Blame it on posture

More and more people, from teenagers to the elderly, are complaining of neck pain. Why?

Neck painNeck pain is a common occurrence.

The reason is simple. Ask yourself the following questions.

Do you worry too much? Do you lean into the computer, or hunch over your desk for long periods of time? Do you drive long distances? If your answer is yes, to any of them, it may mean that you are inviting pain in the neck.

Your neck has bones, joints, tendons, muscles, ligaments, and nerves. Its job is to hold your head up. Overuse or strain, or injury, to any of these parts of your neck can lead to neck pain.

More often than not, when we present ourselves at the clinic with neck pain, the diagnosis turns out to be cervical spondylosis.

Cervical spondylosis

Many of us know that the cervical spine consists of seven vertebrae, each one resting on the other to form the spinal column, which protects the spinal cord running through it. The vertebrae are separated from each other by cartilages called discs. Each disc has a central fluid part called the nucleus and an annular ring of cartilage around it called the annulus. The disc can change its shape depending on the stress applied on it and act like a shock absorber. The vertebrae and the discs are linked together by a series of joints held together by muscles and ligaments.

Spondylosis is a condition where there are degenerative changes in the inter-vertebral joints between the body of the vertebra and the disc. It occurs in persons above the age of 30. The degenerative changes that occur are due to aging, or continuous wear and tear. The annulus becomes coarse and the nucleus loses its fluid and becomes fibrous; the disc loses its height and the inter-vertebral space becomes narrow. The discs in your neck also can herniate. This means that the inner gelatinous material of a disc protrudes through its tough covering, irritating the nearby nerves. Other tissues and bony growths also can press on your nerves as they exit your spinal cord. This can cause pain.

Most patients suffering from neck pain have one of the following precipitating factors.

  • Sleeping in awkward position
  • Sitting for prolonged periods of time in front of the computer, or work-desk
  • Pursuing hobbies such as knitting, or painting, which requires high levels of concentration and a bent position of the head
  • Driving long distances without halts
  • Talking on the phone with the instrument cradled between the shoulder and the head.

Once the factor, or factors, causing the neck pain is identified, treatment can be aimed to stop it so that it does not recur to the extent possible

Easing the pain

One simple solution is to take a break, in-between long sessions. Rest, anti-inflammatory drugs and physiotherapy are helpful in relieving the pain. Physiotherapy modalities like short wave therapy, or interferential therapy and ultrasound, along with cold or heat, are useful in relieving pain.

Traction [the act of drawing, or pulling] has been found useful to relieve nerve root pressure. Some simple measures also help. Wearing the cervical collar is useful in acute cases. It is recommended by doctors to keep the neck in correct alignment. The collar provides passive support; the length of time it has to be worn, of course, depends on the severity of the problem.

Preventing neck pain

Most neck pains are associated with poor posture. So, postural education plays an important part in the prevention of recurrent neck pain.

The goal, of course, is to keep your head centered over your spine, so gravity works with your neck instead of against it.

Some simple changes in your daily routine may also help.

If one gets pain after sleep, then the best thing would be to check your mattress and pillow. Ideally, your pillow should support the natural curve of the neck so that the muscles are relaxed. Feather pillows are generally preferred to foam because they conform easily to the shape of the neck. Also, remember that pillows don't last forever. After a year or two, feather pillows tend to "collapse" and may need to be replaced.

In addition, a bed that doesn't offer enough back support can also be a source of neck discomfort. Avoid sleeping on your stomach because this position leads to stress on your neck. Even when lying on the side, you can choose to keep a pillow to support your top arm. While sitting, it is advisable to sit straight and keep a small cushion to support your lower back. Supporting your lower back and sitting will ensure that the cervical spine gets aligned.

If you work for long hours on the computer, adjust your desk, chair and computer so that the monitor is at eye level. Your knees should be slightly lower than the hips. Use your chair's armrests. While driving long distances, take frequent breaks. Keep your head back, over your spine, to reduce neck strain. While driving the car, adjust the seat to bring you close enough to the pedals so that you don't have to extend your neck forward.

Also, avoid tucking the phone between your ear and shoulder when you talk. If you use the phone a lot this way, get a headset.

Simple exercise

A small and simple exercise can ease your neck muscles when you are sitting at your desk.

  • Shrug your shoulders up and down
  • Pull your shoulder blades together and then relax
  • Pull your shoulders down while leaning your head to each side to stretch your neck muscles.

Neck extension exercises, like looking up at the ceiling and then retracting the head, i.e., pulling the chin into the neck to form a double chin, can also help.

Study Effects

Children, teenagers, and others, studying for long hours, or exams, often present with neck pain, headaches and backaches. The cause could be a combination of stress and anxiety along with long hours of sitting in one position to study. There are some useful ideas which parents can employ to ease the burden on the child and ensure maximum output. Parents could try using different sitting devices other than the same old, firm, straight-backed chair. Rocking chairs or sitting on the floor cross-legged are other options. Just keeping a footrest under the table could help the child change positions more frequently as there are now two surfaces that s/he can put their feet in. If a wobble board is used as a footrest, it could serve a two-fold purpose. First, it increases the activity level while sitting by providing different elevations and positions for the legs. Secondly, while standing on it, children can improve their balance.

You can also adjust the height of the study table. If the height of the table is too low, it can cause slumping, backache and neck pain. If too high, it can cause shoulder girdle pain as well as pain in the arms, forearms, and hands. It would be great if the desk has adjustable heights. If you don't have one, try to introduce one for "sit-stand" options by having a chest of drawers, or some surface at a higher level, so that you can alternate between sitting and standing. These are just a few suggestions that one can follow to ease and prevent neck pain, but if you happen to get shooting pain that radiates to your shoulder, and through your shoulder blades, or down your arm, or numbness or tingling in your fingers, it may indicate nerve irritation. This can pose serious problems. Consult your therapist immediately.

Another important thing to note is injury. Rear-end collisions often result in whiplash injuries, which occur when the head is jerked forward and back, due to stretching of the soft tissues of the neck beyond their limits. It is best to talk to your doctor immediately.

Magnifying lens over an exclamation markSpot an error in this article? A typo maybe? Or an incorrect source? Let us know!

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Geeta Viswanathan, a practising physiotherapist, has worked at KEM and LTMG Hospitals, Mumbai, Apollo Hospital, Chennai, and Al Zahra Hospital, Sharjah, UAE. A certified occupational health and safety therapist from the University of Alberta, Viswanathan is currently based in Canada, pursuing her interests in alternative medicine, integrating diet, home remedies, and energy healing methods.
Lalitha Balasubramanian
Lalitha Balasubramanian is a Mumbai-based freelance writer. Her areas of interest include health, travel, food, and environmental issues.

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