Spine Fundamentals: Acute vs. Chronic Back and Neck Pain

by Justin D. Dumont, DO, MS

Spine Fundamentals: Acute vs. Chronic Back and Neck Pain

Most people will develop neck or back pain at some point in their lives. This pain can affect every single aspect of our day-to-day lives and can make even the most routine daily tasks feel like uphill battles.

As a pain management physician one of the most important things I first attempt to understand is how long a patient has been experiencing pain. When pain is new or has existed for days to several months, we consider this acute pain. When the pain has existed for greater than three months, we consider this chronic pain.

It is important to know how long the pain has existed because this will potentially impact how the pain is treated. Although there may be some overlap in the types of treatments used to address acute and chronic pain, there are some significant differences.

Let’s discuss.

What causes back and neck pain?

Acute pain develops suddenly and it can be due to a variety of factors. It can be due to a specific accident or event like a motor vehicle accident or traumatic event like a fall or injury. It may also develop on its own through the course of daily living.

Acute pain is a normal sensation and serves as a means to alert us of possible injury that needs our attention.

Typically, pain is considered acute if it lasts less than three months. Some common causes of acute neck or back pain include:

  • Muscle sprains or injury to the soft tissues surrounding and supporting the spine.
  • Fractures to the bones of spine from traumatic events or conditions like osteoporosis.
  • Sudden changes to disc material.
  • Nerve irritation which can cause also cause radiation of pain into the arms or legs.

Fortunately, a large amount of people who develop acute neck or back pain do very well with conservative treatments and do not develop chronic pain. Some of these conservative treatments include non-steroidal medications, muscle relaxants, short term activity modification, physical therapy, and spinal injections. In some cases, surgery may be indicated.

Chronic pain is different. Chronic pain persists.

Chronic pain is often due to prolonged pain signals firing in the nervous system. It results in persistent pain that may exist in the neck or back and may even radiate into the arms or legs. Ideally the goal is to address and treat acute pain before it becomes chronic pain.

Some of the most common causes of chronic pain include:

  • Untreated acute pain.
  • “Wear and tear” osteoarthritis resulting in degenerative disc disease or inflammation of the joints in the spine.
  • Prolonged nerve compression or irritation.
  • Central spinal stenosis.

Chronic pain treatment and acute pain treatment may include some of the same surgeries, procedures, and medications. For chronic pain, additional medications that specifically treat nerves may be added. Additionally, there may be the need to treat mood or sleep issues with medical or behavioral treatment services.

Alternative or complementary treatment options such as acupuncture, massage, yoga, tai chi, etc. may also benefit certain patients. Lastly, in certain patients there may be a reason to consider more targeted interventions FDA-approved to treat chronic nerve pain such as spinal cord stimulation, doral root ganglion (DRG) stimulation, or peripheral nerve stimulation.

Can I prevent back and neck pain?

While prevention for many injuries and conditions isn’t always feasible, the following tips can help reduce your risk in developing back and neck pain.

  • Monitor your posture when sitting, working, and performing specific tasks such as lifting.
  • Evaluate the ergonomics or your work environment.
  • Consistently exercise if cleared by your doctor.
  • Avoid the use of tobacco products.
  • Maintain a healthy weight.
  • Maintain a regular sleep schedule and try to get the recommended 6-8 hours of sleep a night.
  • Don’t neglect your emotional and mental health.
  • Monitor your diet. Drink plenty of water and avoid highly processed foods.

At the end of the day, everyone is unique. There isn’t a “one size fits all” paradigm. As a Pain Management Physician, I believe it’s vital to see the whole person. My goal is to understand your specific pain complaints and symptoms and develop a targeted treatment plan.

If you are struggling with back or neck pain, locate the nearest OrthoVirginia physician who can help get you on the road to recovery.