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If muscles don’t have the right balance to provide sufficient support to your spine, the result could be some degree of back or neck pain. When pain of this nature is caused by overlapping overactive and under-active muscle groups in the neck, shoulders, and chest, it’s a condition known as upper crossed syndrome that’s characterized by weak, strained, or tight muscles. A common contributing factor is the posture you may have as you sit and stand throughout your day.

What Causes Upper Crossed Syndrome?

Upper crossed syndrome is so-named because of the “X” pattern that occurs when under -and over-developed muscles overlap in the upper back, shoulders, and neck contribute to pain. If these muscles are stressed or weak, muscles in the front of the neck and lower shoulders are also affected.

Hunching forward to view a computer screen or ride a bike, sleeping in awkward positions that throw off head-spine alignment, and postures where shoulders are rounded or elevated are among the common causes of weakened muscle groups in the upper spine. Having an increased cervical lordosis (inward curvature of the cervical spine) or an increased outward curvature in the same area (thoracic kyphosis) can also contribute to upper crossed syndrome.
Symptoms May Be Delayed

How Can You Tell If You Have Upper Crossed Syndrome?

Symptoms associated with weakened muscles in the upper back and shoulders are sometimes similar to what’s experienced with other types of neck pain. It’s usually a combination of symptoms that suggests that upper crossed syndrome may be the source of any discomfort felt. Some of these symptoms may include:

• Strain in the back of the neck
• Weakness in the front of the neck
• Chest tightness or pain
• Soreness in shoulder blades
• Jaw pain
• Fatigue

What Are Treatment Options?

Exercise and making changes to posture are the most common ways to treat upper crossed syndrome. Do a gentle stretch prior to exercise to warm-up muscles. Exercise to strengthen upper back and shoulder muscles is usually a combination of lying, standing, and sitting exercises to allow all affected muscle groups to be worked equally. If you prefer a gentler form of exercise that targets the same area, consider yoga. Some yoga poses also help with posture.

Stretching exercises that target weaker muscle groups in the upper back, shoulder, and neck area can minimize your risk of developing upper crossed syndrome. Pay attention to how long you sit in the same position and avoid positions that can affect spinal alignment. Referred to as “tech neck,” the habit of repeatedly bending your neck to use or view various devices should be avoided as much as possible. You may be referred to an orthopedic specialist for persistent pain in this area that doesn’t respond to common remedies.

Often associated with automobile accidents, whiplash is a common cause of neck pain that may result in injuries that can produce discomfort ranging from temporary soreness to lingering and debilitating pain. Your experience with whiplash, also referred to as neck strain or sprain, will depend on several factors, including the extent of the initial impact and the specific joints, vertebrae, discs, muscles, ligaments, and nerves affected.

Whiplash Has Many Potential Causes

Whiplash is defined as a sudden back and forth motion of the head affecting the neck. Other than a car accident, this type of injury may be caused by a hard fall, contact while playing sports, or a sudden, forceful neck turn.

Symptoms May Be Delayed

Symptoms related to whiplash may not be immediately felt after the initial trauma to the neck. Pain may develop within 24-48 hours as swelling and inflammation slowly increase and affect nerve roots. If whiplash damages joints or bones within the neck itself, pain may be immediate or become evident when attempts are made to make normal neck movements. The following symptoms may be associated with whiplash:

• Neck stiffness and pain
• Lower back pain
• Radiating pain in shoulders and arms
• Headaches and dizziness
• Increased fatigue or difficulty sleeping
• Numbness or pain sensations extending to the arms and hands

Diagnosis

Oftentimes, whiplash results in soft tissue damage, which cannot be detected on a normal x-ray. Instead, MRI or CT scans are usually done to identify damage to ligaments, muscles, and discs within the neck that may be contributing to whiplash symptoms.

No Standard Treatment

Treatment for whiplash is focused on treating the presented symptoms. Recommended medications for neck pain and related discomfort may include the short-term use of prescription pain medications, non-steroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants. The application of heat or ice, injections directly into the affected area, and massage therapy sometimes provide relief. Physical therapy may involve gentle exercises to restore range of motion as neck muscles recovery. Surgery is rarely necessary, but may become an option if there is damage to the cervical spine or discs.

Icing tends to be more effective at easing swelling and soreness and has replaced bracing as the treatment often recommended to treat whiplash within the first 24 hours. If you are experiencing severe or worsening symptoms following treatment attempts, however, you may be referred to an orthopedic surgeon for further evaluation

Muscle spasms, disc herniation, and degenerative disc disease are among the most common causes of the back pain experienced by 80 percent of the population at one time or another. While it’s understandable for an orthopedic surgeon to consider these potential causes first, there are times when back pain is linked to an uncommon source. Finding the true origin of back pain is the key to experiencing positive results with treatment recommendations, and exploring some other potential causes of spine-related discomfort may lead to an accurate diagnosis and, ultimately, meaningful relief.

Paget’s Disease

Occurring more often in people over age fifty, Paget’s disease affecting bones interferes with the natural process of replacing older bone tissues with new bone. It may weaken the spine and result in localized back pain. If bony areas in the lumbar (lower) spine become thicker due to this condition, it may result in radiating pain similar to sciatica. Diagnosis may involve a bone scan, a bone biopsy, and a blood test. Treatment includes medications to manage inflammation and control the rate of bone recycling to minimize abnormal growth.

Pelvic Bleeding or Infection

Patients taking blood thinners are at an increased risk of developing a pelvic bleeding, which may trigger sciatica symptoms. A pelvic infection may develop as a result of conditions like Crohn’s disease or pelvic inflammatory disease affecting the reproductive organs in women. Lower back pain is sometimes experienced as a symptom of a pelvic infection. Antibiotics are typically recommended to treat this type of infection.

Spinal Disc and Bone Infections

Sometimes caused by staph bacteria, infections of the bone (osteomyelitis) can produce localized back pain. The same is true of infections of the discs that cushion the spine (septic discitis). Tuberculosis inflection of spine (Pott’s disease) is another rare source of back pain. In some instances, sacroiliac (SI) joints may be affected by a bacterial infection. Treatment usually involves the long-term use of antibiotics.

Shingles

Believed to be caused by a dormant version of the herpes virus in spinal nerve roots, shingles (herpes zoster) is a nerve infection that affects the skin. Prior to the breakout of blisters, back pain is sometimes experienced. After an outbreak has occurred, patients may develop chronic nerve pain that’s more noticeable. Treatment includes medications and skin patches.

Aortic Aneurysm

Weakening of the aorta in the abdomen sometimes occurs in older adults who have atherosclerosis. This weakening may cause the wall of the aorta to bulge, which is referred to as an aneurysm. While rare, sharp or throbbing lower back pain may be felt when an aneurysm occurs. Surgical repair of the damaged wall is the most common treatment option.

Neuropathic pain originating from the spine can also be difficult to diagnose since discomfort is felt away from the actual source. Symptoms often attributed to sciatica (pain felt in the legs, thighs, buttocks, or hips) may be due to sacroiliac joint dysfunction or piriformis syndrome. All of these potential sources of localized or radiating back pain emphasize the importance of getting an accurate diagnosis, a goal often achieved with methods such as injecting a contrast dye during image testing and using epidural injections or nerve blocks to confirm or rule out potential pain sources.

Tennis elbow is an informal term that refers to pain along the outside of your elbow. It is common among tennis players, but other people can get it, too. You may be at risk for tennis elbow if you do repetitive motions with your arm. The condition can develop suddenly, such as after lifting a heavy object, or over time.

Symptoms and Causes of Tennis Elbow

Tennis elbow may cause you to experience mild to intense pain about one inch below the bony part of your elbow. You might also notice some weakness in your forearm and wrist. The weakness may cause you to have difficulty with opening jars, gripping a pen, or buttoning a shirt. In most cases, tennis elbow is an overuse injury. Too much physical activity or doing an activity that overburdens your joint and tendons results in this pain. Rarely, a direct injury to the elbow causes tissue swelling in the tendons.

Diagnosing Tennis Elbow

Your orthopedic doctor diagnoses tennis elbow with a physical exam. Some tests may be performed on your arm in order to see which moves trigger your pain. The doctor might tap on certain places around your arm to see if it activates your symptoms. You may need to have an X-ray in order to rule out other possible causes of your pain, such as a fractured elbow, radius or ulna. Your orthopedic surgeon might order other imaging studies to get a better idea of the damage to your tendon. Some of those studies might include a CT scan, magnetic resonance imaging (MRI), or an ultrasound.

Treatments for Tennis Elbow

Rest, ice, compression, and elevation are recommended at-home treatments when you have pain from tennis elbow. You could also do stretching and strengthening exercises. Physical therapy could help you to strengthen the tendons, ligaments and muscles of your arms. Your orthopedic doctor may recommend it if you have mild tennis elbow or to facilitate your recovery if more invasive treatments are needed. Wearing a brace or sling might also help to relieve your pain.

Another option for treating tennis elbow is a steroid injection. Orthopedic doctors inject a corticosteroid into the elbow or directly into the inflamed tendon. The steroid reduces inflammation and swelling, which may put an end to your pain. If a tendon has ruptured, you may need orthopedic surgery to repair it.

An ankle sprain is characterized by damage done to a ligament in the ankle. Ligaments are bands of tissue that connect bones, and they are responsible for much of the stability and movement performed by your foot. Ankle sprains can vary in severity because ligaments can be anywhere from slightly stretched to completely torn.

Ankle sprains can be caused by many things, such as a sudden twist, a fall, or even a direct hit to the ankle. Running on an uneven surface and playing sports are common causes of ankle sprains. If you have suffered from a previous ankle injury, you are more likely to experience an ankle sprain, likely because your ankle is weaker than before.

Symptoms

Symptoms of ankle sprains include bruising, swelling, pain, joint stiffness, and trouble walking. However, if you have had a previous ankle sprain, you might just feel as though your ankle is unsteady while walking.

Diagnosing an ankle sprain is relatively simple. Your orthopedic doctor will evaluate the injury and may use imaging tests, like an x-ray, to determine how serious it is.

Treatment

Treating an ankle sprain is very important. Without treatment, an ankle sprain can lead to chronic ankle instability, which is characterized by your ankle constantly feeling like it is giving way. Your doctor will also need to evaluate you in order to check for a more serious injury, like a bone fracture. Rehabilitation is also needed right away to make sure that the injury has a chance to heal correctly.

The first method of treatment for an ankle sprain is the R.I.C.E. method, which stands for rest, ice, compression, and elevation. Resting your ankle and using ice therapy to reduce swelling are important first steps. A compression wrap and elevating the ankle above the level of the heart can also reduce swelling.

Your orthopedic doctor might suggest physical therapy exercises in order to restore strength and range of motions, and medication can help to reduce pain and inflammation. Surgery for an ankle sprain is very rarely needed and is only used for severe cases. If necessary, surgery can be performed to manually repair the damaged ligament.