Skip to main content
SpringerLink
Log in

Cervical and Lumbar Pain

  • Chapter
Chronic Pain

Part of the book series: Current Clinical Practice ((CCP))

  • 1062 Accesses

Abstract

Ms. Hoffmann is a 45-year-old registered nurse who works in the busy intensive care unit (ICU) of a city hospital. She has worked in this environment for the past 15 years, with two previous episodes of work-related neck pain during the last 5 years. In both cases, her primary symptom was severe muscle spasm, and she returned to regular duties after 1 week. Her current injury occurred when she pulled an obese, sedated patient into a bed. At that time, she developed a searing pain in her neck and upper left arm. Physical examination the next day revealed a reduced biceps reflex and numbness in her upper arm. Magnetic resonance imaging revealed a herniated disc at C5/C6. No improvement was reported after 1 week of rest and treatment with prednisone, valium, and hydrocodone. After an uncomplicated discectomy, the pain was reduced to moderate severity, although numbness and sensitivity to touch in the upper arm persisted. An attempt to return to regular duties was unsuccessful because of intense pain experienced when lifting supplies, reaching across patient beds, and repositioning patients. Ms. Hoffmann was concerned that she would not be able to adequately care for the patients under her charge and went on sick leave. Her physician treated her with daily ibuprofen, and her pain was diminished when she performed reduced activities. Ms. Hoffmann discontinued ibuprofen after 1 month because of gastric upset. Six months later, she was still not working and developed a tendency to hold her arm splinted to her torso to avoid moving it or having anything touch it. Her workers’ compensation caseworker suspected symptom magnification because of her prolonged work absence with this injury and recommended a physical capacity evaluation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Hart LG, Deyo RA, Cherkin DC. Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. tinational survey. Spine 1995; 20:11–19.

    Article  PubMed  CAS  Google Scholar 

  2. Wolsko PM, Eisenberg DM, Davis R, Kessler R, Phillips R. Patterns and perceptions of care for treatment of back and neck pain: results of a national survey. Spine 2003; 28:292–297.

    Article  PubMed  Google Scholar 

  3. Cóté P, Cassidy JD, Carroll L. The treatment of neck and low back pain. Who seeks care? Who goes where? Medical Care 2001; 39:956–967.

    Article  PubMed  Google Scholar 

  4. Webb R, Brammah T, Lunt M, et al. Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general population. Spine 2003; 28:1195–1202.

    Article  PubMed  Google Scholar 

  5. Jacob T, Zeev A, Epstein L. Low back pain-a community-based study of care-seeking and therapeutic effectiveness. Disabil Rehabil 2003; 25:67–76.

    Article  PubMed  CAS  Google Scholar 

  6. Guez M, Hildingsson C, Nilsson M, Toolanen G. The prevalence of neck pain: a population-based study from northern Sweden. Acta Orthop Scand 2002; 73:455–459.

    Article  PubMed  Google Scholar 

  7. Waxman R, Tennant A, Helliwell P. A prospective follow-up study of low back pain in the community. Spine 2000; 15:2085–2090.

    Article  Google Scholar 

  8. Guo HR, Tanakas S, Cameron LL, et al. Back pain among workers in the United States: national estimates and workers at high risk. Am J Int Med 1995; 28:591–602.

    Article  CAS  Google Scholar 

  9. Valat J, Goulippe P, Rozenberg S, Urbinelli R, Allaert F. Acute low back pain: predictive index of chronicity from a cohort of 2487 subjects. Joint Bone Spine 2000; 67:456–461.

    PubMed  CAS  Google Scholar 

  10. Schiøttz-Christensen B, Nielsen GL, Hansen VK, Sørensen HT, Olesen F. Long-term prognosis of acute low back pain in patients seen in general practice: a 1-year prospective follow-up study. Family Practice 1999; 16:223–232.

    Article  PubMed  Google Scholar 

  11. Croft PR, Macfarlane GJ, Papageogiou AC, et al. Outcome of low back pain in general practice: a prospective study. BMJ 1998; 316:1356–1359.

    PubMed  CAS  Google Scholar 

  12. Thomas E, Silman AJ, Croft PR, et al. Predicting who develops chronic low back pain in primary care: a prospective study. BMJ 1999; 318:1662–1667.

    PubMed  CAS  Google Scholar 

  13. Leboeuf-Yde C, Kyvik KO, Brun NH. Low back pain and lifestyle. Part I: Smoking. Information from a population-based sample of 29,424 twins. Spine 1998; 23:2207–2213.

    Article  PubMed  CAS  Google Scholar 

  14. Thomas E, Silman AJ, Croft PR, et al. Predicting who develops chronic low back pain in primary care: a prospective study. BMJ 1999; 318:1662–1667.

    PubMed  CAS  Google Scholar 

  15. Linton SJ. A review of psychological risk factors in back and neck pain. Spine 2000; 25:1148–1156.

    Article  PubMed  CAS  Google Scholar 

  16. Andersen JH, Kaergaard A, Mikkelsen S, et al. Risk factors in the onset of neck/shoulder pain in a prospective study of workers in industrial and service companies. Occup Environ Med 2003; 60:649–654.

    Article  PubMed  CAS  Google Scholar 

  17. Infante-Rivard C, Lortie M. Prognostic factors for return to work after a first compensated episode of back pain. Occup Environ Med 1996; 53:488–494.

    PubMed  CAS  Google Scholar 

  18. Van der Giezen A, Bouter LM, Nijhuis FJN. Prediction of return-to-work of low back pain patients sicklisted for 3–4 months. Pain 2000; 87:285–294.

    Article  PubMed  Google Scholar 

  19. Van den Heuvel SG, de Looze MP, Hildebrandt VH, The KH. Effects of software programs stimulating regular breaks and exercises on work-related neck and upperlimb disorders. Scand J Work Environ Health 2003; 29:106–116.

    PubMed  Google Scholar 

  20. Jensen MC, Brant-Zavadzki MN, Obuchowski N, et al. Magnetic resonance imaging of the lumbar spine in people without back pain. NEJM 1994; 331:69–73.

    Article  PubMed  CAS  Google Scholar 

  21. Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg 1990; 72:403–408.

    PubMed  CAS  Google Scholar 

  22. Siivola SM, Levoska S, Ilkko E, Vanharanta H, Keinänen-Kiukaanniemi S. MRI changes of cervical spine in asymptomatic and symptomatic young adults. Eur Spine J 2002; 11:358–363.

    Article  PubMed  Google Scholar 

  23. Savage RA, Whitehouse GH, Roberts N. The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain, age and occupation in males. Eur Spine J 1997; 6:106–114.

    Article  PubMed  CAS  Google Scholar 

  24. Borenstrein DG, O’Mara JW, Boden SD, et al. The value of magnetic resonance imaging of the lumbar spine to predict low-back pain in asymptomatic subjects: a seven-year follow-up study. J Bone Joint Surg Am 2001; 83-A:1306-1311.

    Google Scholar 

  25. Wiesel SW, Tsourmas N, Feffer HL, Citrin CM, Patronas N. A study of computer-assisted tomography. I. The incidence of positive CAT scans in an asymptomatic group of patients. Spine 1984; 9:549–551.

    Article  PubMed  CAS  Google Scholar 

  26. Carragee EJ. Is lumbar discography a determinate of discogenic low back pain: provocative discography reconsidered. Curr Rev Pain 2000; 4:301–308.

    PubMed  CAS  Google Scholar 

  27. Malmivaara A, Hakkinen U, Aro T, et al. The treatment of acute low back painbed rest, exercises, or ordinary activity? NEJM 1995; 332:351–355.

    Article  PubMed  CAS  Google Scholar 

  28. Faas A, Chavannes AW, van Eijk JT, Gubbels JW. A randomized, placebo-controlled trial of exercise therapy inpatients with acute low back pain. Spine 1993; 18:1388–1395.

    Article  PubMed  CAS  Google Scholar 

  29. Faas A, van Eijk JT, Chavannes AW, Gubbels JW. A randomized trial of exercise therapy in patients with acute low back pain. Efficacy on sickness absence. Spine 1995; 20:941–947.

    Article  PubMed  CAS  Google Scholar 

  30. Rozenberg S, Delval C, Rezvani Y, et al. Bed rest or normal acitivity for patients with acute low back pain: a randomized controlled trial. Spine 2002; 27:1487–1493.

    Article  PubMed  Google Scholar 

  31. Malmivaara A, Hakkinen U, Aro T, et al. The treatment of acute low back painbed rest, exercises, or ordinary activity? NEJM 1995; 332:351–355.

    Article  PubMed  CAS  Google Scholar 

  32. Bendebba M, Torgerson WS, Boyd RJ, et al. Persistent low back pain and sciatica in the United States: treatment outcomes. J Spinal Disord Tech 2002; 15:2–15.

    PubMed  Google Scholar 

  33. Van Tulder MW, Cherkin DC, Berman B, Lao L, Koes BU. The effectiveness of acupuncture in the management of acute and chronic low back pain. A systematic review with the framework of the Cochrane Collaboration Back Review Group. Spine 1999; 24:1113–1123.

    Article  PubMed  Google Scholar 

  34. Van Tulder MW, Ostelo R, Vlaeyen JW, et al. Behavioral treatment for chronic low back pain: a systematic review within the framework of the Cochrane Back Review Group. Spine 2001; 26:270–281.

    Article  PubMed  Google Scholar 

  35. Nabeta T, Kawakita K. Relief of chronic neck and shoulder pain by manual acupuncture to tender points: a sham-controlled randomized trial. Complement Ther Med 2002; 10:217–222.

    Article  PubMed  CAS  Google Scholar 

  36. Harris GR, Susman JL. Managing musculoskeletal complaints with rehabilitation therapy: summary of the Philadelphia Panel evidence-based clinical practice guidelines on musculoskeletal rehabilitation interventions. J Fam Pract 2002; 51:1042–1046.

    PubMed  Google Scholar 

  37. Swenson RS. Therapeutic modalities in the management of nonspecific neck pain. Phys Med Rehabil Clin N Am 2003; 14:605–627.

    PubMed  Google Scholar 

  38. Deyo RA. Drug therapy for back pain. Which drugs help which patients? Spine 1996; 21:2840–2849.

    Article  PubMed  CAS  Google Scholar 

  39. Stanton-Hicks M. Nerve blocks in chronic pain therapy-are there any indications left? Acta Anaesthesiol Scand 2001; 45:1100–1107.

    Article  PubMed  CAS  Google Scholar 

  40. Webster BS, Snook SH. The cost of 1989 workers’ compensation low back pain claims. Spine 1994; 19:1111–1115.

    Article  PubMed  CAS  Google Scholar 

  41. Van Tulder MW, Koes Bw, Bouter LM. A cost-of-illness study of back pain in the Netherlands. Pain 1995; 62:233–240.

    Article  PubMed  Google Scholar 

  42. Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain 2000; 84:95–103.

    Article  PubMed  CAS  Google Scholar 

  43. Seferlis T, Lindholm L, Nemeth G. Cost-minimisation analysis of three conservative treatment programmes in 180 patients sick-listed for low low-back. Scand J Prim Health Care 2000; 18:53–67.

    Article  PubMed  CAS  Google Scholar 

  44. Suter PB. Employment and litigation: improved by work, assisted by verdict. Pain 2002; 1000:249–257.

    Article  Google Scholar 

  45. Ylinen J, Takala E, Nykänen M, et al. Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial. JAMA 2003; 289:2509–02516.

    Article  PubMed  Google Scholar 

  46. Snook SH, Webster BS, McGory RW, et al. The reduction of chronic nonspecific low back pain through the control of early morning lumbar flexion. A randomized controlled trial. Spine 1998; 23:2601–2607.

    Article  PubMed  CAS  Google Scholar 

  47. Frost H, Klaber Moffett JA, Moser JS, Fairbak JL. Randomised controlled trial for evaluation of fitness programme for patients with chronic low back pain. BMJ 1995; 310:151–154.

    PubMed  CAS  Google Scholar 

  48. Faas A. Exercises: which ones are worth trying, for which patients, and when? Spine 1996; 21:2877–2878.

    Article  Google Scholar 

  49. Viljanen M, Malmivaara A, Uitti J, et al. Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: randomized controlled trial. BMJ 2003; 327:475.

    Article  PubMed  Google Scholar 

  50. Irnich D, Behrens N, Gleditsch JM, et al. Immediate effects of dry needling and acupuncture at distant points in chronic neck pain: results of a randomized, doubleblind, sham-controlled crossover trial. Pain 2002; 99:83–89.

    Article  PubMed  Google Scholar 

  51. Ernst E, Assendelft WJ. Chiropractic for low back pain. BMJ 1998; 317:160.

    PubMed  CAS  Google Scholar 

  52. Jamison RN, Slawsby EA, Nedeljkovic SS, Katz ND. Opioid therapy for chronic noncancer back pain. A randomized prospective study. Spine 1998; 23:2591–6000.

    Article  PubMed  CAS  Google Scholar 

  53. Schofferman J. Long-term opioid analgesic therapy for severe refractory lumbar spine pain. Clin J Pain 1999; 15:136–140.

    Article  PubMed  CAS  Google Scholar 

  54. Schonstein E, Kenny DT, Keating J, Koes BW. Work conditioning, work hardening and functional restoration for workers with back and neck pain. Cochrane Database Syst Rev 2003; CD001822.

    Google Scholar 

  55. Hagen EM, Eriksen HR, Ursin H. Does early intervention with a light mobilization program reduce long-term sick leave for low back pain? Spine 2000; 25:1973–1976.

    Article  PubMed  CAS  Google Scholar 

  56. Bendix AF, Bendix T, Lund C, Kirkbak S, Ostenfeld S. Comparison of three intensive programs for chronic low back pain patients: a prospective, randomized, observer-blinded study with one-year follow-up. Scand J Rehabil Med 1997; 29:81–89.

    PubMed  CAS  Google Scholar 

  57. Lanes TC, Gauron EF, Spratt KF, et al. Long-term follow-up of patients with chronic back pain treated in a multidisciplinary rehabilitation program. Spine 1995; 20:801–806.

    Article  PubMed  CAS  Google Scholar 

  58. Rainville J, Sobel JB, Hartigan C, Wright A. The effect of compensation involvement on the reporting of pain and disability by patients referred for rehabilitation of chronic low back pain. Spine 1997; 22:2016–2024.

    Article  PubMed  CAS  Google Scholar 

Download references

Editor information

Editors and Affiliations

  1. Pain Institute, University of Pittsburgh, Pittsburgh, PA

    Dawn A. Marcus MD

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

(2005). Cervical and Lumbar Pain. In: Marcus, D.A. (eds) Chronic Pain. Current Clinical Practice. Humana Press. https://doi.org/10.1385/1-59259-882-X:055

Download citation

  • DOI: https://doi.org/10.1385/1-59259-882-X:055

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-501-9

  • Online ISBN: 978-1-59259-882-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation