By Kim Hawkins, DPT

We hear a lot about back pain but neck pain is also very common. It is often the result of many everyday activities in which the neck muscles are strained or overworked. The human head weighs about 10 to 12 pounds and the neck muscles are holding that weight up all day long. Add poor posture to the mix and then those muscles are working even harder. Most people with neck pain experience low to moderate pain, but some people have more persistent symptoms. Pain coming from the neck may be felt across the shoulders, between the shoulder blades or even down the arm. Some people experience headaches and others can have symptoms such as numbness or pins and needles down the arm and into the hand. Usually these aches and pains occur intermittently, sometimes for no apparent reason. Sometimes they will resolve, but other times they can become constant and debilitating.

neck painNeck pain is often seen in those around the age of 50 and is more common in females. People involved in heavy or repetitive work, or those who sit for prolonged periods, and individuals under a lot of stress are more likely to suffer from neck pain.

When your mother told you to sit up straight she was right. The most common cause of neck pain is from poor posture where muscles and ligaments of the neck are overstretched. Sitting with the shoulders slouched and the head forward, is by far the most common cause. Once you have developed a neck problem, poor posture will often worsen and perpetuate symptoms. Unfortunately many of us spend a lot of our leisure time and work day in a forward, less than ideal neck/head position. Many people are unaware of their poor posture. When neck pain first starts, symptoms can often be relieved by simply correcting your posture. Over time, however, poor posture can change the position of the neck joints, altering the way a joint moves and making it more difficult to get rid of your symptoms. A way to prevent neck pain due to prolonged sitting is to sit with good posture. This means head and shoulders are back, feet are touching the floor and the natural arch in your low back is maintained. Use of a small roll is helpful to passively help you maintain a desirable arch in your low back, or you could actively maintain it by holding the position with your muscles. Taking frequent breaks from prolonged sitting is essential to avoid overstretching of soft tissues and disruption in the joints of the spine. Also sleeping on your stomach or sleeping with too many pillows may push your head into positions that tend to cause problems.

A common and effective treatment used in physical therapy to resolve neck pain is Mechanical Diagnosis and Therapy (MDT), also known as the McKenzie Method. In this approach, repeated movements are used to both diagnose and treat. Certain movements can make your symptoms worse and other movements can make your symptoms improve. Once a preference is decided by your trained physical therapist, you are put on a program to perform these repeated movements, helping to decrease your symptoms.

MDT uses three subgroups for classification of the “syndrome” that you may fit into: Derangement, Dysfunction and Postural. Most people will fall into Derangement syndrome. In a Derangement syndrome there is a disturbance of the normal resting position of the affected joint and pain does not resolve until the joint returns to its original resting position. In Dysfunction, there is a deformation of the soft tissues of the joint from a previous trauma or from inflammatory or degenerative processes. This can cause scarring, shortening or adherence of soft tissues. And lastly, Postural syndrome causes pain by soft tissue (muscle, tendon, or ligament) deformation or insufficient blood flow from prolonged postural or positional stresses. There are some instances where MDT is not appropriate. People with serious spinal pathology such as spinal cord lesions, fractures, tumors, spinal infection, and dizziness are contraindications for this method of treatment.

Once your therapist has evaluated you it is important to perform your self-management exercises regularly until symptoms are gone and function is fully restored. Continue your exercises for at least six weeks to maintain full range of motion and function. Practice good posture throughout the day and avoid prolonged postures or positions. Strengthening the muscles around the spine, neck and upper back can help prevent future episodes. Make the appropriate adjustments with sleeping postures and use only one pillow. If helpful, use a cervical roll in your pillow to maintain proper support of your neck while you sleep.

You do not have to live in pain. The next time you start feeling pain in your neck and/or down your arm, the solution may be as simple as correcting your posture, or it might mean a visit to your local physical therapist. Either way, sit up straight!

Kim Hawkins, DPT is a physical therapist with the Rehab Services at Brattleboro Memorial Hospital. She can be reached by calling 802-257-8255.

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