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Many patients with neck pain have lost the normal curve in the neck. This can affect the brain stem and spinal cord. The physical therapist approach to neck pain is to locate its underline cause, its dysfunction. This begins with a complete case history and thorough examination. Special attention is given to the structure and function of the spine, and its effect on the nervous system. Many factors can be responsible for low back pain. Improper sitting or lifting, overextension, trauma, bulging disc, putting pressure on the spinal cord, damage to a near-by nerve root, or inherited spinal abnormalities may contribute to the cause. The result is often numbness, tingling or pain down the leg. Many of the pain sensing nerves of the spine are in the facet joints, the two interlocking "fingers" at the back of each spinal bone. The normally smooth surfaces on which these joints glide, can become rough, irritated and inflamed. The physical therapy approach is to help restore a more normal motion and position of affected spinal bones with specific mobilization movements. This has helped many patients avoid risky surgery.
Dimitri Cosmios, PT, DPT, CSCS