• Home
  • /

Chronic, Complex and Recurrent back and neck pain

"Take care of your body. It's the only place you have to live." - Jim Rohn

Like all injuries, back and neck injuries can vary from the quite minor to the very severe.

Simple injuries will respond to simple treatments.

Chronic, complex, and recurrent injuries require more thought, more education, more experience, a more holistic and better-managed approach.

Some definitions :

A simple injury is one that affects one area, has a known cause and has been present for a short time. An example might be – right sided neck pain that has been present for a couple of weeks and that came on following a sudden forced rotation of the head.

An acute injury is one that has been present for less than 2 weeks. During this phase of the injury there is likely to be significant inflammation at the injury site. During this phase it is best to avoid movements that cause pain as the site of injury is very vulnerable to exacerbation and possible worsening of the injury.


As the inflammation settles down the injury enters the Sub-acute phase. This usually occurs around 2-weeks post injury. Some injuries resolve of their own accord during this sub-acute phase. Others do not resolve and go on to the chronic stage

A chronic injury is one that has been present for more than 12 weeks. Usually this means that the underlying cause of the pain has not been addressed and in many cases may not have been clearly identified.

By this time the body will have started to change its movement patterns and to adopt pain-modifying, dysfunctional movements. These dysfunctional movements can then prevent healing taking place and can also create new injuries elsewhere. An example might be – left sided low back pain that has been present for over 3 months and is causing a change in walking pattern. This can cause or exacerbate other physical ailments in the legs, the feet and the whole spine.

A complex injury is one that has multiple facets to its causation, or maybe multiple co-morbidities. This might involve an injury to more than one area or to more than one structure. It might be an injury that involves significant referred pain. It might be an injury that has not responded well to the treatment that has so far been provided. An example might be – Someone who has an underlying arthritic condition and gets left sided low back pain that has re-occurred on several occasions over a number of years. The pain now refers down the leg and into the left foot causing significant disruption to lifestyle and activities. Maybe the right knee is also starting to be a source of pain due to overloading on that side. A pre-existing heart condition limits exercise options, the arthritic condition creates a further complications and just getting through the day seems like a big effort.

A recurrent injury is any injury that seems to go away but keeps on coming back.

What kind of back or neck injury do you have?

    1. To the best of your knowledge is the pain coming from your

    2. How long have you been in pain in this episode?

    3. Do you have a clear idea of what caused this episode? – eg a fall or other one off event or injuring force. You would have felt the onset of pain at that time.

    4. How many previous episodes of pain that you consider similar to this have you experienced?

    5. Are there any other factors that you think may be complicating your recovery?

    My particular area of interest from over 30 years of experience is in Chronic, Complex and Recurrent injury of the back and neck. Of course I am very happy to also see simple injuries. Being pro-active with simple injuries is the best way to prevent
    them becoming chronic and recurrent.