Back pain when turning the head can indicate spinal or muscular pathology. Rotation-related neck and back pain is a very common cause of symptoms for millions of people with chronic or recurrent disorders of the upper spinal regions. Rotational back pain is also physically debilitating, since it most often affects the functionality of the head, neck, shoulders and arms.
While some patients cite reports of neck pain from turning their head, we also receive many letters inquiring about the nature of actual back pain from rotating the head. This pain can affect several distinct regions of the dorsal anatomy and might vary in degree from mild to extreme. While the location of pain might help to diagnose its source, the severity of symptoms is not a good indicator of the clinical significance of the origin.
This dialog examines the reasons for pain that is expressed in the back when rotating the head. We will detail the locations usually affected by this rotational back pain, as well as the possible reasons why it exists.
Neck or Back Pain When Turning the Head
We have already covered the topic of neck pain that is experienced when turning the head. Although this article helps many patients, there are some who still ask questions about dorsalgia concerns that exist in the upper, middle and even lower back regions. Therefore, we continue our coverage of the subject in order to address all these possible symptomatic expressions.
First, to recap, most patients who have pain when turning the head experience the discomfort in the neck and region where the neck meets the upper back. Some of these patients also experience symptoms in the shoulders, upper arms, lower arms, ands or fingers, in addition to, or instead of, neck pain. Commonly, tingling, numbness and subsequent weakness are the usual expressions in the upper limbs, although less often, sharp shooting pain or burning sensations might exist in the arms and hands, as well.
When the actual back is affected, most patients will suffer pain in between the shoulder blades, on the spine or slightly off center. There may be a unilateral “pulling” sensation deep under the shoulder blade when the neck is rotated. Far less commonly, patients might experience similar pain lower in the region where the upper and middle back regions meet. This type of pain might exist in combination with neck or upper back pain, but is rarely present by itself in relation to turning the head.
Some patients experience lower back pain when turning the head, especially when simultaneously looking downwards, which involves neck flexion. Usually, there is also a “pulling” sensation involved in the lumbar region off center or directly over the spine when rotating the head to one side or both.
Pain When Turning the Head Causation
Rotational pain can occur due to several possible circumstances detailed below:
Muscular back pain is certainly the most prevalent variety of symptomatic expression. The neck and back muscles are inter-related and inter-dependent in functionality. When one is affected by some circumstance that causes pain, it is common for the patients to suffer a cascade effect into related muscular groups, which is often aggravated by specific forms of motion, such as neck rotation.
Mechanical issues in the spine, such as bone spurs and joint dislocations, can create pain when the affected area is mobilized. Furthermore, these circumstances might affect neighboring vertebrae and may start a chain reaction of pain and spinal dysfunction in rare cases that can be felt several vertebral levels away from the source.
Nerve compression can occur in the neck, but affect tissues below the cervical levels, potentially causing upper back pain and upper limb symptoms.
Atypical spinal curvatures, such as hyperlordosis and especially scoliosis can influence lower vertebral levels when turning the head, as well. We see this most often in cases of cervicothoracic scoliosis and cervicothoracolumbar scoliosis.
Torticollis can cause muscular spasms and painful tension in the upper back and shoulder regions when the head is rotated.
Ischemic pain syndromes can adopt literally any symptomology, regardless of how structurally illogical. We have seen many mindbody oxygen deprivation syndromes creating lumbar pain when turning the head, even though there was no evidence of a structural link.
Back Pain When Turning the Head Additional Information
Pain is a complicated thing. It can be sourced in one place, but experienced elsewhere. This is particularly true when it comes to back pain, since there are so many mechanisms of action that might produce symptoms. Remember that pain which is sourced from neurological irritation or constriction can affect almost anywhere in the body, as long as the location is below the level of the affected nerve.
In our extensive clinical experience, most rotational neck and back pain syndromes resolve organically and are caused by minor muscular issues, such as strain and overexertion. Many are experienced after hard physical labor, participating in a new athletic activity or when sleeping in as strange position. Physical therapists can be very helpful in the accurate diagnosis of rotational pain syndromes and may help to reduce the chance of suffering misdiagnosis of the condition being blamed on an incidental spinal irregularity, such as a cervical herniated disc, which is often the case.
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