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What triggers your neck pain and how to manage symptoms: Part II & III

As established in last week’s blog post, the causes of daily neck pain are plenty. From muscle strains to degenerative disc diseases, such as osteoarthritis, to pinched and/ or irritated nerves, to herniated discs and whiplashes! What a pain in the neck!

Did you know that most neck pain has a postural component as part of the underlying problem? Simply put, if the alignment of the head and spine is not optimal, the neck can be predisposed to injury and the process of wear and tear is felt at a much faster rate. One of the most common conditions that trigger neck pain is forward head and shoulder posture. Forward posture is when the neck slants forward placing the head in front of the shoulders. The part of the neck that is particularly vulnerable to forward head posture is the lower part of the neck, just above the shoulders. The lower cervical vertebrae (C5 and C6) may slightly slide or shear forward relative to one another as a result of the persistent pull of gravity on a forward head. This head position leads to numerous problems:

  •  The forward pull of the weight of the head puts undue stress on the vertebrae of the lower neck, contributing to degenerative disc disease and other degenerative neck problems.
  • Similarly, this posture causes the muscles of the upper back to continually overwork to counterbalance the pull of gravity on the forward head.
  • This position is often accompanied by forward shoulders and a rounded upper back. This not only feeds into the neck problem, but can also cause shoulder pain.

Which neck muscles are involved?

  •  Scalene muscles (three pairs of muscles that help rotate the neck)
  •  Suboccipital muscles (four pairs of muscles used to rotate the head)
  •  Pectoralis minor muscles (a pair of thin triangular muscles at the upper part of the chest)
  •  Subscapularis muscles (a pair of large triangular muscles near each shoulder joint)
  •  Levator scapulae muscles (a pair of muscles located at the back and side of the neck).

So who is more likely to suffer from the above postures?
Patients with professions that require them to look down or forward all day, such as pharmacists who spend hours counting pills, dentists leaning forward over patient’s head and mouth area, Truck and cab drivers, painters, data entry workers and workers who are generally required to look at a computer screen for several hours a day. However, this is only scratching the surface.
Aside from professions, here is a more recent, yet big trigger. Have you ever heard of “text neck”? It is a major trigger of neck pain, becoming an all too common phenomenon! Now-a-days you’ll find most of us attached to our cell phones, whether checking social media or texting up a storm. Your head and neck are in quite a strained and stiff position while using your hand held device. Tilting the head forward while using your phone forces the neck muscles, tendons and ligaments to strain and stiffen just to keep your head held up. Imagine all this strain for an average of 2-4 hours a day on your neck!

How about sports?
People involved in contact sports, listen up! Your neck takes a pounding every time you get tackled or fall. A high-speed collision that throws your head forward or backward can put a lot of force on your neck, just like getting whiplash in a car accident. When the neck is flung backward past its normal limits, it is called hyperextension. When the neck is flung forward beyond its limits, this is called hyperflexion. These sudden movements can tear ligaments — the thick, rubber band-like tissues that connect the vertebrae in your neck — causing a sprain or strain.
When the force of a hit or fall pushes your head to one side, you can get a neck injury called a burner or stinger. Named because of the shock-like jolt of pain it sends racing from your shoulder down your arm, a burner or stinger is caused by damage to the brachial plexus — the bundle of nerves that supplies feeling to the arm. Burners and stingers are common among football players.
Are you weight training the right way? You may be building and defining your muscles, but incorrect posture while weight training can wreak havoc on your neck! Improper technique, such as overextending your neck, shoulders and back; and twisting your body when you lift, can cause injury.

How are you sleeping?
Ever woke up with a particularly stiff neck and found yourself complaining that “you think you slept the wrong way”? It’s likely true. Incorrect sleeping positions can have you waking up with pain and sometimes an accompanying headache. Positions like sleeping on your stomach are tough on your spine because the back is arched and your neck is turned to the side. Your pillow also plays a big role in giving you a good night’s sleep. A high or stiff pillow, which keeps the neck flexed overnight and can result in morning pain and stiffness.
While we don’t often wake up in the same position in which we fell asleep, it’s worth trying to start the night sleeping on your back or side in a well-supported, healthy position.
Did you know however that it’s not always your sleeping position or your pillow? Research suggests that sleep itself can play a role in musculoskeletal pain, including neck and shoulder pain. In one study, researchers compared musculoskeletal pain in 4,140 healthy men and women with, and without, sleeping problems. Sleeping problems included difficulty falling asleep, trouble staying asleep, waking early in the mornings, and non-restorative sleep. People who reported moderate to severe problems in at least three of these four categories were significantly more likely to develop chronic musculoskeletal pain after one year than those who reported little or no problem with sleep. One possible explanation is that sleep disturbances disrupt the muscle relaxation and healing that normally occur during sleep. Additionally, it is well established that pain can disrupt sleep, contributing to a vicious cycle of pain disrupting sleep, and sleep problems contributing to pain.

The fix? 
We realize that there are certainly more triggers out there that can cause your daily neck pain. However, all the triggers listed above cover some of the most commonly reported. It’s not always easy, but there are ways you can help manage your symptoms. Of course, it is vital to talk to your doctor or your local chiropractor for tailored advice on managing your neck pain symptoms.

As noted above, posture plays a major role with regards to neck pain. There are some tips to help alleviate the added stress on your neck and manage your symptoms.

When falling asleep, do your best to be mindful of the position you’re starting out in. Lying on your back may be the best option, as it elongates the spine. Try to avoid sleeping in a fetal position or on your stomach, as this adds excess pressure on your muscles and joints. One thick pillow should suffice, as this allows your neck and spine to be aligned in a neutral position and the space between your neck and shoulders is filled by the pillow. Always ensure that your pillow doesn’t prop your neck up too high, or that your pillow is too low either. Consider yoga or other gentle exercises (like a 20 minute walk) as a method of relaxation. Also, taking a nice warm bath each night can help you fall into a deeper sleep.

Next, consider the ergonomics of your workspace. Perhaps the placement of the desk, computer workstation and/or placement of the computer monitor and keyboard can be improved to encourage proper upper back and neck posture.
When sitting erect at a desk and looking straight ahead, be mindful of the following:
• Eyes should point directly at the top third of the screen.
• Forearms should be approximately parallel with the floor when typing.
• Elbows should be at the side.
• Feet should be flat on the floor with the thighs parallel with the floor.
If patients have a standing work station or perform other sorts of sitting or driving tasks, make sure that one side of the body is not constantly rotated more than the other side. In addition, ensure that there is as much symmetry in repetitive tasks as possible. There are stretches and exercises that are effective at helping restore good posture, thereby taking pressure off the neck and relieving pain.

For all our athletes and gym goers out there, make sure you talk to your health care provider. They may suggest stretching options that can allow your neck to be more limber, therefore increasing your range of motion. Gently bend your neck to one side and then the other. Hold it for about 30 seconds on each side. Talk to your trainers for additional advice on strengthening exercises for the muscles that support your neck. Routine body adjustments and massages may help with alleviating pain as well.
For all you avid texters, be mindful of your posture and the amount of time you spend hunched over! Make an effort to stay in a neutral position so that your ears are aligned with your shoulders. Try to hold your phone in front of your face while keeping your back straight, and if you look down at your device, try to do it just with your eyes.

Remember this information should not be used as a substitute for advice from your healthcare practitioner! Talk to us for more information to find out how we can help you with your neck pain.

Stay tuned for the last topic of our  September series on Neck Pain, where we will cover the topic of whiplash.


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