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Relieving Back Pain and Neck Pain

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Johns Hopkins Health Alerts | Back Pain - Osteoporosis | Relieving Back Pain and Neck Pain

This Health Alert is intended for readers interested in learning about the prevention, diagnosis, and management of back pain.

Is your mattress too hard? Does your neck hurt? Here’s some advice to help soothe your pain.

For those vulnerable to low back pain, minimizing back stress while you sleep can be an important preventive measure. Choosing the right mattress can help. Although conventional wisdom has long held that firm mattresses are best for the back, evidence supporting this idea was lacking. Now a study has shown that a mattress of medium firmness may be the most helpful. When 313 people with chronic back pain had their mattress replaced, those who received a mattress of medium firmness were twice as likely to experience reductions in back pain and the need for pain medication as those who received a firm mattress.

Sleeping position is also important. Adopting certain positions while sleeping can throw the spine out of alignment; for example, lying on one's stomach puts stress on the neck and exaggerates the curve of the lower back. This can trigger a bout of back pain or prolong recovery time. The best sleeping positions allow the back to relax by keeping it aligned.

  • Ideal:The best way to sleep if you have back pain is on your side with your knees bent and a pillow between your knees. This position helps to maintain the natural curves of your spine.
  • Good: When sleeping on your back, keep your knees slightly raised by placing a pillow underneath them. This prevents your lower back from overarching by supporting the weight of your extended legs.
  • Acceptable: If you can't break the habit of sleeping on your stomach, place a pillow underneath your abdomen to keep your spine aligned.

Relieving Neck Pain

Treatments for chronic neck pain include medication, spinal manipulation, improvements in posture and ergonomics, and relaxation techniques. Now a study from Finland shows that neck endurance and resistance exercises are also effective options.

In the study, researchers randomly assigned 180 women (25 to 53 years old) to endurance training, resistance training, or a control group. Participants in the endurance- and resistance-training groups were assigned to five 45-minute sessions a week. Endurance training consisted of neck exercises such as repeatedly lifting the head while lying face up and then face down. Resistance training involved wrapping a specialized elastic band (such as the Thera-Band, available from a physical therapist or a sporting goods store) around the head while bending the neck forward, backward, to the left, and to the right. Both groups also used free weights to strengthen the shoulders and arms and regularly engaged in aerobic exercise. The control group performed aerobic exercises only.

After one year, all groups had less neck pain and disability, but the greatest improvements were seen in the endurance- and resistance-training groups. These two groups were also taking less pain medication than the control group. Benefits in the endurance- and resistance-training groups were seen even in those who attended only two sessions per week. Whether these results would also apply to men is uncertain, the study’s authors note. If you have chronic neck pain and are interested in endurance and resistance training, you may want to make an appointment with a physical therapist who can design and teach you an individualized exercise program. Once you are able to perform the neck exercises independently, you can continue on your own.

Johns Hopkins Health Alerts | Back Pain - Osteoporosis | Relieving Back Pain and Neck Pain

Posted in Back Pain on September 20, 2006


Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer


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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.


Thanks for good advices. Is Tempur-Pedic really better than the conventional beds?

Posted by: kintaro | May 19, 2006 7:56 PM

Approximately two years after having back surgery to remove a Schwanoma growth from my spinal cord (the facia of two of my vertebrae (L1 and L2)had to be removed for this surgery), I developed neuropathy in both of my feet and pain in my lower back. MRI's and X-ray's did not show any additional problem. A spine specialist told me that I was experiencing a crushing effect where additional pressure on the injured spinal cord was causing the neuropathy (perhaps as a result of a slight stenosis from the prior surgery). A neurologist found no problems with my blood work, and recommended that I take up swimming.

Swimming seemed to relieve symptoms, but did not make the neuropathy disappear. So I took up strength exercises by going to a gym several times a week. I got the greatest help from the stretching exercises prescribed by the trainer of the gym. Stretching of the hamstring produced most pronounced results. As I swam and stretched, I also got stronger with weight training. Eventually, I noticed I could not sleep comfortably in my bed. So I bought a new bed with a firm mattress (a good mattress, but nothing real fancy). After about a month, my back pains were gone, and my neuropathy just about gone. I hesitate to comment on the physical processes involved here, except that it relates to the health and good care of the lower back.

Physical therapy, including traction, did not help this problem.

Posted by: Cracking Neck | March 8, 2007 8:06 PM

I read all kinds of articles about back pain. There are very few of them that address middle back pain. I've had an MRI which doesn't show much tissue damage. I was in an auto accident as a teenager..thrown from the vehicle, drug 21/2 times as the car spun around with my head trapped between the tire and the wheel well. Fortunatley my head was just cut, bruised to the point of severe swelling, etc., but, my middle spine has been plagued by severe and chronic pain for years, and not one doctor I've seen in some 30 years understands the pain I go through on a daily basis. However, if my lower back goes out and I'm hunched over from it, I get all of the understanding they can provide. This pain, while it looks more disabling, is nothing compared to the daily pain I suffer from middle spinal problems. My muscles ache and burn and the bones in my spine are extremely sensitive and painful to touch. Will you please respond with a recommendation regarding what type of test(s) I can have done that will help to show someone in the healthcare profession how much I am suffering? Thank you very very much.

Sincerely, Beatrice Griffiths

Posted by: Beatrice Griffiths | August 15, 2007 12:28 PM

Beatrice -- Here at the website we cannot provide personal medical advice. However, we are happy to provide referral information for Johns Hopkins Medicine should you wish to make an appointment with a Hopkins specialist.

The most direct way is for your physician to call the Hopkins Access Line at 1-800-765-5447 (within the continental U.S.) or 410-955-9444 (within the Baltimore area). You may also call to make an appointment yourself at 410-955-5464 (within Maryland), or 443-287-6585 (outside of Maryland, but within the U.S.).

Good luck and we hope you feel better soon.

Johns Hopkins Health Alerts

Posted by: Marjorie | August 15, 2007 3:52 PM

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