I would say 50% of my patients are neck and back pain, & I find that exercise is a great way to diminish and avoid recurrences of these issues. When it comes to exercise, one size does not fit all. There are different things that should be done depending on the diagnosis, and I am NOT a fan of "no pain no gain" when it comes to treating back and neck pain.
On an acute episode often I will just start on some easy nerve gliding or gentle stretches, in addition to a variety of modalities for pain management. Progressing to a little bit more advanced stretching, then cervical, scapular, or core stabilization exercises. Later on we'll start with more aggressive resistive exercises throughout the body.
A simple muscle strain almost always gets better and people do great. Herniated disc on the other hand can lead to future instability , which can then down the road lead to stenosis. This is why it is so important to work on stabilization exercises with these folks and really work on education. When the back and neck are feeling good most people ignore what they should be doing and go back to old habits. Weight loss and improve posture are huge in relieving and avoiding recurrence of back and neck pain, however often are ignored.
I herniated a lumbar disc last year trying to catch a roof box that was falling off my SUV. I could barely move the next morning, and went and saw my PA. I let her know that I had to work so I was not going to take narcotics, and that I did not want to see a surgeon as I was not going to have surgery. Treated with a shot of tramadol that did nothing, muscle relaxers that did nothing, however the next morning I started prednisone and by noon I was probably 50% better. That stuff is hard on your body so I quickly weaned off of it, and started therapy with one of my instructors from continuing medical education classes.
Did some manipulation above and below the disc herniation, dry needling into lumbar and gluteal / piriformis muscles, nerve gliding and gentle stretches. Begin with lying core stabilization exercises, and then progressed to therapeutic ball core stabilization exercises. I did continue doing cardio very gently on an elliptical throughout.
About a year out I am 99%, and continue working on cardio on an elliptical 6 days a week for 1 hour or longer, do Bowflex strengthening 1 - 2 times a week, and therapeutic ball 1 - 2 times a week in addition to other exercising.
I did have other therapists perform a lot of dry needling as that really seem to help me, and also had our pelvic health therapist work on my SI joints periodically.
I also get in the hot tub everyday after working out and just soak and let the Jets blast for 10 minutes or so and then get into a stretching routine for my entire body that I work on for 15 to 20 minutes every morning while soaking in the tub.
We do get great success where I work treating back and neck injuries or problems, however you can not get everyone better with therapy.
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