Chances are, at some point, you’ve been in pain. Whether it’s acute, meaning the pain occurred rapidly as the result of an injury, or chronic, meaning you’ve been in pain for a while, perhaps as a result of an underlying health condition like arthritis — you know it’s no fun to hurt.
Luckily, you’ve got options, especially when it comes to extremely common neck and back pain. We spoke with Dr. Jason Kreiner, pain management specialist at NYU Langone Health, to learn more about ways you can manage common aches and pains.
What are some of the most common types of neck and back pain that you see in your practice?
Some people might come in with acute pain from something like a muscle strain. It’s common this time of year when people are outside doing yard work or gardening and might be bending or lifting. They can easily develop a strain or potentially a herniated disc, which can cause a lot of neck pain or pain that travels down the arm.
Chronic pain may be secondary to arthritis or degenerative changes that can affect the cervical spine as well as the lower back, or lumbar spine. And then I have a lot of these patients who complain of chronic neck pain and may develop headaches. We call them cervicogenic headaches.
It’s estimated that some 39% of Americans experience back pain. How can people prevent this type of pain from ever starting?
I am a huge believer — and I preach this to all my patients — in regular exercise, strength training and weight loss. It’s not easy to tell people that they should lose weight. Patients don’t like to hear it, but that is the No. 1 thing patients can do to prevent or help alleviate a lot of their low back pain.
This is all about physics and has to do with your body mechanics. The more weight you carry, the more load-bearing there is on your lower lumbar spine, the more likely you are to have back pain develop over time and the harder it is to treat.
Lots of us have sedentary desk jobs, and even when we are walking, we’re looking down at our phones — leading to the dreaded “tech neck.” What do you suggest people do to manage that pain?
If you’re walking, put your phone in your pocket. Don’t stare down at your phone. That’s the easiest thing you can do to prevent extra strain on your neck. Next, if you are sitting at a desk all day — I know this is easier said than done — try to get a standing desk. That way you can take frequent breaks, change your position and make sure you’re not stuck in one spot all day long. I think those measures really will go a long way to prevent and help to alleviate a lot of neck pain.
Summer is prime time for road trips. People being stuck in one position for hours, and then when they get where they’re going, they’re stiff and achy all over. Any advice on feeling better after a long car trip?
Absolutely. I say this to a lot of patients — a lot of men especially — who come in with low back pain: Don’t keep your wallet in your back pocket, and don’t sit on your wallet, especially if it’s big or thick. It’s going to increase that curvature to your spine, which is going to alter your body mechanics and lead to a lot of strain.
Don’t be afraid to take frequent stops, and when you do stop, don’t park in the closest spot. Park farther away to allow you more time out of the car and to get a little bit of exercise in.
When people think about pain, they may immediately jump to medications. Things like Advil or Tylenol but also more serious prescription drugs. Are there ways to treat pain that don’t involve taking medications?
Medication does have its place, with either acute or chronic pain. But we believe in more of a multimodal approach, which encompasses different modalities, whether that’s physical therapy, acupuncture or a lot of different injections or procedures to help with that pain. Patients often do really well with a combination of different types of therapy.
For example, an injection may help relieve a lot of the pain initially, which then allows a patient to exercise and work on physical therapy, which ultimately helps patients recover in the long run.
Pain is something that just about everyone will deal with at some point in their lives. What do you want people to know if they’re in pain right now?
Pain management is a rapidly evolving field that’s growing, and it’s gone from just managing pain to actually treating the underlying condition. Newer therapies are more curative and may allow people to eliminate the need for bigger surgeries. Some of these procedures cure the underlying condition so patients don’t even have to come back for frequent treatments.
This interview has been edited for length and clarity.
Jason Kreiner, MD, is a clinical assistant professor in the department of Anesthesiology, Perioperative Care, and Pain Medicine at NYU Grossman School of Medicine and the clinical director of ambulatory pain management at NYU Langone Health in Suffolk County. He specializes in pain management, with interests in back pain, diabetic nerve damage and cervical disc disease.
