Low Back and Neck Pain - Romatem

Scoliosis: What Is It? Symptoms and Treatment

What Is Scoliosis?

Scoliosis is defined as the deviation of the spine, which should normally be straight when viewed from the back, to the right or left by more than 10 degrees. Scoliosis is not just a one-dimensional angular deformity; it is a three-dimensional skeletal and structural impairment that affects the body from the front and sides.

Cervical and Lumbar Pain


  1. What Is Scoliosis?

   1.1 Types of Scoliosis

      1.1.1 Idiopathic Scoliosis (Unknown Cause Scoliosis)

      1.1.2 Neuromuscular Scoliosis

      1.1.3 Congenital Scoliosis (Present from Birth)

   1.2 Scoliosis in Adults

      1.2.1 Adult Idiopathic Scoliosis

      1.2.2 Adult Degenerative Scoliosis

   1.3 What Are the Symptoms of Scoliosis?

   1.4 How Common Is Scoliosis?

   1.5 Scoliosis Degrees

   1.6 What Happens in the Diagnosis Stage of Scoliosis?

   1.7 Steps in the Treatment of Scoliosis

   1.8 Conclusion

   1.9 Frequently Asked Questions About Scoliosis

      1.9.1 Who Is More Prone to Scoliosis?

      1.9.2 How Does Spinal Deformity Occur in People with Abnormal Vertebrae?

      1.9.3 Can Carrying Heavy Backpacks and Standing in Bad Posture Cause Scoliosis and Kyphosis?

      1.9.4 How Is Adult Scoliosis Resulting from Aging Treated?

      1.9.5 When Should Surgery Be Considered for Scoliosis?

      1.9.6 To inquire about spinal deformity treatment

Scoliosis can occur at any stage of life. Genetics are implicated in the occurrence of scoliosis. If the scoliosis angle is high, the visual impact on the body is significant. This cosmetic impairment, besides being a health problem for children in early adolescence, affects self-confidence and can lead to psychological issues.

Apart from the cosmetic impairment, as the angle of spinal curvature increases, complaints such as back and waist pain arise, along with difficulties in breathing, bloating, and quick fatigue due to compression of the lungs and heart within the chest. Disruption of spinal dynamics can lead to pain. Consequently, it can negatively impact the quality of life.
Types of scoliosis:

Types of scoliosis:

  1. Idiopathic Scoliosis (Unknown Cause Scoliosis):

This is the most common type of spinal curvature, the exact cause of which is unknown. The curvature can be lateral, forming an “S” or “C” shape. Besides lateral bending, vertebral rotation around themselves is also observed in all idiopathic scoliosis cases, including mild forms. This rotation of the vertebrae leads to asymmetric protrusions in the back or waist. Its etiology is usually focused on genetic and environmental factors and is more prevalent in adolescent girls, occurring 8-10 times more often in females.

  1. Neuromuscular Scoliosis:

The second most common type of scoliosis is neuromuscular scoliosis, which occurs due to an underlying muscular or nerve disease. Nervous system diseases can originate from the brain and spinal cord, while muscle diseases can occur in childhood or later stages of life. This type of scoliosis can occur in conditions such as cerebral palsy, polio, muscular dystrophy, and tethered cord syndrome.

In neuromuscular scoliosis, there can be more frequent respiratory difficulties and sensory impairments compared to idiopathic scoliosis.


Types of Scoliosis:

  1. Congenital Scoliosis:

This type of scoliosis occurs due to spinal anomalies that develop during fetal development in the womb. Congenital scoliosis progresses rapidly in the early years of life, often requiring surgical intervention at a young age due to its swift progression. There is no gender distinction, and the exact cause of congenital scoliosis cannot always be determined. Certain events during embryo and fetus development can lead to more frequent occurrences of congenital spinal deformities.


  1. Adult Scoliosis:

Adult Idiopathic Scoliosis:

This condition starts painlessly in childhood but may manifest symptoms such as pain and postural deviations in later years. Severe pain can occur due to degeneration in the facet joints. Excessive deformity in the chest area can affect respiratory functions, leading to quick fatigue and breathing difficulties in patients.


Adult Degenerative Scoliosis:

Adult degenerative scoliosis results from wear and tear on the spine due to aging. It typically occurs in individuals over 50 years old. Osteoporosis, which becomes more common in these years, can be one of the causes, and it can also contribute to the worsening of the curvature. Degenerative changes due to aging can occur in any region of the spine – neck, upper back, or lower back – but it is most commonly observed in the lower back region.
Spinal stability and balance can be compromised in individuals with advanced degenerative changes in adulthood. This condition can cause the spine to tilt sideways and the anatomical angle in the lower back to decrease, leading to a forward lean of the body. These imbalances can exacerbate the severity of the curvature and impact the patient’s mobility, often resulting in pain.

In adults with degenerative changes, back pain, lower back pain, pain radiating along the nerve distribution area (radiculopathy) due to nerve compression, and muscle weakness supplied by the affected nerves can be observed. Deformities in the spine structure can lead to spondylolisthesis, where the vertebral bone slips forward. Non-surgical treatment methods are generally preferred. Physiotherapy programs involving stabilization, strengthening, and stretching exercises can alleviate muscle spasms and reduce pain.

In adults diagnosed with rheumatic diseases, osteoporosis (bone loss), and following trauma or infections…

What Are the Symptoms of Scoliosis?

Scoliosis, or curvature of the spine, typically does not cause health problems in its early stages and rarely results in back pain. Therefore, unless careful attention is paid, it might be challenging for families to notice.

Symptoms of scoliosis include uneven shoulders, hips shifting to one side, or one hip appearing higher than the other, and unevenness in the position of the shoulder blades.

An essential step for parents is to regularly have their child bend forward with their back exposed to check if the spine aligns in a straight line. Upon inspection, if there is scoliosis, a protrusion or elevation may be noticeable on the right or left side of the spine or in the lower back. Skin discoloration might accompany scoliosis in some cases.


The symptoms mentioned in the literature can be summarized as follows:

  • Spinal curvature
  • Asymmetry of the shoulders
  • Asymmetry of the hips
  • Back or lower back pain
  • Rotation of the spine
  • Fatigue and quick exhaustion
  • Shortness of breath
  • Irregular positioning of clothes
  • Headaches

An important note for parents is that scoliosis can occur between the ages of 10 to 16, and due to the uncertainty of its onset, spinal checks should be done regularly during this period. Extra attention should be given to children displaying signs of adolescence. If scoliosis is suspected, it is crucial to consult a physician promptly.

Prevalence of Scoliosis:

Scoliosis is a prevalent spinal deformity worldwide, affecting about 2% to 3% of the population. It often emerges during adolescence but can also develop due to congenital or acquired causes throughout life. Scoliosis occurs equally among males and females, although its severity and the need for treatment can vary from person to person. Early diagnosis and appropriate treatment can control the progression of scoliosis, significantly improving patients’ quality of life. Regular health check-ups and awareness play a vital role in the early diagnosis and effective intervention of scoliosis.

Scoliosis Grades:

Scoliosis grades are used to indicate the severity of the spinal curvature. The degree of curvature is expressed using a measurement called the Cobb angle. The Cobb angle measures the most significant curvature between the upper and lower points of the spine. Here is a general classification based on the degree of scoliosis:

Mild Scoliosis (10-25 degrees): Mild scoliosis is usually a condition that is regularly monitored. Progression can be controlled through exercises, physiotherapy, and regular check-ups.

Moderate Scoliosis (25-40 degrees): Moderate scoliosis shows a more pronounced curvature. At this stage, a custom brace can be worn. Physiotherapy and regular check-ups are important in the treatment process.

Severe Scoliosis (40-50 degrees): Severe scoliosis is considered a significant curvature. More aggressive treatment options such as physiotherapy, brace therapy, and surgery can be evaluated.

Very Severe Scoliosis (More than 50 degrees): Cases with this degree of scoliosis are rare but can lead to serious health issues. Surgery is often the most effective treatment method.

The degree of spinal curvature should be properly evaluated by a doctor, and treatment options should be determined under the supervision of a specialist team. The treatment approach varies based on individual differences and the patient’s overall health.

Diagnostic Stages for Scoliosis:

After a detailed history is taken and a clinical examination is conducted by the physician, imaging techniques are employed. Standing spine X-rays can accurately diagnose scoliosis. In rare cases, advanced radiological examinations of the spine (such as MRI scans) might be requested to differentiate other causes. In recent years, non-X-ray body topography analysis systems, which allow monitoring of curvature without X-rays, have become more commonly used.

Early diagnosis is crucial in scoliosis. Therefore, parents should regularly examine the spines of their children between the ages of 10 and 16 and should consult a doctor immediately if there is suspicion of scoliosis.

Treatment Steps for Scoliosis:

There are established algorithms for treating scoliosis. If detected early and if the curvature is low, it qualifies for conservative treatments. Treatment options for scoliosis include observation, physiotherapy and rehabilitation applications, bracing, and surgery.

The treatment of scoliosis depends on the degree of curvature and at what stage of growth the individual is. Currently accepted non-surgical treatment methods include scoliosis-specific exercises, specialized scoliosis programs, and bracing. The main goal of scoliosis treatment is to prevent the progression of the curvature, maintain the child’s spinal mobility, control cosmetic deterioration, and prevent surgery.

Exercises in Scoliosis:

Exercise programs tailored to the specific affected body part, known as three-dimensional spinal exercises or Schroth exercises, are crucial in scoliosis management. These exercises aim to control the pelvis and the muscles and ligaments surrounding the affected spine, ensuring postural control and cosmetic appearance. Mobilization, spinal traction, flexibility, and correct posture control are the foundation for controlling the spine in daily activities.

Regular exercises, along with proper biomechanical control and wearing the appropriate brace for an adequate duration, enhance the child’s postural balance and control the progression of scoliosis angle. Breathing techniques are also incorporated into scoliosis exercise programs. Recently, computer-assisted programs that integrate spinal exercises into a game-like environment have gained prominence, offering opportunities for interactive exercises in various positions, including standing, sitting, and plank positions.

Ideal Timing for Bracing:

The ideal time for bracing is after the age of 10, during Risser stages 0-2 (early stages of bone development), with a Cobb angle between 20-40 degrees, and within the maximum of one year before or after menarche (the onset of menstruation).

Surgical Intervention:

Surgical treatment is applied when conservative methods fail and in individuals with a high risk of progression, especially if the Cobb angle is above 40 degrees. In scoliosis surgery, the spine is corrected by using spinal plates and screws, and the progression of the spinal curvature is controlled. In younger children, the operation might need to be repeated at certain intervals to ensure the spine’s proper growth.


Frequently Asked Questions about Scoliosis:

1. Who is More Prone to Scoliosis?

Yes, scoliosis can occur due to other diseases or conditions. For example, conditions like congenital spinal anomalies, muscle weaknesses, neuromuscular diseases, neurological disorders, or spinal injuries can lead to scoliosis.

2. How Does Scoliosis Develop in Individuals with Abnormal Vertebrae?

Abnormal vertebrae, including congenital or acquired structural abnormalities, spinal weakness, or spinal injuries, can create uneven pressure on the spine over time, leading to scoliosis. These abnormalities or weaknesses in the natural structure of the spine can cause the spine to curve sideways. Such conditions should be evaluated by doctors, and an appropriate treatment plan should be developed.

3. Can Carrying a Heavy Backpack and Poor Posture Cause Scoliosis and Kyphosis?

Carrying a heavy backpack and maintaining poor posture can exert prolonged repetitive stress on the spine. While these situations do not directly cause conditions like scoliosis or kyphosis, they can negatively impact spinal health. Incorrect posture and carrying heavy loads can adversely affect spine health in the long term, leading to muscle weakness, pain, and other posture-related issues. However, spinal curvature conditions like scoliosis or kyphosis typically develop due to genetic factors, congenital issues, or other health conditions. Regular exercise, proper posture habits, and appropriate techniques for carrying weights are essential for maintaining spinal health.

4. How is Adult Scoliosis, which Develops with Aging, Treated?

The treatment of adult scoliosis depends on the severity of symptoms, the degree of spinal curvature, and the patient’s overall health. Treatment methods may include physiotherapy, exercise programs, specialized braces, pain management, spinal manipulation, and epidural injections. In severe cases, surgical intervention might be necessary. The treatment plan should be individually tailored, evaluated by a specialist doctor, and customized based on the patient’s specific needs.

5. When is Surgery Considered for Scoliosis?

The decision to undergo surgical treatment for scoliosis depends on factors such as the severity of the curvature, the patient’s age, growth potential, pain levels, and overall health.

What is Back Pain? Back Pain Treatment

Back pain is the sensation of discomfort or pain in the back area. It is a significant health problem due to its common occurrence, substantial financial burden, loss of work productivity, and time


  • Back pain
  • Causes of back pain
  • 2.0.1. Mechanical and degenerative causes
  • 2.0.2. Inflammatory causes of back pain
  • 2.1. How is it treated?
  • 2.1.1. Medication and rest
  • 2.1.2. Exercise and Physical Therapy
  • 2.2. Types of back pain
  • 2.3. What is Acute Back Pain?
  • 2.4. What is Chronic Back Pain?
  • 2.5. What Can Back Pain Indicate?
  • 2.6. When Should You See a Doctor for Back Pain?
  • 2.7. How is Back Pain Diagnosed?
  • 2.8. Back Pain Treatment Methods
  • 2.9. Is Surgical Intervention Necessary for Back Pain?
  • 2.10. Rules for Maintaining Back Health
  • 2.11. Conclusion
  • 2.12. Frequently Asked Questions About Back Pain
  • 2.12.1. What can be done at home for back pain?
  • 2.12.2. Where does it hurt in cases of back pain?
  • 2.12.3. How can you tell if there is a herniated disc in the back?
  • 2.13.4. Is back pain dangerous?

At least 75-85% of people experience significant back pain at least once in their lifetime. It is the most common reason for visits to primary care physicians among adults.

The back area is the body’s center of gravity and is affected by nearly all movements. Therefore, it is a region constantly exposed to continuous stress and repetitive strain.

Causes of Back Pain

The causes of back pain can be divided into mechanical and degenerative reasons, as well as inflammatory causes.


Mechanical and Degenerative Causes:

These account for approximately 95% of all back pains. Mechanical causes include lumbarization, sacralization, increased lumbar lordosis, disc herniations, trauma, and back pain due to weak muscles. Degenerative causes result from tissues aging, structural deterioration due to various reasons, and calcifications.

In mechanical and degenerative back pain, the pain is generally alleviated with rest, increases with movement, often decreases with warmth, increases with cold, and varies depending on the position. Morning stiffness lasting a short period is common, and there are no abnormalities in blood tests.


Inflammatory Causes of Back Pain:

The term inflammatory refers to inflamed conditions. Inflammatory rheumatism (Ankylosing Spondylitis), infections (such as brucellosis, tuberculosis), and cancer-related conditions can cause inflammatory back pain.

Inflammatory back pain worsens with rest. The pain increases at night and decreases when the person gets up and moves. Morning stiffness lasting for more than half an hour is typical. Pain worsens with warm applications. Blood tests, such as sedimentation rate and CRP, show signs of inflammation.




  1. Medication and Rest:

   – Anti-inflammatory drugs and corticosteroids might be necessary during the acute phase of degenerative and mechanical back pain. Simple pain relievers can be sufficient during the chronic phase. For acute back pain (recent onset), a few days of complete rest might be necessary. After rest, the patient should gradually return to normal daily activities.


  1. Exercise and Physical Therapy:

   – Strengthening the muscles and maintaining a certain level of flexibility are crucial for bearing the loads transferred to our spinal vertebrae. Achieving this requires specific exercises. It’s important to note that not all exercises might be suitable for every patient. The type of exercises should be tailored to the patient based on the acuteness or chronicity of the disease, the shape of the disease, the patient’s physical and social needs, and age. Therefore, exercises should be individualized and prescribed by a physician.


  1. Various Physical Therapy Applications:

   – Several physical therapy methods (surface heaters, deep heaters, analgesic currents, traction methods) can be applied to patients with back pain. These applications take advantage of the pain-relieving, muscle-relaxing, tissue-renewing, and tissue-repair-accelerating effects of physical therapy. The form and duration of these physical therapy applications should be prescribed and applied based on the patient’s and the disease’s characteristics.


Types of Back Pain:


Back pain can be classified into two types:

  1. Acute Back Pain:

   – Acute back pain is a sudden and severe pain that occurs in the back. It is often caused by injury, muscle strain, or improper use of the back. Common causes of acute back pain include muscle strain or sprain, disc problems, trauma, physical activity, infections, and inflammation.

  1. Chronic Back Pain:

   – Chronic back pain refers to continuous or recurring pain in the back region lasting more than six weeks. Unlike acute back pain, chronic back pain persists for a longer period and can often indicate an underlying serious condition. The causes of chronic pain can be complex and may not be attributable to a single factor. However, chronic back pain causes can generally include disc problems, facet joint problems, spinal stenosis, scoliosis, sacroiliac joint disorders, muscle strain, fibromyalgia, psychological factors.

Indicators of Back Pain:

  1. Spinal Problems
  2. Muscle and Connective Tissue Problems
  3. Joint Issues
  4. Neurological Problems
  5. Systemic Diseases

When to Seek Medical Attention for Back Pain:

Although back pain is a common condition that often resolves on its own within a few days, there are specific situations where immediate medical attention is necessary. You should consult a healthcare professional in the following cases:

  1. Severe Pain
  2. Pain Accompanied by Numbness or Weakness
  3. Problems with Urination or Bowel Movements
  4. Fever and Signs of Infection
  5. Presence of Chronic Diseases
  6. Unexplained Back Pain
  7. Back Pain Hindering Daily Activities

Proper diagnosis by a healthcare provider is crucial in determining the underlying cause of back pain, as it can originate from various conditions, each requiring specific treatment approaches. Therefore, if you experience back pain, it is important to consult a healthcare professional without delay.


Methods of Back Pain Diagnosis:

Back pain can arise from various causes, making it essential to consult a doctor for an accurate diagnosis. For those wondering how back pain is accurately diagnosed, here is a brief explanation:

  1. Medical History and Physical Examination:

   – The doctor will ask about your medical history and perform a physical examination to understand your symptoms and evaluate your condition.

  1. Imaging Tests:

   – Imaging tests such as X-rays, MRI scans, or CT scans may be ordered to get detailed images of the spine and identify any abnormalities.

  1. Blood Tests:

   – Blood tests, including sedimentation rate and CRP, may be conducted to assess the presence of inflammation in the body.

  1. Electromyography (EMG) and Nerve Conduction Studies:

   – EMG and nerve conduction studies can help assess nerve function and identify nerve-related issues.

  1. Lumbar Puncture (Sometimes):

   – In some cases, a lumbar puncture may be performed to rule out specific conditions.

Your doctor will determine an appropriate diagnosis based on your symptoms, medical history, and test results. Identifying the underlying cause of back pain is essential for proper treatment, as back pain can stem from various conditions, and treatment options may vary accordingly. Therefore, if you are experiencing back pain, it is crucial to consult a healthcare professional promptly.


Methods of Back Pain Treatment:

The treatment for back pain can vary depending on the underlying causes. Some common treatment methods used to alleviate or treat back pain include:

  1. Rest:

   – Resting the affected area and avoiding exertion can be essential during the initial stages of back pain.

  1. Physical Therapy and Exercise:

   – Physical therapists may recommend specific exercises and physical therapy techniques to alleviate and prevent the recurrence of back pain. These exercises are designed to strengthen the back muscles, increase flexibility, and improve posture.

  1. Medications:

   – Pain relievers, anti-inflammatory drugs, or muscle relaxants may be used to alleviate back pain. However, prolonged use of these medications should be avoided due to potential side effects and the risk of dependence.

  1. Heat and Cold Therapy:

   – Cold compresses or hot water bottles can help reduce swelling and inflammation (cold) or relax muscles and increase blood flow (heat).

  1. Massage and Acupuncture:

   – Manual therapies like massage and acupuncture can help relax muscles and alleviate pain.

  1. Yoga and Pilates:

   – Yoga and Pilates can be recommended to improve body posture and flexibility, aiding in managing back pain.

  1. Ergonomic Changes:

   – Evaluating and adjusting sitting positions, desk and chair setups, mattress quality, and shoe choices can contribute to relieving back pain.

  1. Preventive Measures:

   – Regular exercise, maintaining proper posture, lifting heavy objects correctly, and taking regular breaks can help prevent back pain.

  1. Surgical Intervention:

   – Surgical intervention might be necessary in cases where there is a significant problem in the spinal discs, nerve compression, or other serious spinal conditions.

The best treatment option for back pain depends on the specific diagnosis of the condition. Therefore, if you are experiencing back pain, it is crucial to consult a healthcare professional to receive an accurate diagnosis and appropriate treatment.


Is Surgery Necessary for Back Pain?

In cases where there are significant problems affecting multiple nerve roots and the nerves going to the bladder are affected, surgery may be necessary. Surgical treatment is essential in cases known as cauda equina syndrome, where there is progressive weakness in the leg or foot. However, surgeries performed solely to relieve pain require careful evaluation.

Various complementary therapies can also be utilized to alleviate back pain, including acupuncture, spinal manipulation, mesotherapy, prolotherapy, and ozone therapy.


Rules for Preserving Back Health:

  1. Face the person, object, or item you are looking at directly.
  2. Avoid staying in the same position for extended periods. Sitting and standing times should not exceed 45 minutes.
  3. Use a pillow to support the lower back when sitting.
  4. When working on the ground, squat and avoid bending over excessively.
  5. Keep the back area dry and protected from cold.
  6. Use an orthopedic mattress for sleeping.
  7. The most suitable sleeping position is lying on the side, bending the legs forward towards the abdomen.

These practices are essential for maintaining good back health.


Back pain is a manageable symptom with accurate diagnosis and treatment. The experts at Romatem are here to find solutions to your health problems.

Frequently Asked Questions About Back Pain

What can be done at home to relieve back pain?

People experiencing back pain can try home relaxation methods. Rest is important; hot or cold compresses can be applied to the painful area. Over-the-counter pain relievers can be used, but long-term use without consulting a doctor should be avoided.

Where does the pain occur in the back?

Back pain usually occurs in the lower part of the spine, the area that extends from the middle of the back to the upper hips. These pains can result from problems in the spinal discs, muscles, nerves, or connective tissues.

How can you tell if there is a herniated disc in the back?

A herniated disc is a condition that occurs due to damage to the tissues of the spinal discs, causing pressure on the spinal cord or nerve roots. The presence of a herniated disc can manifest through symptoms such as back pain, leg pain, tingling, numbness, and muscle weakness.

Is back pain dangerous?

Back pain is usually not a sign of a serious health problem. However, in some cases, these pains can be a symptom of a serious condition caused by issues with spinal discs, muscle strains, or poor posture.


Neck Pains

Neck pain is a common health issue that can affect people of all genders and ages. Although neck pain is less prevalent than back pain, it still affects one-third of the population. Most cases are mild and tend to improve on their own in a short period. However, in rare instances, neck pain can be severe, even leading to disability.

Neck pain can radiate to the back of the head, around the shoulders, arms, and the front of the chest. Along with neck pain, individuals might experience numbness in the arms and hands, dizziness, imbalance, and headaches.

The incidence of neck pain increases with age. Daily stresses and job-related pressure can exacerbate neck pain. There’s a correlation between the patient’s occupation and neck pain; those in jobs requiring prolonged periods of fixed positions (such as desk jobs, assembly line workers, and musicians) are more prone to neck pain.

In most cases of acute neck pain, there isn’t a specific identifiable cause; however, mechanical factors are predominant in about 95% of cases.


Causes of Neck Pain:

  1. Related to Bone Structures:
  • Congenital: Torticollis, Klippel-Feil syndrome
  • Traumatic: Fractures, dislocations, herniated discs
  • Degeneration, spinal canal stenosis
  • Rheumatic: Ankylosing spondylitis, rheumatoid arthritis, polymyositis, polymyalgia rheumatica
  • Tumors
  • Infections


  1. Related to Soft Tissues:
  • Postural abnormalities
  • Fibromyalgia and myofascial pain syndrome
  • Nerve and vascular problems


  1. Referred Pain:
  • Pain originating from another source but felt in the neck


  1. Endocrine and Metabolic:
  • Osteoporosis
  • Parathyroid disease
  • Paget’s disease


  1. Psychological:
  • Psychological factors can contribute to or exacerbate neck pain.


Classification of Neck Pain Based on Duration:

  1. Acute: Lasts less than 1 month.
  2. Subacute: Lasts between 1 to 3 months.
  3. Chronic: Lasts more than 3 months.


Patient History in Neck Pain:

The patient’s history is as important as the physical examination. A detailed chronological history of the pain, including any physical or psychological traumas, surgeries, habits, family history, social circumstances, job, and hobbies, should be obtained.

Mechanical neck pain worsens with physical activity, improves with rest and warmth, and even if there’s morning stiffness, it’s brief. Rheumatic pain worsens with rest, improves with mild physical activity, and is associated with more than 1 hour of morning stiffness. Cancer pain starts subtly, worsens at night, doesn’t improve with movement, and often does not respond well to medication.


Physical Examination in Neck Pain:

During the physical examination, the physician evaluates the patient’s posture and neck, checks soft tissues, assesses neck movement, and performs specific provocative maneuvers. If there are signs of nerve compression, neurological evaluations are conducted.


Diagnostic Methods for Neck Pain:

The probability of identifying the cause of neck pain does not exceed 20% to 50% in individuals aged 20 to 50. Therefore, most cases do not require additional diagnostic tests beyond a detailed patient history and physical examination.


– Laboratory Tests:

  • In cases of infections, rheumatic problems, cancers, and widespread bone diseases, laboratory tests are necessary.
  • Electromyography (EMG) and Nerve Conduction Studies:
  • Often performed in cases of suspected nerve root compression to determine the affected nerve root and assess the severity of the condition.
  • Imaging Techniques:
  • X-rays, CT scans, MRI, EMG, or bone scans can be used in selected cases. However, it’s crucial to remember that these tests should complement the history and physical examination findings, not replace them.


Indications for Imaging Studies:

  • Advanced age
  • Recent trauma
  • Prolonged corticosteroid use
  • Presence of cancer
  • Presence of infection
  • Fever
  • Weight loss of 10% within 6 months
  • Persistent, intolerable pain affecting the quality of life
  • Presence of neurological symptoms


Principles of Treatment for Neck Pain:

The primary goal of treatment is to relieve pain, break the pain-spasm-pain cycle, prevent recurrence, and improve biomechanics. The following methods are commonly used in treatment:

  1. Rest and Neck Support:

Patients should be informed about possible causes of their pain and educated about their condition. In acute pain, 2-3 days of rest is sufficient. Prolonged rest can lead to joint stiffness, soft tissue shortening, and decreased muscle strength and cardiovascular fitness. Therefore, activity modification is necessary in acute neck pain.

  1. Neck Collar Use:

Collars should be used for a short duration (less than 1.5 months) in non-traumatic acute neck pain. Prolonged use without exercises can lead to muscle weakness and atrophy.

  1. Medication:

Pain-relieving medications, muscle relaxants, antidepressants, corticosteroids, and antiepileptic drugs can be used based on the patient’s condition.

  1. Physical Therapy:

Physical therapy sessions and exercise programs play a significant role in managing neck pain. Modalities such as heat application, TENS or interferential currents, ultrasound, laser therapy, traction, cupping therapy, massage, taping, dry needling, trigger point injections, mobilization, and manipulation can be applied.

  1. Exercises:

 The main goals of exercises in neck pain are to achieve pain-free and full range of motion of the neck and shoulders, ensure muscle strength, endurance, and balance, prevent functional impairment, avoid recurrences, and enhance physical fitness.

In the acute phase, exercises aim to reduce pain and protect structures from further damage. Subacute exercises focus on restoring the functions of damaged or supportive structures. In the chronic phase, the aim is to address psychological issues and reduce physical impairment.


  1. Balneotherapy:

Spa therapy can reduce pain thresholds and muscle spasms and improve quality of life.


Surgical Treatment for Neck Pain:

Surgical intervention (surgery) is required in the following neck-related problems:

  • Cervical disc herniation causing progressive muscle weakness, sensory loss, and reflex abnormalities due to spinal cord compression
  • Spinal tumors or abscesses
  • Persistence of symptoms for more than 3 months, unbearable pain, and decreased quality of life despite conservative treatment
  • Spinal fractures and significant spinal misalignments
  • Severe neurological problems due to spinal cord compression


Useful Tips for Individuals with Neck Pain:

  • Avoid lifting, pulling, and pushing heavy objects. Divide the load equally between both hands.
  • Do not carry loads with your head. Do not lift loads above head level.
  • Do not keep your neck constantly bent forward or in the same position.
  • Avoid trapping the phone between your neck and shoulder while talking.
  • Maintain a straight back while sitting and lean back if necessary.
  • Use a neck pillow that supports your neck’s natural curve while sleeping.
  • Do not sleep in a position where your neck drops excessively.
  • Avoid using excessively high pillows.
  • Organize your work conditions well.
  • Change your position every 30 minutes, especially when working on a computer or at a desk.