Neck and mid back pain are not as common as low back pain but it can still have a significant impact on one’s well-being. The majority of the time neck and mid back pain are related to one another but they can present as separate entities. The reasons we experience neck and mid back pain varies, but the majority of the time they are associated with poor posture combined with age-related wear and tear.

Symptoms

Symptoms can range from a dull ache to a stabbing or shooting sensation. Pain can be local or may radiate from the primary area of complaint due to increased muscle tension and/or down your arm(s)/torso depending what nerve roots are affected. Pain is generally worse with movement of the neck/ shoulder and mid back and improves with rest. Neck and mid back pain is also often associated with headaches. Acute symptoms generally only last from days to weeks, however if a more significant injury has occured symptoms may persist for some time. Following an injury it is also possible to have a delayed onset of symptoms.

Symptoms That Require Urgent Care

If you have been involved in a motor vehicle accident or serious trauma, or if you suffer from radiating pain into both arms or legs (myelopathic pain), problems with balance or coordination, loss of bowel or bladder control, loss of bowel or bladder control, unintended weight loss, fever or chills and/ or a severe headache with stiff neck seek medical care as soon as possible.

Causes

The causes of neck and mid back pain can vary widely.  Here are some of the most common causes:

• Postural/ repetitive strain
• Discogenic pain
• Muscle strain
• Ligament or joint sprain
• Degenerative processes
• Arthritic/ inflammatory conditions
• Sport injuries
• Lifting
• In rare cases other pathologies may cause pain in these region

It is important to note that especially for neck pain, discomfort may result from dysfunction elsewhere in the body (ribs/ mid back/ shoulder). We at the Robichaud-Levesque clinic strive to identify the specific cause of our patient’s symptoms in order to maximise patient outcome.

Risk factors

Prolonged sitting and immobility such as working in a sedentary work environment can influence neck and mid back pain just as much as repetitive loading. Therefore, it is important to maintain proper posture when sitting and standing just as much as when we are moving. Being overweight, smoking, inactivity and other comorbidities (other diseases) can all contribute to increased risk of suffering from neck and mid back pain. Trauma, such as whiplash injuries, are also common causes of neck and mid back pain.

Prevention

Avoiding aggravating factors should be the first thing you address if you suffer from neck and mid back pain. Improving your physical condition and practicing proper body mechanics and maintaining a good posture are paramount in managing these conditions. Adjusting your work environment/desk so it meets your needs, taking frequent breaks, not carrying anything heavy in one arms or on one shoulder, ensuring good sleep posture, maintaining a healthy weight and habits, staying active and not smoking can also all have a drastic impacts on one’s condition. Remember: stand smart/ sit smart and lift smart.

Headaches

Headaches are often associated with neck pain. These are referred to as cervicogenic headaches. If dysfunctions in the neck or surrounding areas can be normalized these will often lead to a significant decrease in headache intensity, severity and frequency.

Rib dysfunctions

Rib dysfunctions (costovertebral dysfunctions) are characterized as tight and tender areas on either side of the spine that can often refer pain up the backside of the neck. Rib dysfunction are also commonly associated with headaches. Many muscles from the neck attache to the upper ribs. When these joints are dysfunctional and do not move properly the surrounding muscles have to worker harder than they should. This increased stress exerted on the muscles and cause them to become hypertonic (tight). This increases the risk of compressing nerve roots that supply the scalp which may cause headaches if the conditions is not managed properly or in a timely manner.

Treatment Options

Standard medical care of neck and mid back pain is primarily based on pain management and reducing dysfunction(s). Not all neck and mid back pain are the same, therefore at our clinic we focus on identifying the root cause of an individual’s pain in order to tailor treatments and rehabilitation protocols accordignly.

Chiropractic care, , including the Sigma Ultralign Instrument, can help maximise joint mobility and reduce the muscle tension associated with neck conditions. Laser/photobiomodulation therapy can help by influencing tissue regeneration, increasing blood flow to the injured area and controlling inflammation leading to long term positive outcomes. Active rehabilitation is also useful in the management of these conditions. Surgery is rarely needed but sometimes necessary.

What’s next?

It’s important to note that once you suffer from neck and mid back pain you may be predisposed to recurrences. Secondary conditions such as degenerative disc and joint disease are also more likely to occur. Therefore, it is important to continue to maintain proper posture, movement patterns and continue to complete rehabilitative exercise even when you’re feeling asymptomatic to decrease the risk of re-aggravation. Regular spinal assessments may also be important in maintaining balance of all neuromusculoskeletal structures minimizing injury or dysfunction.