What you consume can play a major role in your recovery process

When you visit a physical therapist for an injury, you typically expect to be provided with a program that includes various exercises, techniques and other treatments intended to reduce your pain and improve your physical abilities. What you may not expect is advice on nutrition and your diet, since physical therapy seems to be more focused on how the body moves. Focusing on patients’ physical condition is certainly a big part of physical therapy, and it’s for this very reason that some physical therapists are starting to offer nutritional education on top of their regular treatment as a useful tool to improve patients’ overall health outcomes. Since what you put into your body will affect how it works and how well it moves, these therapists are realizing that proper nutrition should be considered an essential component of any treatment program.

Five conditions associated with pain that better nutrition can help address

Learning about nutrition and making changes your diet can result in a bounty of benefits that will improve your health in a number of ways. But there are several conditions associated with pain that can directly benefit from a better diet, including these five:

1. Inflammation: many foods that are popular in the Western diet—like vegetable oils and fried foods—increase inflammation and can often make injuries worse; a Mediterranean diet, on the other hand, which is rich in healthy fatty acids, fruits, vegetables, and fiber, fights inflammation and can be beneficial for individuals with rheumatoid arthritis and other inflammatory conditions
2. Obesity: being obese contributes to many other chronic pain conditions, and the pain can, in turn, lead to less physical activity and make the problem worse; this is why weight loss through proper nutritional health should become a crucial part of overall pain rehabilitation
3. Osteoarthritis: patients who are overweight or obese have an increased risk for developing osteoarthritis, especially in the knees and hips; it’s also been suggested that deficiencies of certain nutrients—including vitamins C and D, and selenium—contribute to osteoarthritis; this shows that focusing on nutrition may address osteoarthritis in several ways
4. Autoimmune disease: approximately 23.5 million Americans have an autoimmune disease, and new research is suggesting that dietary changes over the past 50 years may have played a part in increasing rates of these diseases. Moving away from a high-sugar, high-salt and heavily processed diet to a more nutritious one may, therefore, reduce the occurrence of autoimmune disease.
5. Prediabetes and type 2 diabetes: High pain levels in patients with type 2 diabetes can negatively impact their quality of life, physical function, and physical activity abilities. Diet is an integral part of managing diabetes, and improving it can yield a host of benefits.

How your physical therapist may be able to help

If you’re dealing with any of the conditions listed above along with an injury, your physical therapist may be able to offer some professional advice and education on the role your diet may be playing. By asking you about some of your dietary habits, suggesting that you keep a food diary, and establishing some simple and attainable goals, they can start you on a path to better nutrition and better overall health, which will, in turn, result in a faster recovery from your injury. Following a course that focuses on proper nutrition will also set you up for a better functioning body and a reduced risk for injury in the future.

-Summarized from a Nov. ’16 article published by theAPTA

Many treatments available for extremely common condition

Approximately 80% of the population will experience low back pain (LBP) at some point in their lifetime, and it’s one of the most common reasons that leads patients to visit a medical professional for treatment. There are many treatments available for addressing acute LBP, which is pain that has lasted for less than six weeks, including pain medications, muscle relaxants, exercises and physical therapy. One intervention that physical therapists may utilize for LBP is called spinal manipulation, in which they manipulate certain parts of the spine with their hands in order to bring about changes that will reduce patients’ pain levels. Although some studies have found spinal manipulation to be beneficial for patients with LBP, others have found mixed results and called into question its actual effectiveness. For this reason, a powerful pairing of studies called a systematic review and meta-analysis was conducted to determine the true value of spinal manipulation for LBP.

26 studies are included in the comprehensive review

To conduct the study, investigators searched through four major medical databases for studies that evaluated spinal manipulation for LBP. They identified 40 articles and then screened them for inclusion, and from these, 26 randomized-controlled trials (RCTs) were accepted for the review. RCTs are high-quality studies in which groups of patients are randomly assigned to different treatment groups, and they are considered the gold standard for evaluating if an intervention is effective. Once accepted, all 26 RCTs were analyzed and their findings were compared to one another. In the final step, each study was assessed for its level of quality in order to help determine how reliable its findings were.

Spinal manipulation leads to significant benefits for six weeks

Results showed that spinal manipulation led to significant benefits for patients with acute LBP that lasted for at least six weeks. In particular, the treatment was found to be associated with reduced pain and improved function, and these improvements were graded as modest. In addition, spinal manipulation was only associated with very minor and temporary harms afterward. Twelve of the included studies were classified as high quality, while the other 14 were graded as low quality. This review adds to the literature that already exists on the topic, and should further strengthen recommendations to use spinal manipulation for patients dealing with acute LBP. Based on these findings, taking this type of approach will bring about several benefits in the short term. For this reason, additional studies are also needed to evaluate the long-term effects of spinal manipulation for patients with acute LBP.

-As reported in the April ’17 issue of JAMA

Research lacking on the potential benefits of immediate physical therapy

Low back pain (LBP) is one of the most common and costly conditions in the world. It ranks as the leading cause of disability, and in 2014, approximately 68.6 million Americans—or 28.6% of the population—reported having LBP for a whole day or more in the prior three months. Physical therapy is supported by research as an effective treatment for LBP, and approximately 20% of patients are referred to a physical therapist by their doctor. Although it is generally agreed that these patients should remain active when LBP strikes, there is no consensus on when the best time is for them to begin physical therapy. While some guidelines recommend delaying physical therapy for several weeks, other studies have shown that this approach can cause patients to use more healthcare services and spend more in the process. There is also not a great deal of research on the potential benefits of immediate physical therapy in which patients see a physical therapist within three days of first experiencing LBP. With this in mind, researchers decided to conduct a study to examine healthcare usage and costs when patients receive physical therapy at various points in time.

Large health insurance claims database used

To conduct the study, investigators searched through a large health insurance claims database to identify patients with LBP. After excluding patients for various reasons, this search led to 46,914 fitting the necessary criteria and being accepted into the study. Based on their data, these patients were then divided into five groups depending on whether they received physical therapy and when therapy started: 1) no physical therapy, 2) immediate physical therapy (receiving physical therapy within three days of seeing their doctor), 3) early physical therapy (between 4-14 days), 4) delayed physical therapy (between 15-28 days), 5) late physical therapy (between 29-90 days). With these groups in place, researchers then compared healthcare usage and costs between them to determine if there were any advantages of seeing a physical therapist early.

Immediate physical therapy is associated with lowest costs and healthcare use

Of the 46,914 patients included in the study, 6,668 (14.2%) received physical therapy within 90 days. Of these patients, 2,052 (30.8%) started immediately, 2,219 (33.3%) did so early, 1,044 (15.7%) were delayed, and 1,353 (20.3%) were placed in the “late physical therapy” group. Comparisons between the patients that received physical therapy showed that those who did so immediately reported the lowest healthcare usage and costs in nearly all outcomes measured. In particular, it was found that these “immediate physical therapy” patients had the lowest opioid and pain medication use, emergency department visits, fewest advanced imaging tests (like MRIs), and lowest non-LBP-related costs. The results also showed that both costs and healthcare usage gradually increased as patients waited longer to begin physical therapy. Based on these findings, it appears that seeing a physical therapist for LBP immediately or early—within 14 days—will lead to the lowest costs and usage of various healthcare services, since physical therapists usually only recommend additional testing or procedures if they are completely necessary. Patients who are currently dealing with LBP are therefore encouraged to see a physical therapist as soon as possible in order to get started on a direct path to recovery without any detours.

-As reported in the May ’18 issue of Physical Therapy

For many individuals in our fast-paced society, every day is often seen as an opportunity to “get things done” in the most efficient and productive manner possible. But, there is a world of possible obstacles that can derail your daily plans, a painful condition like back pain can often be your biggest challenge.

Back pain is generally considered to be the most common condition that causes disability in the world. The back muscles and spine support much of the body’s weight, and we use these muscles in a significant number of our everyday movements like sitting, standing, and walking. So it’s not hard to see that when back pain arises, it can truly interfere with an individual’s productivity and ability to perform their best at work, and in daily life.

As a result, the response to this interference is usually the same for most people: how can I get rid of this pain quickly so I can return to functioning normally? Unfortunately, there is an abundance of options, but no single cure—or cures—that will work for everyone. What completely eliminated your friend’s back pain may not do a thing for you, and vice versa. This is why the smartest approach you can take is a process of trial and error, giving many different remedies a shot and seeing which ones lead to improvements. In most cases, it won’t be just one change, but rather a combination of several that are right for you. Below are some of the most effective home remedies that are worth trying.

Home remedies that can help alleviate your back pain

• Ice/heat therapy: ice and heat are two of the most commonly recommended remedies for pain relief, and the reason is that they often work; try both for 20-30-minute intervals every few hours
  • Ice therapy reduces inflammation, which is often a culprit in any type of back pain, and it acts as a local anesthetic by slowing down nerve impulses; icing is best within the first 2-3 days after pain arises
  • Heat therapy stimulates blood flow, which brings healing nutrients to the painful areas of the back, and it inhibits pain messages being sent to the brain; use heat about 3 days after the pain starts, and try several methods like a hot compress, heating pad, or hot shower
• Sleep: both how you sleep and how much you sleep can each have a big impact on your back pain, so it’s best to address both of them head-on
  • Change your sleeping position: sleeping flat on your stomach or back should generally be avoided, while some of the better positions for individuals with back pain are on your side with a pillow between your knees or in the fetal position, on your stomach with a pillow under your abdomen, or on your back with a pillow under your knees
  • Get more sleep: about 2/3 of people with chronic (long-lasting) back pain also suffer from some type of sleep disorder, and bad sleep can make back problems worse, so try to get the recommended 7-8 hours every night
• Exercise: while it may seem logical to avoid movement when you have back pain, lack of physical activity can actually make your pain worse
  • General exercise: try to get at least 150 minutes of moderate-intensity exercise (like brisk walking) or 75 minutes of vigorous-intensity exercise (like jogging) every week
  • Core strengthening exercises: core strength can have a big influence on back pain, and these muscles are often not worked on in a normal day, which is why they should be specifically focused on; try these ab exercises
  • Hamstring stretches: if the hamstring muscles in the front of the thigh are too tight, the lower back and hip joints can get more stressed, which leads to more back pain; try stretching them out with these exercises
  • Additional strengthening exercises for the lower back
• Other: some patients also find back pain relief through a variety of other home remedies and lifestyle changes
  • Posture training
  • Improving your workstation
  • Yoga, Tai chi, and meditation
  • Epsom salt baths

Also remember that many of the same tactics to prevent back pain also apply to treating it, so if you’re interested in learning more ways to ease your back pain, read our last newsletter that covers some smart back pain prevention strategies. Click here for our article on the “Best ways to reduce your chances of developing back pain.”

The fact that back pain is so common in the general population might make you feel as if you’re powerless to do anything to stop it from occurring. This can prove to be one of the biggest mistakes you can make, as failing to take any action whatsoever is certain to only make matters worse.

The truth is that your chances for developing back pain depend on a multitude of factors. Some of these factors, like your genetics, bone alignment, and age-related changes that eventually occur in everyone, are more or less completely out of your control. However, there are a great deal of other factors related to your everyday life and habits that also play a significant part in determining your chances of getting back pain. These are the factors that are ripe for change.

Weight problems, for example, are a big contributor to back pain. Not being a healthy body weight can put excessive pressure and strain on the spine, which weakens structures and increases the potential to experience pain. Obese individuals are especially more likely to suffer from low back pain because of their extra weight in the midsection, which pulls the pelvis forward and strains the lower back even more. Reduced fitness levels can also contribute to back issues, as having muscles that are weak or inflexible means there is less support for the spine and it can, therefore, become damaged more easily.

Key lifestyle changes to reduce your risk for experiencing back pain

If you’re concerned about your chances of confronting back pain at some point in your life, the best strategy you can devise is to make smart modifications now to your lifestyle. While there are no guarantees that any lifestyle changes will completely eliminate your risk, following these tips is sure to have a significant impact on reducing it:

• Become more physically active: if you’re not already getting the recommended 150 minutes of moderate-intensity activity (like brisk walking) or 75 minutes of vigorous-intensity activity (like jogging) each week, you should make it a primary goal to reach these weekly targets; try various types of exercise to figure out which are best for you, and create a feasible exercise plan that you can stick with in the long term
• Maintain a healthy weight: as mentioned above, weight is one of the bigger factors in determining risk for back pain, so losing weight should be another major focus if you are currently overweight; this is obviously easier said than done, so it may be best to see a dietician or nutritionist to identify dietary issues and establish a healthy eating plan
• Stop smoking: smoking restricts blood flow to the intervertebral discs that lie in between the spinal bones (vertebrae), which gives smokers a much higher chance of having back pain; so quitting now is another great way to reduce your risk
• Minimize excessive stress on the spine: the way you position your body when you’re sitting, standing, and walking all affect your spine, and excessive stress on the spine, over time, can cause back pain; so if you work at a computer, make sure it’s at eye level, sit with your feet flat on the floor and the back of your chair in an upright position; the keyboard should also be directly in front of you, close by, and at a height so your shoulders are relaxed, elbows slightly bent, and wrist and hands straight
• Reduce stress levels: stress can cause you to tense and tighten your muscles, which deprives them of the energy needed to support the spine and can result in back pain; any activity that alleviates stress can therefore also affect back pain risk
• Avoid high heels, extremely tight pants, and heavy handbags and briefcases: these lesser-known factors may also contribute to the development of back pain in various ways, so you should try to take steps to avoid them as much as possible

If you need additional motivation, you should notice that perhaps the best part of these lifestyle changes is that they don’t only apply to back pain risk. These are healthy behaviors in general that will lead to a number of other benefits in your life, so you can improve your health while also lowering your risk of experiencing back pain.

There are very few guarantees in life but chances are you’ll experience back pain at some point in your lifetime, as about 8 out of 10 people will deal with it at least once. The type of back pain you may experience will depend on your age, habits, and health, and it’s important to realize that some cases can be avoided while others are completely out of your control.

The spine consists of 33 bones called vertebrae, which are stacked on top of one another and interlocked to form the spinal column. The vertebrae are connected by small joints that allow the spine to move in various directions, and in between each vertebra is a structure called an intervertebral disc. These discs are filled with a jelly-like substance and their purpose it to absorb shock and prevent these bones from rubbing against each other. Together, these features allow you to rotate and turn your torso, and they help to make the spine one of the sturdiest structures in the body. But as with every other body part, there are many different things that can go wrong within the back, and the result is often pain.

The amount of control you have over your back pain decreases with older age

Between sports, playing with friends, and due to their seemingly never-ending source of energy, most kids lead a pretty active lifestyle. As a result of the constant activity, their bodies can take quite a beating, which are very resilient but still have a breaking point. When pushed too far, the result can be back pain, which is more common in children and adolescents than you might think.

Most of these cases are due to strains and sprains of the muscles and ligaments of the back, which can occur either from a single injury or over time after continuing to abuse the back. In particular, children that participate in various sports year-round without enough time to recover may have a higher risk for injuries like back pain. There’s also been an increase in adolescent back pain related to being overweight, as the extra weight puts stress on the immature spine and throws off posture, which causes the lower back to work harder to stay upright.

While these types of problems are possible throughout life, in young adults, back pain is more commonly associated with other types of resting behaviors. Many individuals in this age group spend a great deal of time on screens such as laptops, tablets, and smartphones. Hunching over and staring at a screen with poor posture for extended periods of time can strain the muscles attached to the back and the result is often lower back pain. These are also examples of habits that can be changed to prevent pain from occurring.

With age, different problems arise due to age-related changes that may be less under your control. One of the more common changes that occurs with age is that the intervertebral discs eventually begin to dry out. These discs are originally soft and squishy to better absorb shock, but over time they lose some of their height and strength, and can no longer take on as much impact. Other changes that usually start to occur in middle age include a narrowing of the space surrounding the spinal canal and a weakening of the joints that connect the vertebrae together. As a result of all of these age-related changes, a number of other conditions become more likely to strike, such as:

• A herniated disc: occurs when some of the softer jelly-like substance pushes out through a tear in its tougher exterior, which may or may not cause symptoms
• Spinal stenosis: the name for the narrowing of the spinal canal, which can put pressure on the spinal cord and lead to pain
• Spondylosis: a general term used to describe any pain related to age-related changes in the spine, which becomes more common with aging

All of these back-related issues remain likely for older adults over age 65, but other conditions like osteoarthritis and osteoporosis become even more common in later life as well. Osteoarthritis occurs when individuals lose some of the protective cartilage surrounding the ends of the vertebrae, which allows them to rub against one another and often results in pain. Osteoporosis is a condition that causes bones to become weak and brittle, which increases the chances of fractures in the back. Further adding to the potential for back pain in older age is the loss of flexibility that many individuals experience. Reduced flexibility often has a negative impact on activity levels, which can create a vicious cycle of less movement and a higher risk for injuries like back pain.

So as you can see, back pain can occur at any age, and the risk for it increases as we get older. While this may not be the most encouraging piece of news, the most important thing to understand is that you have the power to influence your risk based on the habits and behaviors that define your life.

Neck pain remains one of the most common reasons patients seek treatment

Neck pain is extremely common, as it ranks fourth of all conditions that are responsible for causing disability. As a result, neck pain is also one of the most common reasons that individuals seek out treatment, and the majority of them go to their primary care doctor for an evaluation. Doctors usually recommend medication, additional testing, a referral to a specialist, or some combination of these interventions, but evidence is lacking to support many of the approaches that are used. On the other hand, recently published guidelines recommend many of the interventions used by physical therapists for neck pain—such as education, stretching exercises, and manual therapy—as research has found them to be effective for reducing patients’ costs and their use of healthcare. Seeing a physical therapist early is also generally recommended, but research evaluating how the timing of going to therapy affects costs and healthcare usage on neck pain patients is lacking. For this reason, a study was conducted to investigate the impact of seeing a physical therapist at different points in time on costs and healthcare use.

Patient records are collected and analyzed

To conduct the study, researchers scanned medical records to identify patients with neck pain who sought out care from a physical therapist, and they found 308 that fit all the necessary criteria. Once the patients records were collected, the researchers divided them into three groups depending on when the patient consulted with a physical therapist: 1) early physical therapy (for those who saw a therapist within 14 days of first seeing a medical professional), 2) delayed physical therapy (between 15-90 days), and 3) late physical therapy (91 days or more). Using these groups, data from the patients was then analyzed to determine if there were any associations between the time it took for them to see a physical therapist and their overall usage of healthcare services over one year. They particularly focused on opioid prescriptions, spinal injections, and imaging tests (X-rays, MRIs, and CT scans), as well as the overall costs of these services for each patient.

Patients with neck pain are encouraged to see a physical therapist early to save on costs and avoid unnecessary interventions

Of the 308 patients in the study, 160 (52%) consulted a physical therapist within 14 days for their neck pain, while 74 (24%) did so in 15-90 days, and 74 (24%) waited for more than 90 days. In general, results showed that those who saw physical therapist early typically underwent fewer treatments and tests, and spent less on their care compared to those in the “delayed” and “late” groups. More specifically, it was found that consulting a physical therapist late (>90 days) for neck pain was associated with a more imaging tests, spinal injections, and opioid prescriptions, all of which added up to more healthcare utilization. In addition, patients in this late physical therapy group spent an average of $2,172 more on healthcare over one year compared to those in the early physical therapy group who consulted within 14 days. Taken together, these findings suggest that when a patient sees a physical therapist early for their neck pain rather than waiting, they may be reducing their chances of undergoing tests and treatments that may not be necessary, and saving on healthcare costs as a result. Patients who currently have neck pain are therefore encouraged to consult with a physical therapist as soon as possible so they can get started on a personalized treatment program right away while avoiding additional interventions that have questionable value.

-As reported in the November ’18 issue of BMC Health Services Research

According to the Centers for Disease Control and Prevention (CDC), about 20% of Americans have experienced neck pain at least once in just the past three months. If you count yourself as one of these individuals or are dealing with neck pain currently, the most important question you probably have is: how can I relieve my pain right now?

Many causes of neck pain and stiffness are related to muscles in the region becoming weaker over time from poor posture and other bad habits that lead to misuse of the neck. So in a way, the sum of many of your daily behaviors can be seen as a major indicator of whether or not you’ll develop neck pain and how severe it will be.

This also means that if you have neck pain at this very moment, one of the best things you can do is to take a close look at how you use your neck throughout the day and identify any postures that might be contributing to your pain. For example, if you take public transportation to work, observe your neck position throughout your commute. If you notice that you tilt your head down when reading or to the side when taking a nap, you should try to change your habits to avoid these movements and consider using a neck pillow for the short naps to keep your neck properly aligned.

Here are some additional tips that will help to alleviate your neck pain right now:

• Use ice or heat: for minor neck pain that has just started, try applying an icepack to the neck for 20-30 minute intervals every few hours the first 2-3 days; after this period, apply heat to the area with a hot compress, heating pad, or hot shower
• Perform neck stretches: it’s important to keep moving your neck even when you’re in pain, but to avoid any jerking movements that can put strain on the neck; there are also some specific stretches you can perform anywhere:
  • Roll your shoulders backwards in a circle for 10 repetitions
  • Squeeze your shoulder blades together for 10 repetitions
  • Bring your ear to your shoulder 10 times on each side
  • When riding in a car, push your head back into the head rest while keeping it straight, and hold it for 30 seconds
• Exercise in a pool: many individuals find pools—especially those kept at a warm temperature—to be soothing for neck pain; aquatic exercise, gentle swimming strokes, or simply moving around the water with the neck submerged may all help
• Reduce stress: high levels of stress can cause you to tense the muscles in your neck and may make pain worse; this is why it’s important to try to find ways to reduce your stress in order to prevent further neck pain and stiffness
• Stay hydrated: the intervertebral discs that cushion all the bones of the spine are made primarily of water, so staying properly hydrated will help to keep them strong and flexible, increasing your chances of recovering from neck pain

Many of the recommendations for prevention also apply to treatment, so if you’re interested in learning more ways to ease your neck pain, read our last newsletter that covers some smart neck pain prevention tactics.

The neck has an incredibly important job to do. It supports the head and allows us to move it in a wide range of directions so that we can better navigate the world around us. But because of how frequently it’s used and its position in the body, the neck is also a very common location for pain, and sometimes all it takes is one bad night’s sleep to ruin your day.

In any given individual, there are many factors that may be responsible for the development of neck pain. What is most important to realize is that some of these factors are completely out of your control, while others can be modified and improved to reduce your chances of developing neck pain. For example, age-related changes to the structures of the upper spine will eventually occur in all individuals. Nothing can be done to stop these changes, and they may contribute to neck pain for some people.

But on the other hand, there are many changes that you can make to your life right now that can help prevent neck pain from occurring. Most of these modifications relate to avoiding postures and positions that might strain or otherwise aggravate the neck, particularly in bed and at workstations—the two places where we generally spend most of our time.

Bed setup

We spend roughly one-third of our lives sleeping, so the habits we develop in both our sleeping patterns and in how our beds are set up can have a major impact on the rest of the day. Sleeping in the wrong position or on a pillow that’s not supportive enough can both lead to neck pain either the next morning or gradually over time. To optimize your bed setup, we recommend the following tips:

• Avoid sleeping on your stomach: the best sleeping position is on the back, followed by the side, while stomach sleeping turns the neck to the side and can lead to neck pain; sleeping positions are often established earlier in life and difficult to change, but trying to start a night’s sleep on the back will increase your chances of staying there
• Use a pillow that’s right for you: make sure your pillow is of the appropriate firmness for your neck; different types of pillows are better for different individuals, but a good rule of thumb is to try to use a pillow that keeps your upper spine in neutral alignment, which means the natural curve of the neck is supported and maintained; feather and memory foam pillows may be helpful, while pillows that are too high or too stiff should be avoided
• Get enough sleep every night: aim for the recommended 7-9 hours each night, as not getting enough sleep can actually lead to more pain

Workstation setup

For many individuals, a great deal of time every day is also spent sitting at a desk and working on a computer. As with bed setups, the way in which a workstation is set up affects the neck and can play a part in the development of pain developing. To ensure that your workstation is not adding any strain to your neck, we recommend the following:

• Make sure your computer is at eye level and not too close or far away from you; you shouldn’t have to crane your neck down or strain your eyes to look at it
• When seated, the feet should be flat on the floor and the back of the chair should be in an upright position
• Keep the keyboard directly in front of you, close by, and at a height so your shoulders are relaxed, elbows slightly bent, and wrist and hands straight
• Consider using a document holder placed next to your computer to avoid constant neck movement when switching between the two

Other

• Avoid neck strain when using your phone by raising it to eye level, taking frequent breaks, and minimizing phone time
• Use a headset or headphones if you are on the phone frequently
• Use a neck pillow for flights and long car rides
• Regularly perform stretching and strengthening exercises for the neck to keep it flexible and strong

There’s a good reason that we often call things that bother us a “pain in the neck.” Neck pain is one of the most common health problems in the world, and it’s second only to back pain in terms of painful muscle and bone disorders. Statistics vary on just how prevalent neck pain is, but some figures estimate that as many as 80% of Americans experience it at least once each year. Depending on your age, there are different types of problems that can affect the neck, but the result is usually the same: neck pain and discomfort that gets in the way of normal movement.

The skeletal part of your neck is called the cervical spine, which is made up of seven bones (vertebrae). The vertebrae are referred to as C1-C7—the “C” stands for cervical—starting at the base of the skull (C1) and counting up towards the chest area (C7). Between each vertebra is an intervertebral disc, which cushions the bones and serves as a shock absorber. We use our cervical spine every time we nod, turn, or rotate our head in any direction, and this wide range of motion is one of the main reasons neck pain is so common.

For children and young adults, neck pain is far less common than it is later in life, but there are still plenty of issues that can occur. In this age group, most neck problems are due to strains and sprains of the muscles and ligaments in the neck. Here’s what usually happens:

• Neck muscles and ligaments are flexible, but sometimes they can be pushed too far
• This often occurs from holding bad postures—like staring down at a computer or cellphone—for extended periods of time, or sleeping on the neck wrong
• Symptoms include pain and discomfort in the back, side, or front of the neck that limits movement and activity

As we get older, neck strains and sprains remain common, but a number of other neck-related conditions are also more likely to start developing. In the course of the normal aging process, several age-related changes begin to occur in certain parts of the cervical spine. What generally tends to happen is that the structures that make up the neck become weaker, the intervertebral discs lose some of their height, and the joints in the neck adapt to other changes in the body. Eventually, these changes make the structures of the neck slightly less effective, and as a result:

• Osteoarthritis may develop, which occurs from losing some of the protective cartilage that surrounds the ends of bones
• Spondylosis is another general term used to describe any pain related to age-related changes in the spine; this also becomes more common with aging
• Problems with the intervertebral discs can lead to a herniated, or “slipped” disc, which may cause pain and other symptoms that radiate through the arms

These types of issues typically tend to develop between ages 40-60, but can be seen even earlier in certain individuals. Symptoms also range significantly, as some people experience regular pain and physical limitations, while others don’t notice any symptoms, even though these age-related changes are still occurring.

For adults over the age of 65, age-related changes continue to occur and may begin to become more advanced in some cases. This means that conditions like osteoarthritis and spondylosis are even more likely at this age, and they can be more severe for some individuals. Other conditions like spinal stenosis and osteoporosis also become more common in older age and add to the list of possible neck problems. Spinal stenosis is a narrowing of the spinal canal that puts pressure on the structures within it, while osteoporosis is a condition that causes bones to become weak and brittle. Other mobility limitations could make neck-related issues even more of an impairment for the elderly, but all of these problems are still treatable.

What’s important to understand is that while there is nothing that can be done to stop the aging process, there are countless changes you can make to your everyday life that can significantly reduce your chances of experiencing neck pain at any stage of life.