Some diseases involve the whole spine or develop suddenly in a specific area for example as a result of an osteoporotic compression fracture. Other conditions develop gradually and cause symptoms in several areas such as postural pain and muscle tension, scoliosis and hypermobility syndrome.

Causes

The causes of a problem that affects the whole spine depend on the specific condition. The spine is a single functioning unit with 25 mobile segments, controlled by muscles that can span nearly its whole length as a result a condition that starts at the bottom can spread upward involving new areas of the spine by a chain reaction. Furthermore, the joints of the spine are made of the same tissues as other joints in the body, so an inflammatory disease can involve several joints. In addition bones lose mineral content with age and progressively weaken as a result.

Symptoms

Symptoms of postural disorders or advanced scoliosis that affects the whole spine will vary from pain and aching due to sustained contraction of muscles, fascia and ligaments being stretched or strained. In inflammatory disorders aching is symmetrical or strained. In inflammatory disorders aching is symmetrical and is usually worse in the morning or after a period of inactivity. In osteoporosis there are no symptoms apart from a gradual change in posture until a trivial fall or knock causes a vertebra to collapse producing intense pain. Hypermobile joints will seem to keep “catching” and clicking and will feel unstable.

Risks and Complications

The risks are related to the condition that is causing your symptoms. Some spinal pains are part of a chronic pain condition called fibromyalgia which involves other regions of the body. A diagnosis of fibromyalgia will prevent you from receiving unnecessary and excessive localized treatment. Some metabolic conditions such as vitamin D deficiency may cause widespread aching and this requires careful medical screening.

Physical Therapy for Whole Spine Conditions

Once your doctor has referred you your therapist will perform a thorough assessment. Depending on the findings of the assessment your therapist may:

• Perform soft-issues massage, passive mobilizations and postural taping.
• Teach you about posture and ergonomics.
• Begin functional retraining.

You may begin:

• Mobilizing exercises such as Mckenzie extensions, seated and lying trunk rotations.
• Strengthening exercises such as four-point supine knee lifts, kneeling supermans and calms.
• Stretching exercises such as knees-to-chest stretches, side glides, levator scapulae stretches, seated back extensions, seated waist extensions and seated twist extensions.

If you have a lot more mobility and less pain and have modified your daily activities to prevent postural strain, your therapist may advice you to:

• Move from moderate core-strengthening exercises to high-level exercises such as curl-ups, Swiss ball twists, side crunches, prone arm and leg lifts planks from knees, single leg bridges and side planks.
• Begin functional training such as squats, stationary lunges, forward lunges, reverse lunges with knee lifts and walking lunges.
• Begin sensorimotor training such as single-led stands.
• Begin cardiovascular training by using a cross-trainer or running on the treadmill or outdoors.

If you now have no pain and a full range of movement in your back, your therapist may advice you to:

• Begin more intense strengthening exercises such as prone breast stroke, Swiss ball side crunches, Swiss ball side crunches with twists and Swiss ball back stretches.
• Begin swimming, tai chi or pilates.