Question
I have been trying so sort my back problem out for 18 months now, I have seen 3 different practitioners but problem not sorted. Have now been referred to an NHS physio by my doctor. He seems nice but am worried that there might be a better option. My right upper back feels like its been concreted into my position and that my neck is bent back on itself. I have severe pain in my upper back, neck up to my ears, shoulder and upper arm ache and headaches in the evening and my muscles feel that they can never relax. When they do there feels like there is a stone deep in the rights side of my upper back that keeping everything else tense and out of position. I saw the physio for the first time on friday and he says that my upper spine is flat and is shouldn't be, he can fit his hands under my shoulder blades and my lower back is curved more that it should. he also says that now I have had the pain more than 6 months that it is termed Chronic and is much more difficult to deal with. How do I know if my spine is like this because of any muscle spasm I may have which may have pulled my spine out of shape,  or whether that it is my natural shape that has caused this? It seems a bit chicken and egg to me.
My back feels like I want someone to crack it and knock everything back into place. My physio seems to think stretches and exercises and possibly the use of tens machines will sort it. I have been doing stretches that he gave me since thursday very gently but my back/neck is very painful and throbbing & I've hardly slept for 2 nights. Am I going down the right road do you think? I don't care what it takes I just want to get it sorted permenantly.

Sorry for the long text but I am desperate now.
many thanks,

Answer
Follow-up:  Jayne, I would suggest that you not wait to see the chiropractor, rather explore working with the physio and chiropractor at the same time.  The separate treatments can be very complimentary especially when both healthcare providers are working in conjunction to ease your pain.  And yes, please feel free to follow-up with me if you feel the need.  Good Luck... Dr. Leatherman

Dear Jayne,

Well, I am assuming that you are writing from the UK because of the terminology you are utilizing...is that correct?

The fact that you have been experiencing these problems for 18 months is definitely an indication that you are in chronic pain, and the physio is correct that it will be harder to correct.  

I am not quite sure of the spinal configurations you have explained, but I think you are trying to tell me that your cervical (neck ) curve has been reversed, and that the thoracic (upper back) curve has been reduced while the (lumbar)low back curve has been increased (hyperlordosis). If this is correct, it is not caused by muscle spasms but the exact opposite...the muscle spasms are a direct response to the altered spinal curves.  

The muscles spasm because they are taking the majority of the stress by trying to maintain an upright posture under gravitational load.  Not to mention that long standing muscle spams actually progress to trigger points which refer pain away from the focal area of spasm.  If you would like to read more on trigger points as well as visualize the pain transmission patterns, research Travell and Simons on the internet.  They are the authors of the best ever written book on trigger points, which has been referenced in almost every rehab or musculoskeletal medicine textbook.

Aggressive exercise protocols and stretching will help to regain function and reduce the muscle spams you are experiencing. I do think that you should continue with the physio recommendations to increase your functional status, but remember that function must follow form.  So, if the underlying structure is not addressed, then the relief will be temporary and the pain will reoccur as the structural dysfunction was not corrected...so I would further recommend that you try to find a chiropractic physician to help you remodel the spinal curve, especially the neck curve in your case.  

There area few techniques that have been found to consistently correct abnormal spinal curves such as Pettibon technique and Chiropractic Biophysics that you can easily research on the internet.  Both techniques are valid and will correct the spinal curves, and have physician locators on their respective websites so that you can search for doctors in your local area who have been properly trained to restructure the curve. feel the need.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net