What Is It?
Neck and back pain encompasses a broad clinical spectrum. Acute mechanical pain — arising from a specific incident such as a lifting injury — typically resolves within six weeks. Chronic presentations (persisting beyond 12 weeks) are more complex, often involving a combination of structural dysfunction, muscle imbalance, trigger point referral, and central nervous system sensitisation.
The lumbar spine is the most commonly affected region, with the cervical spine a close second. Thoracic pain is frequently associated with prolonged postural loading and is commonly seen in desk-based workers. Many presentations involve all three regions simultaneously through compensatory movement patterns.
Common Causes
- Sustained forward head posture and prolonged sitting (desk work, driving, screen use)
- Muscle imbalances — overactive upper trapezius and levator scapulae; underactive deep cervical flexors
- Lumbar disc degeneration or herniation with associated muscle guarding
- Trigger points in paraspinal, gluteal, and hip flexor muscles generating local and referred pain
- Psychological stress — which increases resting muscle tone and pain sensitivity
- Repetitive occupational loading or sudden overload (e.g. heavy lifting in a fatigued or compromised position)
- Prior injury that was inadequately rehabilitated, leaving residual weakness and altered movement patterns
How Myotherapy Can Help
Myotherapy addresses neck and back pain through a combination of modalities selected on the basis of clinical assessment rather than a generic protocol:
- Soft tissue therapy — reduces resting muscle tone in hypertonic paraspinals, upper trapezius, and hip flexors
- Trigger point therapy — deactivates myofascial trigger points generating local and referred pain
- Dry needling — provides deeper neuromuscular inhibition of trigger points when manual therapy alone is insufficient
- Cupping — myofascial decompression to address deep fascial restrictions around the thoracic spine
- Joint mobilisation — restores segmental movement and reduces joint pain in hypomobile spinal segments
- Exercise rehabilitation — deep cervical flexor and lumbar stabilisation programmes to address the underlying weakness driving recurrence
Expected Outcomes
Acute presentations typically show significant improvement within 3–6 sessions. Chronic neck and back pain requires a longer treatment course — expect 6–12 sessions over 8–16 weeks. Key outcomes include reduced pain intensity on movement and at rest, improved range of motion, decreased muscle tone, and better tolerance of sustained postures. Pain may be temporarily increased following dry needling or deep soft tissue work — this typically resolves within 24–48 hours and is not a sign of harm.
Likely Symptom Changes
In the first 1–3 sessions: reduced acute muscle tension and improved range of motion, though pain may fluctuate. By sessions 4–6: pain intensity and frequency should be measurably decreasing; inter-session relief periods lengthen. By sessions 8–12: functional improvement in daily activities, reduced recurrence frequency, and improved posture with exercise compliance. Full resolution of chronic pain may require ongoing management beyond the initial treatment course.
References
- GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries. The Lancet, 392(10159), 1789–1858.
- Hoy, D., et al. (2014). The global burden of low back pain: Estimates from the Global Burden of Disease 2010 study. Annals of the Rheumatic Diseases, 73(6), 968–974.
- Gross, A., et al. (2015). Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database of Systematic Reviews, Issue 9.
- Lluch Girbés, E., et al. (2013). Evidence for central sensitization in patients with osteoarthritis pain: A systematic literature review. European Journal of Pain, 18(10), 1367–1375.
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