Back, neck & Shoulder pain

Back pain is very common, and is not normally due to anything serious – even if the pain is very bad. Most people will experience back pain during their life and  typically many episodes of back pain will settle within 6 weeks, although it's not uncommon to be longer especially if pain is felt into the leg.

What are the symptoms? Back pain is usually felt in your back and/or your buttock area, sometimes it can refer pain down your leg and you may experience some pins and needles and/or numbness/neuropathic pain. (See Red Flag Section for further information on symptoms)

Why do I have back pain? Back pain  can occur due to an obvious injury but sometimes there may be no specific injury but often an underlying cause, routinely sitting at work for a long time without a break for example. 

Persistent/chronic Back pain- we can help get you on a supported self-management programme

Neck pain is also common problem and most cases are not caused by a serious problem.

What are the symptoms? Pain around the neck is the most obvious symptom but it can be referred into the shoulders, shoulder blade area or to the face and head - this can vary from an intermittent ache to a more severe sharp pain. Frequently joint stiffness and tense muscles limit the movement of your neck and headaches are a common result of longstanding neck irritation. If a cervical nerve is irritated in the neck area, you may feel pain and/or numbness/pins and needles in your arm and hand. Dizziness and feeling light headed can also be a symptom of neck strain.   

 (See Red Flag Section for further information on symptoms)​  

Why do I have back Neck Pain? The cause of this pain can be obvious like an accident, spondylosis (spinal arthritis) or more subtle when related to a repetitive task or prolonged positions. Also anxiety and stress can cause tension in neck and spinal muscles. Head and neck movements when eyesight is deteriorating or the wearing of varifocal glasses. These and many other stresses can affect all ages from young children to adults. The popularity of laptops, electronic gaming and texting has led to an increase in teenagers experiencing neck pain. Cervical joints that are already affected by wear and tear are particularly susceptible to strain.    

Our Physiotherapists can help diagnose your symptoms and have you back on the road to recovery in no time

What to do about Neck Pain

• Regular movement is key to recovery so gently move your neck often as pain permits — avoid keeping your neck completely still and do not wear a collar, you need to allow your muscles chance to regain strength through movement.
  
• Relax: One technique is to relax and ‘let go’ of the muscles around your neck letting your shoulders gently drop as you breathe out.  Tension should be avoided so be aware if you are clenching your teeth! 
  
• Take regular breaks from using computers — Avoid looking at screens offset or for too long 
  
• Reduce your anxiety and stress levels, take time to unwind  and maybe try using a heat pack around your neck, following any instructions carefully to avoid burning yourself!
  
• Over the counter painkillers that work for you can be taken - relieving the pain can help to relax muscles and allow you to move your neck​ more frequently

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If you are unsure of concerned about your back pain then contact one of our Physiotherapists who can help diagnose your condition and put together a recovery plan with a specific exercise regime and personalised advice.​

A shoulder injury or condition hampers your ability to move freely and can cause a great deal of pain and discomfort. Shoulder pain can come from the shoulder joint itself or from any of the many surrounding muscles, ligaments, tendons or bursa. Shoulder pain that comes from the joint usually worsens with activities or movement of your arm or shoulder. Shoulder pain that is referred from a different, underlying condition usually doesn't worsen when you move your shoulder.   (See           Red Flag section for further information on symptoms)

Why do I have shoulder pain? Shoulder pain can arise from an acute trauma, disease or be a gradual onset often due to repetitive tasks.

What are the symptoms?  There are many and varied problems arising from the shoulder some of which are listed below: 

• Shoulders get their range of motion from the rotator cuff which is made up of four tendons, tendons are the tissues that connect muscles to bone. It may be painful or difficult to lift your arm over your head if the tendons or bones around the rotator cuff are damaged or swollen.
• Rotator cuff tendons can get damaged or diseased (tendinopathy) and this is a common cause of shoulder problems and can cause significant discomfort on movement.
  
• Osteoarthritis of the glenohumeral (shoulder joint) can cause morning joint stiffness and pain and swelling.
  
• Osteoarthritis of the acromioclavicular joint (a joint at the top of the shoulder) can also cause joint stiffness and pain and swelling.
  
• Glenohumeral instability general laxity can occur following a previous dislocation or be due to underlying hypermobility, a condition that features joints that easily move beyond the normal range expected for that particular joint.
  
• Frozen Shoulder (adhesive capsulitis) is a condition that affects the ability to move your shoulder as it causes a change in the capsule of the shoulder causing stiffness and pain which reduces normal movement. Frozen shoulder usually only affects one shoulder, although in approximately 1 in 5 cases the condition occurs in the both shoulders. The condition is uncommon in young people and most cases occur in people between the ages of 40 and 60. It has 3 stages which can be spread over months or years: 
  
  • Stage one: the shoulder starts to ache and feel stiff, before becoming painful. Pain is often worse at night and when you lie on the affected side. This stage lasts between two and nine months
    
  • Stage two: this is known as the adhesive stage. The shoulder typically becomes more and more stiff, although the pain does not normally get worse. The muscles may start to waste slightly as they are not being used. This stage lasts between four and twelve months.
    
  • Stage three: this is the recovery stage in which you gradually regain movement of the shoulder. The pain also fades, although it may recur from time to time as the stiffness eases. Although you may not regain full movement of your shoulder, you will be able to do many more tasks. This stage lasts five to twelve months​​​

First of all, don' t worry! For the vast majority of problems there is no special cause for concern other than treating the problem you are experiencing. Typically first stop is to book a session with your PFO physiotherapist who will make an assessment. We are formally trained in diagnosis which can, at times, uncover symptoms that need further investigation by your GP.

For example, you may experience 

• Unsteadiness on your feet
• Severe pain which is getting worse rather than better over the course of 1-2 weeks                                         
  
• ​You may feel quite unwell due to the back pain
  

If you have any of these symptoms you should seek an urgent appointment with your GP as soon as possible

Cauda Equina Syndrome is a comparatively rare but very serious condition which occurs when the nerves located at the bottom of the spinal cord – known as the ‘cauda equina’ – become compressed. This compression causes Cauda Equina Syndrome which can manifest in a number of different ways:

• Loss of feeling/pins and needles between your inner thighs or genitals
• Numbness in or around your back passage or buttocks
• Altered feeling when using toilet paper to wipe yourself
• Increasing difficulty when you try to urinate
• Increasing difficulty when you try to stop or control your flow of urine
• Loss of sensation when you pass urine
• Leaking urine or recent need to use pads
• Not knowing when your bladder is either full or empty
• Inability to stop a bowel movement or leaking
• Loss of sensation when you pass a bowel motion
• Change in ability to achieve an erection or ejaculate
• Loss of sensation in genitals during sexual intercourse

Any combination of the above warning signs could be symptoms of Cauda Equina Syndrome.

Seek emergency medical help within 12 to 24 hours either at your GP setting or A&E

Regarding neck Pain we are formally trained in diagnosis which can, at times, uncover symptoms that need further investigation by your GP.

For example, you may experience:

• A lack of coordination(for example; finding fiddly tasks increasingly difficult)
• Problems walking
• Loss of bladder or bowel control
• A high temperature (fever)
• Unexplained weight loss
• Radiating left sided chest pain

If you have any of these symptoms you should seek an appointment with your GP as soon as possible