HEALTHWATCH
A pain in the neck
DR. KAARTHICK MANI
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The increasing incidence of neck pain can be attributed to faulty postures while sitting for long hours.
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Watch how you sit: The forward head can cause pain.
PAIN and impairment of the neck are common. According to the different studies published in the journal Spine, individuals who will have neck pain sometime in their lives range from 22 per cent to 70 per cent. Increasing incidence of neck pain has been reported and one of the most common reasons for this is faulty posture.
Prevalence of neck pain increases with age and is most common in women in their fifties. Patients with neck pain are frequently encountered in outpatient physical therapy practice, mechanical neck pain secondary to faulty postures make up approximately 15 per cent of a physical therapy clinic case loads in the U.S.
Common cause
One of the most common causes of mechanical neck pain among computer users is the forward head posture. A healthy back has three natural curves: a slight forward curve in the neck (cervical curve), a slight backward curve in the upper back (thoracic curve), and a slight forward curve in the low back (lumbar curve).
Good posture actually means keeping these three curves in balanced alignment. Strong and flexible muscles also are essential for good posture. Abdominal, hip, and leg muscles that are weak and inflexible cannot support our back's natural curves.
A "perfect" head posture shows an imaginary line dropped from the centre of the external auditory meatus (outer ear opening) would land directly in the centre of the shoulder.
A faulty neck-head posture causes stress to the neck bones (vertebrae). The bones will not be aligned properly, and the muscles, joints and ligaments take more strain than Nature intended.
The perfect head posture.
Faulty posture may cause fatigue, muscular strain and, in later stages, pain in and around neck and upper back region. The causative factor for these symptoms is faulty posture for many years.
In the forward head posture, the head moves "forward", and the muscles in the upper back and neck have to work harder to keep the head (chin) from dropping forward onto the chest. This forces the muscles that raise the chin to remain in constant contraction, putting pressure on the suboccipital (base of skull) nerves.
This can cause headaches at the base of the skull commonly called as cervicogenic headaches, and even mimic sinus or migraine headaches. Pain is usually on one side. Even if it affects both sides of the head, it is usually more severe on one side.
Forward head posture can also compress the nerves that run from the neck into the arms. Such compression may weaken the muscles of the upper extremities, and cause painful sensations in the arms or the hands. If untreated, this can cause disc herniation commonly called as pinched nerve or intervertebral disc prolapse where people complain of pain in the neck and radiating symptoms to the arm, forearm and hand areas.
Treatment options
There are various physical therapy treatment options available including exercise therapy, manual therapy techniques like joint mobilisation or manipulation, mechanical traction, interferential current, heat/cold applications, and other modalities used by the physical therapists. Evidence-based practice through multiple research studies found that many respond well to cervical and thoracic joint mobilisation or manipulation techniques if there are any spinal derangements resulting from faulty posture.
One randomised controlled study has found ultrasound therapy to be ineffective in treating neck pain trigger points. Prevention is better than cure. Those who are prone to neck pain like computer professionals should work on changing their posture and redesign the office workstation ergonomically.
Longstanding neck problems take a long time to resolve. Cultivate patience along with good postural habits. An acute strain will take four to six weeks to resolve with avoidance of prolonged computer use with a forward head posture.
Good posture
APTA suggests that, "the best way to improve or maintain our posture is to always practise good posture, when sitting, standing, or moving. Practising good posture is not always as easy as it sounds, especially for some of us who have forgotten what good posture feels like."
The writer is an Orthopaedic Manual Therapy Specialist based in Chicago, U.S.
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