I you happen to suffer with neck and back pain, you are going to love this article.

Questions you may ask yourself (if this is you) are:

“If I have neck pain, does that automatically mean I will have back pain too? Or if I already do have neck and back pain, are the two even related”?

If you don’t ask yourself those questions, then those are two excellent questions any back pain sufferer, neck pain sufferer or both, should ask.

I think that they are excellent questions to ask because if they are related, and you happen to suffer with neck and back pain, then the answers may help you solve your own pain, and better yet, help you learn the reasons why you seem unable to lose your neck pain once and for all.

One of the best reference books relating to the anatomy and functioning of the spine ever published is aptly named:

THE SPINE

Edited by two highly renowned doctors, Richard Rothman MD, PhD and Frederick Simeone MD, both were past Professors at Pennsylvania Medical School, Rothman for Orthopedic surgery, and Simeone for Neurosurgery.

In this reference book called “The Spine”, the second chapter is called “Applied Anatomy of the Spine”.

In that chapter, the author basically related how the “23 or 24 individual motor segments”, affect the entire spine.These 23 motor segments being referred to are better known as the bones of the spine and everything else that makes them complete, in terms of joint mechanics and electrical “wiring” (if you will).

The chapter explains how that no:

“Disorder of a single major component of a unit can exist without affecting: a) the function of the other components of the same unit, and b) the functions of the other levels of the spine.

That complex yet simple statement could very well hold a secret as to how neck and back pain are related, and more importantly what we can do about it.

In that quote above, the author is trying to get across two points. Firstly, when a problem develops in one area of the spine, then the spine will have a problem in the same area, but with the other components of the spine.

Seems like common sense actually.

By saying “components of the spine” the author is referring to having a problem with all the aspects of the structure and function of the spine. The bones, the nerves, the joints, the discs, the ligaments, the tendons, the cartilage, and anything else that helps make up the components in that area.

But the second more interesting point of that quote is the fact that when a problem develops with a major component of one unit” in the spine, then a problem will develop with the functioning of “another levels of the spine”

Very interesting finding, indeed.

The main take away idea of that entire quote is the fact that a problem in one component of the spine will affect the other components or “functions” of the same area, and the functions of “other” areas.

So picture this, if you have functional problems in your lower back (one component), like not being able to bend as far as you use to do, not beingas flexible, having pain with sitting, pain with standing, changing positions, and pain with walking, then the problem can very likely be coming from the neck.

Other functional problems that can develop as a result of problems of the neck are the even more familiar activities of daily living, things like washing the dishes, cleaning up around the house, vacuuming, being on the computer,trying to get comfortable while watching television and trying to sleep comfortably.

If you have pain with doing any of these activities, you may be surprised to learn that you problem may very well start from your neck!

As well, similar problems and pains that you have in your neck, not being able to turn very far, pain into the upper shoulders, even weakness into the neck, arms and shoulders allmay be as a result of the components of the lower back.

This idea that the entire spine can act like a singularly related “functioning entity” sounds kind of spooky I realize. Probably even harder to believe, but I assure you that this idea is supported by a vast array of literature, doctors, and references as you shall soon see.

For example, another reference text is entitled “Disorders of the Cervical Spine”

In regards to this references book, the authors tend to be a bit more specific.In this book, Dr. Bland a Professor of Medicine at the University of Vermont College of Medicine, states that “we tend to divide the examination of the spine into the regions: cervical, thoracic, and lumbar spine…this is a mistake”

Dr. Bland goes on to explain why this is a mistake, by stating the cervical spine may “be symptomatic

because of a thoracic or lumbar spine abnormality, and vice versa!”

Over the decades, numerous other publications point to the fact that the cervical spine and its problems can influence movements, perception of pain and the neurology of the lower back.

If you actually just stop to think about it though, the neck and back affecting one another should make complete sense.

The signals that go up and down the spine into the lower back must ultimately pass through the neck to get to the brain. As well, all the information travelling down from the brain to the back, must travel through the neck on its way down to arms, trunk, lower back, and legs in order to make them move (and what not).

Mechanical problems of the neck unfortunately can really “mess” with both the signals originating in the spine going to the brain (called afferents) and the signals originating or being relayed from the brain to the spine ( called motor function).

Something I find equally interesting about this phenomenon is the fact that it is not new.

In 1942 the only neurosurgeon in the Hawaiian Islands during Pearl Harbor was Dr. Ralph Cloward.

Operating endlessly and saving countless lives, Dr. Cloward pioneered numerous diagnostic and spinal surgical techniques.

He published an article entitled “Cervical Diskography” and notes that spinal cord compression by a midline cervical disc protrusion can cause “pain extending down to the feet”.

Several years later, and as early as 1946, Some of the best clinical observations as it relates to the spine comes from Herman Kabat, MD, PhD, published in a book entitled “Low Back and Leg Pain From Herniated Cervical Disc”

Dr Kabat explains that herniated discs in the neck is usually as a result of trauma, but he goes on to say that the compression of the cervical spinal cord by herniated discs in the neck is “the most common cause of low back and leg pain”

The other interesting finding in this presentation of lower back and leg pain as a result of neck herniations is the fact that these symptoms are “indistinguishable from the characteristics symptoms of a herniated lumbar disc”

IF you have ever suffered with lower back pain, and have not been able to find any relief, or very little relief, all of the above findings should be a complete paradigm shift.

A paradigm shift because, while you have been focusing on back exercises, epidurals in the back, physical therapy and chiropractic in the back, and even surgery in the back, they may have been all for not, because the real problem, the real source of your pain, is in the neck.

Dr. Kabat confirms this fact when he suggests that “conservative treatment exclusively of the herniated cervical disc in a large series of cases has routinely produced complete and lasting relief of pain in the low back and leg”

Sometimes too, with herniated discs in the neck, pain in the low back and leg is the only complaint, without experiencing any pain in the neck or arm. When this is the case, it is easy to see how we can miss the true cause of the pain.

So what happens when we miss the true cause of lower back pain, especially if the true cause is coming from the herniated disc material in the neck?

Well for one, doctors often recommend lumbar spine surgery. I know that if that were me, and doctors recommended that I have back surgery to relive my back pain, and the real cause of my back pain was coming from my neck, I certainly would want to know that.

Wouldn’t you?

Well Dr. Kabat found that patients that did not get any relief from back surgery were found to have a herniated cervical disc which was “exclusively responsible for the low back and leg pain”

I know that that statement above in the very least raises several concerns that must be addressed.

Number one, you must be thinking how the two, the neck and lower back, anatomically, actually relate to each other?Better yet, how in fact can a herniated disc in the neck, result in function problems, pain, and problems in the back? Explain it to me.

Number two, if the neck and the compression that occurs there can cause low back pain and leg pain, why have I never heard about it until now? Why is it not included and considered in the management of people like me, people that suffer with lower back pain?

In part two of this series “How does my neck pain relate to my back pain”, I will be discussing the above concerns, and hopefully shed some light on why you keep suffering with lower back and neck pain.

In the last installment, I will give you a simple do at home exercise and stretching program that you can do own your home, to help relieve the compression in your neck, and ultimately live a pain free life.

Till next time, watching your back and neck.

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Today, three weeks after I turn 40 years old  I reflect on what feels different.

The particular day itself, I’d have to say It was a great day all around. From the sunday morning I got up at the urging of my 7 year old daughter Zoe, who said daddy come on lets get up a bit earlier then I would have liked. Actually that turned into an awesome day, and hopefully a good omen for the year ahead.

But I wanted to reflect, after all 40 is a big milestone, So what feel’s different?

Well, as it relates to what I write about, neck and back pain, I definitaly feel “older”.

Since I work and help my patients who have all varieties of neck and back pain, as I age, I really feel my neck and back pain too!

Yeah, its true, and I believe it the reason why I write about the topics I  I injured my back almost 17 years ago, and have had to be careful ever since.

But at forty years of age, I am ever more aware of the little aches and pains that I feel. I’ll give you an example, we went out for a nice mexican restaurant the other day. We sat at a table which were the bar stool type chairs.

Ok, these ladies weren’t actually there, but I thought the picture was hilarious, and kind of painted a picture of the back type area.

Anyways, we were sitting at the bar type chairs that had very little back support, and throughout the entire meal, I was thinking not only about how uncomfortable these chairs were, but how bad my back was hurting.

That made me feel “old”. Going out for a nice friday night dinner with friends, and feeling the discomfort of sitting in a god awful chair, just waiting for the evening to end so that I can get some relief when I go home.

Anyone else feel this way?

So the stools were more like this so that you have an idea as to what I was sitting on.

I thought this would make for a great post, because if you are ever in the same situation when you go out to eat at a restaurant, and have a really awful chair, you would know what to do help.

Because there is very little support for your lumbar spine, what happens is that gravity sets in, and has our back go into a rolled up crappy kind of posture.

When it stays like this for too long, muscle fatigue, joint discomfort, and overall misery sets in.

So what is one to do?

In picture A, notice this guy rounding out his back. With that awful bar stool, force yourself to sit like this for a good 30 sec. It is going to hurt, and you might just get flashbacks of trying to sit up in grade school, and if your old enough reading this, it was the same nuns that would put the ruler across the wrist if you didn’t sit up properly, pictured above at the bar.

Then relax in picture B for another 30 sec. Try doing this for 5 more sets. The goal of this exercise is to try and try yourself to maintain a great posture. All to often with back pain, we really way to much on the support provided to us by the chair we sit on, in order to maintain the curve in our spine. Big no no.

Eventually with practice, you will have a really great posture, and you won’t even need a lumbar support.

The great thing is, you are never too old to practice this, and unfortunately, you are going to find yourself in more and more situations where your back and neck really bother you.

What else have I noticed since turning 40, well Zoe told me that “daddy 39 was a little bit old, but forty is really old”

Till next time, watching your back and neck.

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I read an article the other day entitled “FDA Warns Against Fat Dissolving injections”.

Without getting too politically outspoken, I consider that a huge victory for the public, simply because the FDA is not always adament and decisive when it comes to the riskiness of pharmaceutical use, even with thought to be ”safe” medications.

In the article,, the Food and Drug Administration says that the drug Lipodissolve “has not been proven safe and effective”.

It’s not like I really want to split hairs or anything, but  since when has being proven “safe and effective” been a requirement for 100% of the drugs on the market.

But I digress.

Anyway, the article goes on to say that lipodissolve is being used as a nonsurgical alternative to liposuction, which is supposedly used to dissolve fatty deposits around the legs, arms, and belly.

I happen to live in Florida, and if you believe that above claim, I also have some great land to sell you in these parts, just so happens it in a swampy area, but I got to tell you, its an up and coming area.

Here’s a picture of it, aint it beautiful?

The FDA further goes on to say in this article claims made for lipodissolve injections are false and misleading in that they are not supported “substantial evidence or substantial clinical experience”.

I don’t  know for sure what the motivation behind FDA’s push for ”cracking down” on these supposed fat melting injections it may very well be that it doesn’t like the competition with its state hospitals.

Either way, I guess it doesn’t really matter what the motivation of the FDA are, if at the end of the day the general public is protected from dangerous and unproven technology

However, the entire story stinks of hypocrisy when I  read it, and felt the need to at least give some kind of commentary of my own.

Number one, it’s not like the liposuction procedures are proven safe and effective, just ask Kanye West mother who died of a cosmetic surgery.

Number two, the FDA is missing the entire point of the what the actual procedure implies, and misses the boat on a valuable opportunity to not only protect the public, but actually educate and empower the public.

Unfortunately, its not the entire FDA’s fault. As a society that wants everything now, without the accountability,  we tend to live in the “should be” world, vs the “is” world.

We should be able to have a magic pill. You know, the kind that is a purple one, that you watch on television, running though a field, smelling the flower, floating on air,and all your problems can be helped by the purple pill.

You can go to bed at night, take the magic pill, and presto you wake up in the morning, and all your problems are fixed. That is the “should be” world. Who wouldn’t want to live life this way?

On the other side of the coin, you have the “is” world.

The reality is, we have to be accountable for our actions, there is a cause and effect. Whereas in the “should be” world you have the magic pill, on the other side of the spectrum, you have the cold hard reality.

The cold hard reality is you don’t get to be Jack in the beanstock, buy some magic pills, and wake up with a huge path to a pot of gold at the top of a beanstock.

That is what the FDA should be teaching. Because we live in the “is” world, if the FDA was truely concerned with protecting the general public, then they would be teaching us the rules of the “is” world.

Proper nutrition education, proper liftestyle management, proper exercise recommendation and prevention in general is what the FDA should be pushing.

Instead, they push other pharmaceuticals for an array of conditions that are much better helped through lifestyle modification and habits (ie, weight bearing exercise and exercise in general for “pre” osteoporotic patients, let alone osteoporotic patients).

What is the heck is ”pre ____” anyways???

So what does this have to do with neck pain?

Well, easy. when I have a consultation with many of my patients, they have what I call “selective amnesia”.

When we go over their case, and determine how bad their neck pain problem is, how much they suffer, how they are unable to do the things they love to do, how severe it is actually impacting their life. when it comes time to take responsibility for there situation, they tend to be looking for the magic pill solution.

Take a pill, go to bed, and all that postural stress you put on your body, your job, your day to day activities, your sleeping habits, all disappear with that magic pill.

Forget about putting the time in to learn what it is that you are doing on a daily basis to continue the downward spiral into continued neck and upper back pain.

Forget about the time and energy to strengthen deconditioned musculature, posture, core strength, and flexibility that is needed.

The selective amnesia kicks in when we discuss the time, energy, and money that is going to have to go in to changing their life.

If you happen to agree with me, if you happen to understand the sacrifices that must go into changing your life, to help with your aches and pains, then you realize it doesn’t happen over night.

Safety and effectiveness should always be a concern, but living your life with accountability, living your life doing the things you love to do, were meant to do, is your job either way.

Not  the FDA’s job.

Till next time, watching your back, and neck.

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