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Institute of Advanced Orthopedics, MOSC Hospital and Medical College, Kolenchery, Ernakulam, Kerala

Neck pain and cervical spondylitis

There are many different reasons for developing neck pain. Not only can the pain be present in the neck itself, but symptoms such as headaches or pain, tingling, and/or numbness into the upper extremity, can be related to the neck.

  • Injuries: Sports-related injuries, car accidents, or falls can cause a neck sprain (often called “whiplash”). When the neck is forced to move beyond the normal range of motion, muscles, ligaments, and other soft tissues are stretched. This may cause pain, swelling, and limited motion.
  • Posture: The spine needs to be in balance with the line of gravity. Weak musculature of the trunk and neck or poor postural alignment (head forward, repetitive leaning over, hunched shoulders, or looking in one direction) can create muscular fatigue, joint compression, or musculoskeletal imbalances. This may result in tightness or pain.
  • Emotional stress: Stress can contribute to holding patterns in the neck by contracting the neck/shoulder muscles. This may aggravate or prolong healing of an existing neck injury.
  • Wear and tear: With age, the spine undergoes changes in the discs and joints which can be exacerbated by lifelong poor posture. The degeneration of the discs and joints often creates stiffness or swelling, and may cause impingement of the nerve root at one or several levels in the spine. 

Posture

Neck pain usually has a postural component as part of the underlying problem. Recognizing and understanding poor posture can play an important role in finding neck pain relief.

  • Increased stress on the cervical spine. As the head is held forward in poor posture, the cervical spine must support increasing amounts of weight. One rule of thumb is that for every inch that the head is held forward in poor posture, an additional 10 pounds of weight is felt on the cervical spine. So if the average head weighs between 4 to 5 Kilograms, just 1 or 2 inches of forward head posture can double or triple the load on the cervical spine.
  • Muscle overload. Some muscles in the neck and upper back must continually overwork to counterbalance the pull of gravity on the forward head. As a result, muscles become more susceptible to painful strains and spasms.
  • Text neck. It is an overuse syndrome or a repetitive stress injury to the neck caused by holding your head in a forward and downward position for extended periods of time. When holding your head in this position, excessive amounts of tension are created in the deep muscles of your neck and across the shoulders causing both acute and chronic neck pain. Chronic headaches have also been linked to this condition. Image result for neck good posture

Treatment

Neck injuries must be rehabilitated in order to prevent re-injury or a chronic problem. There are many things to consider that will help, regardless of the reason for the neck pain.

  • Postural awareness (Ergonomics): Maintain proper postural alignment throughout the day in order to decrease any strain created on your neck

Take a short break after every 30 minutes of desk-work. Continuously maintaining one posture for a long time causes spasm of the supporting muscles of the neck (especially in the back of the neck). This also reduces the blood flow to the muscles and makes them inflamed. After every 30 minutes take as short walk if possible, or move your neck and shoulders 10 times in different directions and do the stretching exercises given in the exercise chart. This will maintain the suppleness of the muscles and maintain them well balanced. A good neck and shoulder health provides you better concentration and more quality of work output.

Click here to download the Neck exercises chart

Extended mobile phone usage for texting and social networking like whatsapp should be controlled.

Good sleep posture

  • Control swelling and pain: With an acute injury (first 2-3 days) start with:
    • Rest: Lie down on your back with a thin pillow or lie down on your side with a thicker pillow to support the neck. This will relieve the pressure and relax any tight muscles.
    • Ice: Use a bag of crushed ice or frozen vegetables for 20 minutes. Repeat 4-5 times daily. The ice will help decrease swelling and muscle spasms.
  • Encourage pain-free movement: After an injury, your neck will become stiff. Gentle movements starting as soon as possible will help to regain full range of motion, reduce pain from swelling and muscle spasms, and prevent your muscles from becoming weak.
  • Relaxation and stretching: After the acute phase, it is necessary to relax and stretch the neck muscles. A massage or lying down and applying heat before stretching exercises will assist in relaxing sore muscles and increasing the circulation in the general area. To self-massage, gently rub your neck with your fingers for several minutes. Alternatively, heat can be applied for 10-15 minutes by taking a warm shower, using a moist warm towel, or using a heating pad. Stretching exercises can help to relax the neck muscles and restore range of motion .
  • Strengthening and stabilizing the neck: To regain/maintain good posture, your neck needs the support of neck, shoulder, and trunk musculature. Simple exercises done every day will build that essential support.
  • Prevention:
    • Posture! Posture! Posture!
    • Place your work at eye level to avoid awkward postures.
    • Take frequent breaks (every 30 minutes) and do stretching and range of motion exercises.
    • Sleep on a firm mattress. Use a thin pillow to lie on your back or a thick pillow to lie on your side. This will keep your neck in alignment with your spine. Avoid sleeping on your stomach

Click to see Neck Exercises

Click here to download the Neck exercises chart

Osteoporosis or weakening of bones is a common cause of neck and back pain, as the age increases. Osteoporosis commonly affects females after menopausal age. Weak bones predispose to progressive inability of the vertebral column to take the load of the body. Weak bones along with bad posture can cause severe neck pain and predispose to canal compromise in the vertebral column and radiculopathies to the arms . Read more about osteoporosis.

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