Chronic neck and back pain are the most common musculoskeletal complaints, with up to 20% of the population experiencing this pain at any given time (1, 2). Not only does this create a great burden on a personal, societal, and economic level, but it can be incredibly difficult to find relief from these frustrating conditions due to the wide variety of root causes and symptoms.
What are common symptoms of neck and back pain?
While symptoms may vary for each person, the most typical symptom of neck and back pain is some form of sharp, dull, burning, or shooting pain. This pain may be concentrated in one spot, or cover a large area (3). Some people find that their arms or legs tingle or fall asleep, while others can trace lines of shooting pain from their neck to their fingers, or from their back to their thigh, calf, or toes. For others, including children and teens, pain may show up as a persistent ache, especially after looking at a device, sitting, or standing in one posture for an extended period of time (3, 4). For as many different types of chronic neck and back pain there are, there are at least as many root causes, which is part of what can make this chronic pain so hard to treat.
What are some possible root causes?
Lifestyle factors, such as straining, improper form or overuse, muscle tension, obesity, and smoking can all cause serious chronic pain. Pain from strenuous or improper muscle use can result from attempting to carry too much weight with poor form while working out or doing physical labor, from poor posture while sitting, standing, or looking at a device, or even from repetitive movements (4). Muscle tension, especially from chronic stress, improper posture, or teeth grinding can cause chronic neck pain (5). Smoking reduces blood and oxygen supply, also increasing the risk of pain (5). Lastly, obesity often causes higher levels of inflammation throughout the body, triggering increased levels of neural damage and resulting in a greater risk of pain as well (6).
Injury is another common source of chronic neck and back pain. Any sort of trauma, including strains, sprains, ligament or muscle tears, fractures, and herniated or pinched discs can all result in long-term pain (3). This trauma can occur as a result of an event such as a fall or car accident, or from long-term strain from muscle tension or poor posture (5). Chronic pain is especially common in those who have experienced accidents resulting in brain trauma (see this recent article for more information on keeping your brain healthy and avoiding head injury) (7). The general effects of aging, as well as more specific age-related degeneration such as osteoporosis, compression fractures, and tumors or spurs on the spine are other risk factors for chronic pain (3).
What does conventional treatment offer?
Initial measures to treat chronic neck and back pain generally involve icing, heating, stretching, and sometimes exercise to flex or strengthen specific muscles (3). Other physicians may prescribe braces or corsets, as well as NSAIDs, muscle relaxants, opioids, and even nerve blockers (3). For the most extreme cases of chronic pain, invasive surgeries may be recommended (8).
While some people may find relief from these measures, studies are finding that all forms of invasive procedures are associated with high risks of adverse effects (8, 9). Even non-invasive pain management options, such as NSAIDs and opioids, still have a very high risk of complications. These complications include adverse side effects, addiction, and long-term toxicity that has resulted in many patients and physicians determining that the risk of pharmaceuticals outweighs the benefit for chronic pain (more on the risks of opioids here) (1, 8). In terms of chronic back pain treatments, one study found that no conventional treatment stands out as a definitive solution (8).
So, what treatment options will work?
An alternative to traditional neck and back pain treatments can be found in regenerative and functional medicine. Functional medicine is the melding of conventional and alternative therapies to get to the root cause of disease and illness through a personalized health care approach. For some people with mild to moderate neck and back pain, massage, acupuncture, and chiropractic care (especially for slipped discs) can provide great relief (10). For others, regenerative therapies, either alone or in combination with some of the alternative therapies listed above, can bring healing and pain relief. The most common regenerative therapies that are offered here at TCIM are pulsed electromagnetic field therapy, stem cell therapy, ozone, and platelet-rich plasma, all of which are safe and free of long-term risks!
How can an electromagnetic field help my chronic pain?
Pulsed electromagnetic field therapy, also known as PEMF therapy, restores our cells’ natural magnetic charge to healthy levels by placing a resonating magnetic field device over the painful or injured area. This magnetic field interacts with the body’s cells in such a way that they receive an energy boost, resulting in enhanced cellular activity and repair, as well as regeneration to damaged tissue (8).
PEMF therapy can help relieve pain intensity, improve movement and functionality, and lower overall disability for those suffering from chronic neck and back pain (11, 12, 13). For those with spinal fractures due to injury, or bone loss due to osteoporosis, it can enhance bone growth and formation (8). PEMF therapy can even bring pain relief to sufferers of chronic pain due to osteoarthritis, disc herniation, and fibromyalgia (2). While PEMF therapy is able to reduce pain on its own, it is also used in conjunction with the two therapies listed below to maximize healing for every patient that comes into our office.
What is Platelet Rich Plasma therapy? How does it work?
The platelets in our blood contain growth factors that work all throughout our bodies to stimulate regeneration and healing through kickstarting the body’s healing process. Platelet Rich Plasma (PRP) is created by drawing blood and placing it in a centrifuge to separate the components of the blood, leading to an isolated mixture of just the platelets and plasma. Voilà, healing Platelet Rich Plasma! This PRP is then injected back into the body at the site of injury, inflammation, or chronic pain, and the PRP works to stimulate healing, leading to further healing where the body may have previously plateaued.
PRP Therapy is an incredible therapy for those who suffer from chronic neck or back pain and have not found relief from other treatment, because it can bring remarkable pain relief and improvement to those suffering from neck and back pain, especially for those whose pain is caused by disc herniation (14, 15). It is safe, free of major side-effects and complications, and according to one study, has an 87% success rate, which is either on par or better than other therapies (15). The results are also long-lasting, making PRP therapy a great option for those suffering from neck and back pain that is chronic in nature.
How can stem cells help chronic pain?
Stem cell therapy works by injecting ethically donated stem cells into the body, which then disperse and recruit existing stem cells to work more efficiently and repair damaged tissues more effectively than they could on their own. While stem cell therapy is still considered experimental and is not approved by the FDA, multiple studies have been done to determine the safety and effectiveness of stem cell therapy on chronic pain, and specifically chronic low back pain. Across these studies, stem cell therapy is associated with greater function, decreased disability, and greatly improved pain relief (1, 16).
What does this mean for your chronic pain?
If you, your children, your parents, or any other loved ones are suffering from back or neck pain, please give us a call. Our functional and regenerative therapies have helped many patients work through their chronic pain and they now enjoy greater relief, function, and mobility. We would love to troubleshoot the root problems of your pain and work together to find effective lifestyle changes and therapies that will work for you!
Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.
Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.
info@tcimedicine.com
951-383-4333
Barakat, A. H., Elwell, V. A., & Lam, K. S. (2019). Stem cell therapy in discogenic back pain. Journal of spine surgery (Hong Kong), 5(4), 561–583. https://doi.org/10.21037/jss.2019.09.22
Karakaş, M., & Gök, H. (2020). Effectiveness of pulsed electromagnetic field therapy on pain, functional status, and quality of life in patients with chronic non-specific neck pain: A prospective, randomized-controlled study. Turkish journal of physical medicine and rehabilitation, 66(2), 140–146. https://doi.org/10.5606/tftrd.2020.5169
Back and Neck Pain. (n.d.). Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/back-pain
Fares, J., Fares, M. Y., & Fares, Y. (2017). Musculoskeletal neck pain in children and adolescents: Risk factors and complications. Surgical neurology international, 8, 72. https://doi.org/10.4103/sni.sni_445_16
Mayo Foundation for Medical Education and Research. (2020, July 31). Neck pain. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/neck-pain/symptoms-causes/syc-20375581.
Hozumi, J., Sumitani, M., Matsubayashi, Y., Abe, H., Oshima, Y., Chikuda, H., Takeshita, K., & Yamada, Y. (2016). Relationship between Neuropathic Pain and Obesity. Pain research & management, 2016, 2487924. https://doi.org/10.1155/2016/2487924
Karen-Amanda Irvine, PhD, J David Clark, MD, PhD, Chronic Pain After Traumatic Brain Injury: Pathophysiology and Pain Mechanisms, Pain Medicine, Volume 19, Issue 7, July 2018, Pages 1315–1333, https://doi.org/10.1093/pm/pnx153
Elshiwi, A. M., Hamada, H. A., Mosaad, D., Ragab, I., Koura, G. M., & Alrawaili, S. M. (2019). Effect of pulsed electromagnetic field on nonspecific low back pain patients: a randomized controlled trial. Brazilian journal of physical therapy, 23(3), 244–249. https://doi.org/10.1016/j.bjpt.2018.08.004
Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, Ferreira PH, Fritz JM, Koes BW, Peul W, Turner JA, Maher CG; Lancet Low Back Pain Series Working Group. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018 Jun 9;391(10137):2368-2383. doi: 10.1016/S0140-6736(18)30489-6. Epub 2018 Mar 21. PMID: 29573872.
Furlan AD, Yazdi F, Tsertsvadze A, Gross A, Van Tulder M, Santaguida L, Cherkin D, Gagnier J, Ammendolia C, Ansari MT, Ostermann T, Dryden T, Doucette S, Skidmore B, Daniel R, Tsouros S, Weeks L, Galipeau J. Complementary and alternative therapies for back pain II. Evid Rep Technol Assess (Full Rep). 2010 Oct;(194):1-764. PMID: 23126534; PMCID: PMC4781408.
Andrade, R., Duarte, H., Pereira, R., Lopes, I., Pereira, H., Rocha, R., & Espregueira-Mendes, J. (2016, October 28). Pulsed electromagnetic field therapy effectiveness in low back pain: A systematic review of randomized controlled trials. Porto Biomedical Journal. https://www.sciencedirect.com/science/article/pii/S2444866416300514.
Lisi, A. J., Scheinowitz, M., Saporito, R., & Onorato, A. (2019). A Pulsed Electromagnetic Field Therapy Device for Non-Specific Low Back Pain: A Pilot Randomized Controlled Trial. Pain and therapy, 8(1), 133–140. https://doi.org/10.1007/s40122-019-0119-z
Oke, K. I., & Umebese, P. F. (2013). Evaluation of the efficacy of pulsed electromagnetic therapy in the treatment of back pain: a randomized controlled trial in a tertiary hospital in Nigeria. The West Indian medical journal, 62(3), 205–209.
Mohammed, S., & Yu, J. (2018). Platelet-rich plasma injections: an emerging therapy for chronic discogenic low back pain. Journal of spine surgery (Hong Kong), 4(1), 115–122. https://doi.org/10.21037/jss.2018.03.04
Cameron JA, Thielen KM (2017) Autologous Platelet Rich Plasma for Neck and Lower Back Pain Secondary to Spinal Disc Herniation: Midterm Results. Spine Res. Vol. 3 No. 2:10 doi: 10.21767/2471-8173.100030
Wu T, Song HX, Dong Y, Li JH. Cell-Based Therapies for Lumbar Discogenic Low Back Pain: Systematic Review and Single-Arm Meta-analysis. Spine (Phila Pa 1976). 2018 Jan 1;43(1):49-57. doi: 10.1097/BRS.0000000000001549. PMID: 26953666.