September 30, 2004
The A - Z of neck pain
The A - Z of neck pain
September 30 2004 at 12:58PM
By Roger Dobson and Marika Sboros
Six million people will have awakened in Britain with neck pain this morning. In South Africa, the number is also likely to run into the millions.
For some, the pain and stiffness will last a few hours; for others; days, weeks, months or longer.
A UK report says that at any one time one in 10 people has neck pain, and three-quarters of the population will suffer at some time in their lives.
Neck pain is prevalent in modern 21st century living, says Johannesburg medical doctor and acupuncturist Dr Ella Jardine. One of the biggest causes is stress, but also changing lifestyles, says Jardine.
We are living more sedentary lives, spending time sitting down, working with computers, watching TV, playing video games and driving. These activities require a lot of upper body tension, she says. This causes not only neck pain but other problems such as headaches, sinusitis, allergies, and jaw pain from clenching.
Here, in conjunction with a new report from doctors at Harvard University in the United States, we offer an A to Z guide to causes of neck pain and treatment options.
A for Acupuncture: The ancient Chinese form of therapy is based on the meridian or energy pathways in the body and is proven to be an effective method of treating neck pain. Depending on the cause, one session may be enough to make the pain disappear.
B for Breasts: Many women with larger breasts get neck pain, largely as a result of posture. Where neck pain is breast-related, exercises involving stretching the pectoral muscles and strengthening shoulder- girdle muscles can help. Other treatments include wearing a properly fitting supportive bra with padded shoulders, taking painkillers and losing excess weight.
C for Chondroitin sulphate: Chondroitin sulphate is part of a compound that makes cartilage. It’s thought that when taken as supplements, it encourages new cartilage to grow and slows down further loss, while reducing inflammation and pain.
D for Discs: Situated in the neck and back, they can cause pain when they slip out of position and press against nerves. The problem disc can be removed or fused with the next one, but this can lead to loss of movement. In a new treatment, artificial discs made from a range of materials, including polyethylene, are implanted to replace those removed. Some research suggests artificial discs result in better movement after surgery, and they could soon become widely available. When a disc presses on nerves and causes pain it might need to be surgically removed. In a discectomy, the bone and any bits of bony debris that could eventually press on nerves and cause pain can be removed. In some circumstances, the space left behind can be plugged with bone taken from the hip.
D is also for Drugs: Drugs that reduce inflammation have a beneficial effect on pain. Corticosteroid injections in joints in the neck and back can provide quick and dramatic relief of neck pain. These drugs have serious side-effects. Long term, they are associated with bone weakening, diabetes, high blood pressure and cataracts.
E for Exercise: Many different exercises can help with neck pain. To exercise front neck muscles, place your palm on your forehead and press gently as you try to bring your chin to your chest – your neck muscles will tighten without your head moving. Hold for a count of 10. For the rotation muscles, put your right hand on the right side of your head. Try to rotate your head to the right, resisting with your hand. Hold for a count of 10. Repeat for the left side. For back neck muscles, put both hands behind your head and use them to resist as you press your head backward.
F for Fusion: A form of fusion treatment is called arthrodesis, in which the spinal bones are joined together to support each other, can help neck pain. This treatment is often used where the neck is unstable as a result of disease, such as rheumatoid arthritis, or as the result of a fracture. The surgeon connects vertebrae with metal implants or bone grafts. The downside is that fusion limits neck flexibility, though not usually enough to interfere with everyday activities.
G for Glucosamin: A substance found in cartilage and the fluid that lubricates the joints. It can be boosted through taking supplements.
H for Heat: Applying heat is a good way to reduce pain and stiffness and relieve muscle spasms. Try a homemade hot pack for the neck. Heat a damp, folded towel in a microwave for about 10 to 60 seconds, depending on the oven and towel.
I for Ibuprofen: An anti-inflammatory drug that, along with muscle relaxants to ease spasms, can be used to treat a sprained neck – usually an injury to a ligament as a result of overstretching – a common cause of pain. Applying a cold pack to the neck for 15 to 20 minutes, four times a day for two to three days, may also help.
J for Joints: Especially the facet joints. These are the small stabilising joints located between and behind vertebrae – the bony building blocks of the spine. To relieve painful facet joints, injections of a
local anaesthetic and an inflammation-reducing steroid can work. When there is rapid relief, this is usually confirmation that the pain is being caused by that joint.
K for Knowledge: Don’t rely on one source of information. Get to know as much as you can about the cause of your neck pain and what treatment options are available.
L for Lift: Lifting objects the wrong way puts stress on the neck as well as the back. To lift properly, bend the hips and knees instead of the back. Keep the object close to the body while straightening the legs. When lifting something over the head, don’t tilt your neck back. Strengthen your arms to make lifting easier.
M for Massage: Massage therapies that involve techniques for learning to relax the muscles help to loosen tight muscles. Specific exercises include lifting the shoulders upward to feel the tension in the neck, then releasing them after 10 seconds and relaxing for 20 seconds.
N for Nerves: Nerve root blocks are epidural injections delivering a local anaesthetic and steroid into the area where a nerve root is coming out of the spine. This can be given for some types of slipped disc problems. Some patients avoid surgery by having a series of nerve blocks to give the disc time to heal.
O for Opioids: One of a class of prescription-only drugs, with morphine-like effect, that are used only for severe pain. They dampen down pain by interfering with the signals going to and from the brain. They don’t tackle the symptoms, nor do they deal with any inflammation. Opioids are usually used with caution for short-term treatment of severe neck pain or after neck surgery. Because opioids cause physical dependency, there is a risk of withdrawal symptoms if they are stopped suddenly.
P for Posture: Neck pain is often a result of poor posture. One problem identified by researchers is the use of bifocal glasses, that encourage the wearer to look down. The bottom portion of bifocals is designed for close-up vision, which means the wearer might have to bend to see the ground clearly while walking. So-called walking glasses have only distance prescription lens with no bifocal.
P is also for Pilates: A form of exercise to improve posture by strengthening and toning the core muscles of the body. The aim is to align muscles along the spine correctly, which alleviates neck pain. Correct spinal alignment rids the body of neck and back pain. Physiotherapy and other forms of physical therapy, including chiropractic, can also help back pain.
R for Rub-on essential oils: Mint is one oil that can ease the minor neck pain caused by muscle tension, arthritis and rheumatism. Research has shown that camphor, an active ingredient in some oils, helps to dilate the blood vessels, improving circulation and increasing the sensation of warmth. A local analgesic effect reduces the feeling of pain.
S for Shiatsu: An ancient Japanese form of pressure-point massage therapy based on unblocking the meridians – energy pathways that run through the body. Neck pain is one symptom of blockages in the meridians. Once the energy flows freely, the pain dissipates.
T for Tai Chi: an ancient Chinese martial art and a holistic system of health exercise. Its focus on posture and deep relaxation helps to alleviate and prevent neck and back pain. Its mode of practice makes it suitable for all ages.
U for Ultrasound Diathermy: This form of therapy uses soundwaves to heat tissue beneath the skin. It’s widely used to treat several neck conditions, including muscle pain, pinched nerves and degenerative arthritis. The ultrasound is delivered through a wand rubbed gently over the painful area. In phonophoresis, an anti-inflammatory drug is rubbed onto the skin. It’s thought that ultrasound gets the blood vessels to expand, soaking up more of the pain-relieving medication.
W is for Warmth: A warm shower or bath before bed can also help. Stand with your arms at your sides. Then for a minute or two, slowly and rhythmically lift your shoulders up and back, then relax them back down. This exercise can be done holding weights in your hands.
Y is for Yoga: Research has shown that yoga is also beneficial and can loosen tight neck muscles and increase the range of movement. However, anyone with neck pain should avoid positions that require substantial neck movements, such as the shoulder stand, backbends and headstands.
Z is for ZZZZZZ: The deep rest from a good night’s sleep may be all that is needed to relieve neck pain.
For more information check out the Harvard University website.
This article was originally published on page 18 of The Star on September 30, 2004
