure relief.

This pillow is available on the following link: Memory Foam Pillow for Sleeping – Ergonomic Design with Dual-Sided Firmness for Side, Back, and Stomach Sleepers – Cervical Support Pillows for Neck & Shoulder Pain, Charcoal & Gel-Infused : Home & Kitchen

neck pain


The best pillow for neck and shoulder pain is firm enough to hold the head at a healthy angle but soft enough to alleviate pressure points. Most sleepers find success with either memory foam, latex, buckwheat, or feather pillow, as these materials offer the best balance of support and pressure relief. An example of such pillow is available on the following link: Memory Foam Pillow for Sleeping – Ergonomic Design with Dual-Sided Firmness for Side, Back, and Stomach Sleepers – Cervical Support Pillows for Neck & Shoulder Pain, Charcoal & Gel-Infused: Kitchen & Home

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back pain


Upper cross syndrome and lower cross syndrome are terms referring to muscle weakness and tightness in certain areas of the body that may be contributing to pain and/or reduced functional level. Each “syndrome” entails two predominant areas of muscle tightness and two predominant areas of muscle weakness. Oftentimes, these limitations occur as a result of impaired posture and can lead to pain. Once identified, both upper cross and lower cross syndromes can be effectively treated and managed with physical therapy care.


The upper cross syndrome refers to the “upper half” of the body; the waist up. The two zones of muscle tightness are the pectoralis (pec) muscles and the upper trapezius/levator scapulae muscles. The pec muscles (pec major and minor) are located on the anterior (front) aspect of the chest. The upper trapezius and levator scapulae muscles are both located on the lateral (side) aspect of the neck and connect into the back. At the end of a long workday at a desk, posture can become less than ideal which includes forward head posture and slouching of the shoulders. With poor posture, these muscles become stretched and are unable to perform their jobs as effectively as needed and can lead to pain.


The lower cross syndrome refers to the “lower half” of the body; the waist down. The two zones of muscle tightness are the lumbar (low back) paraspinal and the hip flexor muscles. The lumbar paraspinal is located in the lower back on either side of the spine. The hip flexor muscles are located on the front of each hip. Standing posture contributes to the prominence of the lower cross syndrome and includes increased curvature through the lower back and positioning of the abdomen in a more anterior (forward) position. Over time, standing with increased curvature through the lower back and can lead to increased tightness through the lumbar paraspinal and hip flexor muscles. These limitations form half of the “cross” of the lower cross syndrome. The second portion of the cross of lower cross syndrome involves weakness through the gluteal and abdominal muscles. With poor standing posture, these muscles become stretched and are unable to perform their jobs as effectively as needed and can lead to pain.

neck pain


(1) LOFT. The loft determines the angle of your head in relation to your spine. A pillow that’s too high or too low can force your neck to bend at an unnatural angle, causing strain and discomfort over time. That’s why sleep experts recommend choosing a pillow loft that keeps your head and neck aligned with your spine.

(2) SUPPORT. In addition to being the right height under your head, a pillow should also adequately support your neck.

(3) FIRMNESS LEVEL. The pillow firmness will determine where your head comes to rest, so it’s important to give this aspect careful consideration. Pillows that are too firm may cause pressure points, for example in the ears when side sleeping. On the other hand, pillows that are too soft may sag under your head and fail to provide proper support.

(4) PRESSURE RELIEF. A good pillow provides pressure relief by taking the strain off the neck and contouring to reduce pressure points. For the best pressure relief, choose a pillow that’s the appropriate shape and size for your sleeping position, and the appropriate firmness to alleviate pressure at contact points.

(5) PRICE. When shopping for a pillow, keep in in mind that certain types of pillows will last you for years, while others may need to be replaced after a year or two as their materials wear out and lose their loft or conforming abilities.

(6) QUALITY MATERIAL. Within broad categories such as memory foam or feather pillows, the quality of the individual pillow plays a significant role in determining its longevity and comfort.

back pain, Facet joint radiofrequency denervation, neck pain



The spine is a column of bones arranged one on top of the other. The bones are linked at the back by joints called facet joints, one on each side. The facet joints hold the bones together and stabilise the spine, while also allowing movement.

The facet joints may become painful either due to wear and tear (also called degenerative change), stress or injury, although the reason is not always clear. Pain is felt around the facet joints and in the surrounding area. For example, pain starting from the joints of the lower back will often be felt in the buttocks and upper legs.


The denervation procedure is usually considered after trying less invasive treatments, such as medication, physiotherapy, transcutaneous nerve stimulation (TENS).

Exercise, acupuncture, yoga/pilates and relaxation therapy may also help ease back pain. Spine surgery could be also considered in selected cases.

Denervation is usually only considered if you have responded well to local anaesthetic injections near the affected areas, and these have helped to reduce pain.


Facet joint radiofrequency denervation is a procedure in which nerve fibres supplying the painful facet joints are selectively destroyed by heat produced by radio waves and delivered through a needle.

The treatment is usually performed after an injection of a local anaesthetic close to the affected joints has helped to reduce feeling and pain.

The denervation treatment involves placing a special needle (radiofrequency probe) near the nerve of the joint; when a radiofrequency current is passed down the probe, a very small area of heat is created that causes a break in the nerve. This procedure does not affect any other part of the body.

back pain, Back pain after bending over, Back pain after exercise


(1) Muscle spasms

Muscle spasms or cramps are quite common. They can happen at any time of the day, but especially during exercise or in the days following a workout. They are commonly caused by muscle overuse, nerve compression, lack of blood flow, dehydration.

Muscle spasms in the lower back often occur when you are bent over and lifting something, but they can happen during any movement involving your lower body.

(2) Strained muscle

A strained or pulled muscle occurs when a muscle is overstretched or torn. It’s commonly caused by overuse, physical activity, lack of flexibility.

(3) Herniated disc

The spine is made up of many parts including spinal discs and vertebrae. If a disc slips, it means that the soft center of the disc has bulged out, which can irritate the nearby spinal nerves. A slipped disc may be accompanied by severe shooting pain.

(4) Spondylolisthesis

Spondylolisthesis is caused by an injured vertebra shifting or slipping forward on the vertebra directly below it. More likely in younger people who participate in sports like gymnastics and weightlifting, spondylolisthesis is often the result of untreated spondylolysis. Spondylolysis is a stress fracture or crack in the small, thin portion of the vertebra that connects the upper and lower facet joints.

(5) Arthritis

Lower back pain may be the result of arthritis. Your joints are protected by cartilage, and when your cartilage deteriorates, it can cause pain and stiffness. There are many different types of arthritis, including osteoarthritis, psoriatic arthritis, rheumatoid arthritis.

The back pain you are feeling when you bend over is likely due to a muscle pull or strain. It could, however, be something more serious such as a herniated disc. If you are experiencing severe back pain, blood in urine, changes in bowel or bladder habits, pain when you lie down, or fever, you should get medical help right away.
If your back pain does not go away or improve over time, schedule an appointment with your doctor for a full diagnosis.