The Stress of Neck Pain

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Probably the most common complaint among adults at some point in their lives is the complaint of tightness or pain in the neck. While such a condition obviously has many causes, there are a number of modifications or stretches you can do to minimize or eliminate your pain.
Possible causes of neck pain range from structural changes like degenerative disc disease, a disc herniation, osteoarthritis which may or may not create nerve irritation. Traumatic strains like in a motor vehicle accident, neck/shoulder weakness, poor posture and the simple muscle strain are just as likely. Straining of the neck muscles may simply be due to overuse during stressful periods or when held in prolonged postures such as sitting and driving or when spending countless hours in front of a computer.

Symptoms of neck pain may be chameleon-like, taking many forms at different times of the day. Commonly one may complain of neck pain alone, or in combination with pain extending into the shoulder, arm or upper to middle back. Neck and shoulder stiffness with difficulty in moving during normal tasks often occurs.

The diagnosis or identification of the culprit as to why you are feeling this way is often achieved via a thorough history of the symptoms and physical examination by a physician or therapist. Any previous injury would be noted as well as what potentially aggravates and reduces the symptoms at this time.

Although neck pain is extremely common, it often requires no medical diagnosis or treatment outside of self remedies. It is important to know when it's time to see your physician and pursue further treatment. Be proactive if you are experiencing pain from blunt trauma or a whiplash-type injury, radiating numbness, sharp shooting pain, difficulty swallowing, tingling, dizziness, lightheadedness, loss of strength or a sudden change in bowel and bladder control. These symptoms indicate the possibility of neurological impact and if left untreated may become more serious and in some cases permanent.

Common options include rest, ice/heat, immobilization, physical therapy and chiropractic manipulation. Unfortunately, local injections, traction or surgery are sometimes required where there is neurological involvement with the possibility of permanent deficits if left untreated. If this is the case your physician may request that you undergo further, more extensive testing such as an MRI, myelogram or EMG to test the nerves for damage.

Although the proper treatment of neck pain will depend upon the precise cause and origin of the pain, you will most often be able to self treat for reduction of pain. If you are experiencing simple neck tightness and pain without any further radiation of pain into the shoulder and arms, then simple ice or heat with stretching is often the solution. Within the first 1-2 days of a new onset of pain, ice is the answer and anytime after your choice of ice or heat is dictated by preference.

Gentle stretches from side to side, forward, back or turning side to side is advised to reduce tightness and pain. Be sure to move slowly and safely within a limited motion to eliminate overdoing it. Hold your stretches for 10 to 30 seconds each. You should never be in more pain as a result of gentle stretching. If you are, you have overstretched. Gentle neck and shoulder circles or rows may help loosen you up.  
 
Many times posture and shoulder tightness is associated with neck pain. Remember the 'Rule of 90's' when sitting at the computer. Keep your head over your shoulders with ears in line with the outer tips of your shoulders. Sit up straight, shoulders directly over your hips, hips resting at a 90 degree angle, knees bent to 90 degrees and your feet flat on the floor. If your chair is too high, bring the floor closer via a footrest. The posture of your entire body below your shoulders will dictate where your head will rest, and thus alter the stress on the neck. Proper positioning will minimize this stress.

Prevention of further exacerbations may be achieved by taking breaks and moving yourself out of a posture which you may regularly hold. Adjust your chairs and desks to maintain the 'Rule of 90's.' Don't wedge the phone into the side of your neck. Hold onto it or use a headset if speaking on the phone is a large part of your day. Finally, stretch gently even when not in pain. You may eliminate your pain before even experiencing it.

If you or someone you know suffers from neck pain, it is ill-advised to begin a new exercise program without consulting first with your physician, physical therapist, certified athletic trainer, physiatrist or other specialist who regularly treats neck pain. It is important to first get an accurate diagnosis for the cause of pain, as the specific exercises recommended will depend on the cause. Simple neck pain, if left untreated, may become a much more serious condition so be sure to take good care of it immediately.

James Markwica, MS PT, is a New York State Licensed Physical Therapist at LaMarco Physical Therapy, 417 Geyser Road in Ballston Spa. For questions or follow-up, contact James at (518) 587-3256 or online at www.lamarcopt.com.

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