Chronic Pain: Neck, Back, and Joint Issues Explained

Soreness issues?

Hello Doctor: When I was a child, I slipped and fell, and since then I have been experiencing frequent neck, back, and lower back pain.
Sometimes, after walking too much or standing for too long, I experience severe pain from my buttocks down to my knees.
Even simple tasks like bending over to wash my face in the morning cause me significant pain.
I have had several X-rays taken, and various chiropractors have mentioned that the spaces between my cervical and coccygeal vertebrae are too narrow, which could be causing the pain.
However, despite visiting many places over the years, I have not been able to resolve the issue.
I am hesitant to see an orthopedic doctor for fear of needing surgery, and I am unsure of what to do.
Additionally, I have worked as a typist, and recently I have noticed that when I wring out a mop while cleaning the floor, my entire wrist, elbow, and even shoulder become so sore that I cannot sleep.
Even using a nail clipper causes pain in my wrist to the point where I cannot use it.
Could my widespread muscle soreness be related? Thank you.

Kay, 20~29 year old female. Ask Date: 2005/10/02

Dr. Lin Yijun reply Orthopedics

Hello Kay,
You have sustained an injury, and given your symptoms of soreness, it is suspected that you may have a lumbar disc herniation causing nerve root compression.
You mentioned that the X-ray showed "too dense spinal intervals," which could be indicative of a herniated disc on the X-ray.
If this is the case, traction therapy (commonly referred to as "spinal decompression") is likely to be effective.
As you are a typist, the neck pain and symptoms in your hands are more likely due to overuse.
I recommend that you maintain proper posture while working, avoid working too quickly, and develop a habit of taking regular breaks (approximately 10 minutes every hour or 5 minutes every half hour).
During these breaks, perform appropriate stretching exercises.
If the pain does not improve, I suggest consulting a rehabilitation specialist for physical therapy.
If there is significant inflammation, local corticosteroid injections may be considered for anti-inflammatory treatment.
Since I have not conducted a direct examination and have not seen the X-ray, I can only provide this analysis based on the information given.
However, I strongly recommend that you seek a proper diagnosis and necessary treatment from a rehabilitation specialist.
Surgery will only be suggested if medications and physical therapy are ineffective; it is not the case that seeing an orthopedic surgeon automatically leads to surgery.
Wishing you good health,
Lin Yi-Jun
Department of Rehabilitation, Taipei Medical University

Reply Date: 2005/10/02

More Info

Chronic pain, particularly in the neck, back, and joints, can significantly impact daily life and overall well-being. Your history of falling and subsequent pain in these areas suggests a possible underlying issue that may have developed over time. It is not uncommon for injuries sustained in childhood to manifest as chronic pain later in life, especially if the injury led to structural changes or muscle imbalances.

From your description, it seems you are experiencing a combination of musculoskeletal pain and possibly nerve-related discomfort. The tightness and pain in your neck and back could be attributed to several factors, including muscle strain, poor posture, or even degenerative changes in the spine. The fact that you have undergone multiple X-rays and have been told about the close spacing of your cervical and coccygeal vertebrae indicates that there may be anatomical factors contributing to your pain.

Chronic pain can also be exacerbated by lifestyle factors such as prolonged sitting, repetitive movements, and inadequate ergonomics, especially in occupations like typing. The pain you experience while wringing out a mop or using a nail clipper suggests that you may have developed repetitive strain injuries, which are common in individuals who perform repetitive tasks without proper breaks or ergonomic support. This can lead to conditions such as tendinitis or carpal tunnel syndrome, which can cause pain and discomfort in the wrist, elbow, and shoulder.

To address your concerns, it is essential to consider a multifaceted approach to treatment. Here are some recommendations based on your symptoms:
1. Physical Therapy: Engaging in physical therapy can help you strengthen the muscles supporting your neck and back, improve flexibility, and correct any postural issues. A physical therapist can design a personalized exercise program tailored to your specific needs.

2. Ergonomic Assessment: Since you spend a lot of time typing, an ergonomic assessment of your workspace can be beneficial. Adjusting your chair, desk height, and keyboard position can help reduce strain on your neck, back, and wrists.

3. Pain Management: Over-the-counter pain relievers, such as NSAIDs (e.g., ibuprofen), can help manage pain and inflammation. However, it is crucial to use them as directed and consult a healthcare provider if you find yourself relying on them frequently.

4. Alternative Therapies: Consider exploring alternative therapies such as acupuncture, chiropractic care, or massage therapy. These modalities can provide relief for some individuals suffering from chronic pain.

5. Mind-Body Techniques: Techniques such as yoga, meditation, and mindfulness can help manage pain by reducing stress and promoting relaxation. These practices can also improve your overall physical condition and enhance your coping mechanisms.

6. Consultation with Specialists: If your pain persists despite conservative management, consider consulting with a pain specialist or a rheumatologist. They can provide further evaluation and may suggest additional diagnostic tests, such as MRI or nerve conduction studies, to identify any underlying conditions.

7. Lifestyle Modifications: Incorporating regular physical activity, maintaining a healthy weight, and ensuring adequate sleep can all contribute to reducing chronic pain. Additionally, being mindful of your posture during daily activities can help alleviate strain on your body.

In conclusion, chronic pain is a complex issue that often requires a comprehensive approach to management. By addressing both the physical and lifestyle factors contributing to your pain, you can work towards improving your quality of life. It is essential to communicate openly with your healthcare providers about your symptoms and concerns to develop an effective treatment plan tailored to your needs.

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