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Instep Dance Magazine Articles

Reprints of monthly column as first appearing in Instep Dance Magazine.

December 1999

Back Pain - Part 1: Overview

By Rick Allen, DC

"Better health leads to better dancing."


As a chiropractor, I am often asked, "Why does my neck and back hurt?" There are a number of reasons. I'll briefly review in a series of articles over the next few months the ten causes of back and neck pain outlined by Michael Gazdar, D.C., C.C.S.P. in his book, Taking Your Back to the Future:

  1. Trauma
  2. Poor posture
  3. Facet syndrome
  4. Disc problems
  5. Subluxated ribs
  6. Failed back surgery
  7. Common referred pain
  8. Scalenus Anticus syndrome
  9. Arthritis
  10. Direct trauma to the head

Trauma:

Trauma to any part of the body, including the neck and back, comes in two broad categories: macrotrauma and microtrauma.

Simply stated, macrotrauma is major injury, such as falling from a ladder or a motor vehicle accident resulting in a whiplash. Macrotraumatic injuries cause serious disruption in the tissues. According to Gazdar, "There could be a sudden tear or pull of the soft tissues away from the spine or other bones of the body. There may or may not be external bleeding. Almost surely there would be some bleeding on a microscopic level in the muscles, tendons, or ligaments. There would probably be swelling, redness, and heat over the area, as the body begins its normal healing response to this type of trauma. This in turn would lead to fibrous adhesions, or scar tissue being formed. All this causes PAIN!"

Microtrauma is not necessarily minor injury. It can be quite serious and difficult to correct. It just doesn't have the gross disruption of tissues or the frank injury found in major trauma. It is often caused by repetitive or prolonged activity that causes low-grade injury, such as holding your head in a certain position reading or watching television, typing, or assembly line work. As Dr. Gazdar explains, "When you hold your head forward, the muscles and ligaments in the back of the neck and upper back must work harder and harder to keep the head in balance.... The tissue stretches and deforms (called plastic deformation) and will eventually scar as it tries to repair itself."

The macro/micro trauma division is not really black and white. There are shades of gray -- overlapping situations, such as continuing microtraumatic re-injury of the neck from altered movement resulting from an earlier macrotraumatic whiplash injury, especially if it was improperly treated with just immobilization and drugs.

Poor posture

Your mother, father, and dance teacher have all probably harped at you about "standing up straight." I have written two columns about it in Instep. It is so important, and so overlooked, that I want you to bring it to your consciousness by trying an experiment to actually feel what your upper back and neck muscles do all day long. Dr. Gazdar elaborates, "Take a 10-lb. weight and, while seated, hold the weight in your hand close to your shoulder with your elbow supported on the arm of a chair. No problem, right? Now take your hand and hold the weight out away from your body. A little tougher, right? This is what happens when your head, which weighs about 15 lbs., moves out in front of your shoulders. You not only lose the natural neck curve, you build up tension in your neck and shoulders."

Next article: Try the experiment mimicking forward head posture. Really get a feel for the problem. Next month I'll show you some the consequences. In the coming months, I'll continue with more details on the subject of back pain.

PS: If you would like a copy of Michael Gazdar's book, Taking Your Back to the Future, stop by my office. If you promise to read it, I'll give it to you for free!

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