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  • Q&A with Australian Health Practitioners

    How can back and neck pain be treated?

  • Find a professional to answer your question

  • 2


    Antony Lo


    Musculoskeletal Physiotherapist (trainee Specialist) in Marrickville, Sydney, NSW, Australia. I specialise in the spine, especially the thorax and pelvis (SIJ). I enhance sports performance, address … View Profile

    Hmm, this is a tough question. I can outline for you all the possible treatments that exist for back and neck pain in a specific or general way. But perhaps a better approach is show you how physiotherapists think.

    1. While the source of your pain is important to us, we are also very interested in the factors that contribute to your pain. The source of pain might be a pinched nerve or arthritic joint or a “disc” or a muscle or many other things…it can even be your brain “playing tricks” on you making something that is a normal sensation to feel like a “painful” one. As physiotherapists, we want to know *why* the things that are sore are sore. That is why physiotherapists perform a thorough physical assessment after taking a good history.

    2. Once we know what is the source of your pain and what the contributing factors are, we will address these issues with many different approaches. Some have more research evidence than others and some therapists prefer certain approaches over others but the main point to understand is that we are seeking to address the source and the cause/s of your problem.

    3. It may be helpful to think of the 6 areas that physiotherapists might treat:
    a. The Articular System - these are your bones, joints, ligaments, cartilage etc. We use manual therapy, electrotherapy and even put casting materials on for broken bones, splints etc in the treatment of these probelms. Other things include acupuncture, exercise, advice, etc etc
    b. The Myofascial System - these are your muscles, tendons and coverings (fascia) that can pull and tramsit tension throughout the body. The treatments are similar to above
    c. The Neural System - this is about your brain, the nerves and how they coordinate the whole body's systems including how you move
    d. The Visceral System - not many physiotherapists work on this area - this is more traditionally an osteopathic type of treatment - however the effect of the internal organs and how they are functioning can cause your musculoskeletal system to work differently. Identifying and addressing the visceral causes of your problem is a possible treatment option - sometimes the “treatment” is a referral to your doctor for further tests
    e. Your strategies for performance and function - this is basically where we look at how you are moving and how you “do” life. Often our physical examination begins with looking at how this area. Common treatments are posture correction, movement correction, technique correction, etc.
    f. The Psychosocial considerations - this is how factors in your life andyour beliefs about what is going on in your body can affect your physical wellbeing and outcomes. We often have to encourage our patients to move when they think they should rest OR to rest when they want to play. Encouragement, education, addressing the things that are important to you are all part of this area we treat.

    4. Lastly, it is important to note that you should feel long lasting benefit from your treatment. Sometimes, it is not oossible to be completely pain-free. However, your ability to get on with life and do the things you want to do are still valid outcomes. If you end up seeing a therapist with no improvement with how you feel or ability to work, then you have to ask yourself the question “Is this working for me”. Obviously you have to be realistic (e.g. a back fracture takes 6-8 weeks to heal for example). The goal of any therapy of chronic neck or back pain should be on helping you become more self reliant and aware of when you can take care of yourself and when you need a therapist to help.

    Hope that helps!

  • 1


    Dr Peter Dun


    Rehab - Sports - X-Ray - Standing MRI - Second Opinions. We provide strategies for chronic and more complex function problems to help restore active … View Profile

    I certainly agree with the principles that Antony has outlined.  Regardless of which type of health care practitioner is consulted, the principles of clinical management to achieve the best outcome for each patient should not really vary that much.  This is because different practitioner types provide assistance to people who have similar body structure and function, based on the genetic template for the human species.  However, when it comes to particular practitioner treatments, numerous different methods have been developed over the centuries in an effort to tackle this major health problem.  Many methods/treatments have been discarded - relegated to the dustbin of history.  Others have stood the test of time along with increasing evidence of their effectiveness, while others still are yet to be developed.
    Optimum results are most likely when a skilled health care practitioner chooses methods (or clinical tools) that are best suited to addressing the source of each patient’s pain according to the principles of the human body structure and function.  With a focus on management of spine-related problems for over a century, chiropractors are trained to be able to perform a thorough patient assessment to identify as closely as possible the particular mechanism causing their pain.  Having first done this, chiropractors have a wide range of modern, effective and safe methods/treatments from which to then choose in order to help the patient overcome their back and/or neck pain.  It is also important to understand that there is a range of different types of chiropractors across the spinal health care spectrum, as of course there are physiotherapists and medical practitioners of different types for their various areas of expertise. 
    Key points:

    • Highly skilled health care practitioner.
    • Most appropriate practitioner type, eg. paediatric/adolescence, sports, rehab, occupational
    • Clinical management approach – treatments/methods – most closely matched to the mechanism causing the pain.
    • Use of effective and safe treatments by both practitioner and patient according to the principles of human body structure and function.
    • Respect for each patient’s goals, values and preferences.
    • Helping patients optimise their self-management strategies.  
    For an outline of the principles in managing back and neck pain, see my response to the following questions: Can a chiropractor treat degenerative disc disease? and Can a chiropractor help me find the source of my back pain?

  • 1


    Sandra McFaul


    Do you suffer from chronic lower back pain or neck pain? Based in SYDNEY, Sandra is 1 of ONLY 15 Physiotherapists in Australia with ADVANCED … View Profile

    Back and neck pain returns. 

    Once you have had it once, the chance of it returning withing one year is over 50%

    So, seek the help of a therapist who shows you simple exercises that relieve the pain and teach you how to stop it from coming back.  That way you are in control and it will save you lots of money …. you won't need to keep going back to the therapist to get it fixed.  The therapists I recommend is McKenzie Method Physiotherapists - they are experts in showing you how to get rid of pain and their aim is always to show you how to stop it from coming back.

    GOOGLE - McKenzie Method…. see someone who has a Diploma Dip MDT as they have advanced training in back and neck pain.  Generally speaking, most people need about 4-5 sessions in total and at the end you will know what to do to stop the pain from coming back.  Hope this helps…

  • 1


    Josephine Perry

    Bowen Therapist

    Josephine is a fully qualified Bowen Therapist, with full insurance cover and Association membership. Rebates provided by most health funds, according to levels of cover.Practice … View Profile

    Bowen Therapy is extremely effective in treating acute or chronic back and/or neck pain.  It is a gentle, non-invasive series of moves which stimulate the brain to relax a specific muscle or group of muscles.  This can have the effect of reducing constriction around joints or the spine.  A Bowen Therapist will recommend stretching and strengthening exercises if deemed appropriate.

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