Is your neck being a pain in the neck?
By Chan Yin Keen, D.C | B.HSci (Chiro), M.Clin.Chiro
One Spine Chiropractic, D27, 3rd Floor, Center Point Sabah, Kota Kinabalu.
Neck pain is one of the leading causes of disability in the world. Annually, 30% to 50% of adults will experience some form of neck pain. As one of the most commonly reported symptoms to primary care physicians, neck pain represents a high global burden in terms of disability and economic cost. Though in most cases not life threatening, neck pain tends to have a negative effect on quality of life and can cause a reduction in individual productivity.
The prevalence of neck pain is generally higher in women than in men and tends to peak around the early to mid forties. With current trends of people working longer hours in front of laptops and looking down to their handheld devices, neck pain is becoming more common among young adults. Also of note is that neck pain is typically associated with other issues such as headaches, back pain, joint pain or even depression.
To understand neck pain, we must know the anatomy of our neck. The neck is part of your spine. Specifically, it is known as the cervical spine and represents the top 7 out of 33 bones that make up your spine. The cervical spine is what holds our head up, an incredible feat considering a typical head weighs about 5 kilograms, or about the weight of an average bowling ball. The neck is able to move in almost all directions, and it is this flexibility of movement that makes it prone to pain and injury.
There are several ways people commonly get neck pain. Accidents and injuries are one of them. A sudden whipping motion of the neck, known as a whiplash injury, can damage the surrounding soft tissue structures in the neck and is typical of car accidents. The whiplash motion causes the muscles to react by tightening and contracting involuntarily, leading to pain and stiffness. Severe cases can cause damage to the disc or even nerves.
Other common causes of neck pain include but are not limited to, osteoarthritis, degenerative disc disease and even poor posture. A lot of our neck pain can be due to poor posture, repetitive stress and even weak core muscles.
Weakness in our abdominal muscles or even shoulders can lead to imbalances in our spine, causing the neck to lean forward to compensate. This forward leaning of our head and neck is called anterior head carriage and can be quite deleterious to our cervical spine health.
Our heads should typically be sitting upright, with our ears in line with our shoulders. For every inch that the head deviates forward, we increase the pressure the head applies to our neck by an additional 4 kilograms. Effectively every inch forward nearly doubles the weight of our head, much to the despair of our necks as it fights a losing battle against gravity.
Even breastfeeding mothers are prone to neck (and back!) pain, especially if they are craning their neck down to observe their baby while breastfeeding. Reclining and having a pillow to act as head support will greatly reduce the amount of grief your neck will give you if you find breastfeeding difficult.
So how are we to deal with our neck pain? If our pain is typically occurring while working on our laptops, adjusting the height of the screen to be at or just below eye level will help prevent
pain from the head tilting down too much.
Doing so might put the keyboard of your laptop at a poor angle for your shoulders, as we typically want our arms straight with our body and elbows at 90 degrees. I typically advocate for using
a desktop computer as that makes it easier to adjust your monitor and keyboard to best serve your neck and back, but if we are going to use a laptop, an external keyboard is a lot cheaper and easier to bring around with your laptop than an external monitor.
The other thing to note with working in front of computer screens is that it is a very repetitive action. The body does not like repetition, especially if it involves sitting in the same place for 7 to
8 hours everyday. Having a good stretch will provide relief to a stiff and painful neck. Try putting your hands behind your head and push your head backwards against your hands for a good 30 seconds, followed by bringing your ear to your shoulder 5 to 10 times on each side, and finally squeezing your shoulder blades together 10 times.
The best thing one can do for neck pain though, regardless of how it came about, is to have a visit with your primary care physician, whether it be your GP, your physiotherapist or your chiropractor. In each of these cases, a physical and neurological exam will be done to locate where the pain is coming from, as well as questions regarding the history and nature of the pain to get an idea of what the primary issue is.
In the case of a chiropractor, once the source of the problem is determined to be musculoskeletal and not a more sinister issue, we have several tools in our bag to use for helping with neck pain. The most well known being the spinal adjustment or manipulation, where the patient is either lying on their back or sitting, and the chiropractor gently provides a high-velocity (fast), low-amplitude (short) thrust to the affected vertebra in the neck that is experiencing stiffness or pain using just our hands. A cracking sound may occur during the adjustment, similar to cracking one’s knuckles. The sound may give the impression that it is uncomfortable, though many patients typically report a sensation of immediate relief from it.
Other techniques we might use are joint mobilisation, joint traction, and soft tissue therapy. Joint mobilisation usually involves moving the joint in a side to side, figure eight or bending motions to
introduce motion to fixated joints and reduce restrictions in the neck. Traction is a light pulling and stretching of the cervical spine to facilitate a reduction in tightness of the neck muscles. Soft tissue therapy is mainly a firm massage of trigger points in the neck to again, reduce tension and restrictions in the neck. All this is typically followed up with a regime of stretches or rehabilitation exercises to help prevent neck pain from becoming a recurring chronic problem.