In general the physician should recommend a work-up, evaluation, medication and treatment.  Some of the more popular conservative treatment approaches are exercise, massage, therapy, acupuncture, and chiropractic. 

In general, the treatment approach should include some guided intervention by the practitioner followed by a home exercise program. The treatment should provide some positive benefits within a reasonable amount of time without setting up a lifelong, dependent relationship with the practitioner to achieve a successful outcome.  

What about those patients who have nagging back or neck pain that no longer goes away? 

Robin McKenzie, a physical therapist from New Zealand described this as postural pain syndrome. 

Postural pain syndrome is thought to be due to poor seated or standing posture, which stresses soft tissue structures at their end range of movement without any actual pathology.  This poor posture position, if held over time tends to decrease the blood supply to the area and overloads the supporting soft tissue structures thus causing pain. 

The hallmark of postural syndrome is that once the poor posture is corrected, and the end range stress is removed, the pain resolves.  McKenzie gives the example of stressing one’s finger by pushing it into an “over extended” position toward the wrist and holding it.  

As this position is held, pain begins to develop and tends to worsen with time. Once the position is released, the pain subsides. In many cases the treatment is just as simple as that, once again enforcing what our mothers always told us, to “sit up straight”.  

McKenzie as a treatment approach has been shown to be a consistent, reliable, conservative treatment approach for back and neck pain. The assessment guides the treatment and within two to three visits should be able to affect a positive result or identify if the symptoms are not mechanical in nature.