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Sunday, December 2, 2001
Keeping fit

When bad posture becomes a pain in the neck
B.K. Sharma

THE word cervical is derived from the Latin word cervix which means ‘narrow part of the body’ and thus anatomically refers to the ‘neck’ of the body or any organ. Although no vital organ is located in the neck, the neck is a very vital part of the body and connects the brain with the rest of the body. The traffic is two ways. All the communication between the brain and the body travels through the neck and the supply of blood to the brain from the heart and back also passes through it. The cervical spine supports the head and the neck. This consists of seven vertebrae and the discs in between and is supported by very strong ligaments and muscles. Though strong and solid, it is flexible and mobile in all directions and muscle and tendon pull it like ropes and rotate like pulleys. The first vertebra at the top is known as atlas as it supports the globe (head), from the leg and of atlas supporting the earth. In addition, the wind pipe (trachea) and the food pipe goes through the neck to the lungs and stomach respectively.

Pain in the neck

Cervical pain or the pain in the neck is fairly common in the adult population and goes on increasing with the age. According to a survey, on an average one in every 10 suffers from in the neck. In many instances, pain in the neck and pain in the shoulders and the arms goes together. The pain in the neck can be due to serious problems which we will only mention briefly. These causes include trauma, accidents, inflammation of the brain (encephalitis) or its covering layers (meningitis), haemorrhage in the brain, infections or tumours of the bones, various types of arthritis and some rare neurological disorders.

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Pain referral zones of the posterior neck muscles
Pain referral zones of the posterior neck muscles

In some cases pain following a heart attack may be felt in the neck along with the chest but sometime it may be only in the neck and may thus mislead the patient as well as the doctor. Headache and pain in the nape of the neck is considered symptom of very high blood pressure although in actual practice this is not common. In children certain anatomical abnormalities of the cervical spine may produce painful conditions of the neck. Apart from headache, cervical pain may be accompanied by pain in the shoulders and arms, dizziness, vertigo, ataxia, buzzing in the ears, visual aberrations and occasional loss of consciousness. The latter symptoms are due to a transitory block of blood supply to the brain as the vertebral arteries pass through the holes in the cervical vertebrae in a very delicate manner.

Cervical spondylosis and the cervical disc protrusion

It is perhaps a disease of the modern civilisation. Every third person you come across seems to tell you that he has a cervical problem. This may occur because of the natural aging process and due to physio-chemical changes in the spinal discs and the bones due to loss of water and elasticity. The disc becomes hard and fragile and may move out of its normal place and produce pressure on the nerves or the spinal cord. The edges of the vertebral bones become rough and grow spurs called osteophytes. However, this process is accelerated by the present-day work culture.

These factors include:

Holding head in a forward position over a long period.

Long hours of work at the desk or the computer.

Too high or too thin a pillow.

Sleeping with the twisted neck or on the stomach.

Reading or watching TV while lying down.

Sudden jerky movements of the neck.

Quick acceleration or de-acceleration of the body in an automobile produces what is known as the whip-lash injury which strains the muscles and ligaments of the neck.

Carrying weight on the head.

Stress of any kind produces spasms in the neck muscles and is thus a very common cause of pain in the neck as well as the head.

Inflammation of the muscles or nerves in the neck area can produce very severe pain and tilting of the neck to one side lasting for days and weeks. This condition is known as torticolis (wry-neck). The condition can be painful and cause may be a virus or other unknown factors. The pain may have to be relieved by cutting of nerves at the point of origin in the spinal cord.

Prevention of cervical pain

Nobody can halt the ravages of aging and time but a lot can be achieved by exercising maintaining a healthy lifestyle and a good posture.

Holding the neck in a neutral position while sitting i.e. neither over extended nor flexed as both strain the ligaments and muscles.

Any reading material should be at eye level.

Computer should be at eye level and the document holder and the monitor should be at the same level.

Individual spending long hours at telephone are advised to use headsets or speaker phones.

Take frequent breaks if your job requires you to sit for long hours. This relines fatigue of the muscles and joints.

Car seats should have a good head support.

Correct your sleeping posture if the pain is worse in the morning. Avoid high pillow as well as a very flat pillow. It should be soft and thin enough to support nape of the neck.

There is not much we can do about the changes in the bones or the discs but a lot can be done to maintain the cervical muscles in good health. Daily exercise of these muscles at a convenient time can go a long way to tone up these muscles.

Sitting straight on a stool or chair, various groups of muscles should be exercised by providing a gentle resistance with the hands and move the neck against the resistance. This include backward (extension), forward (flexion) towards both sides and rotating at the chin level. Repeating all these steps 10-20 times will go a long way in keeping these muscles in good shape.

Lifting the shoulders towards the ears is another very good way to exercise the trapezius muscle which is attached to the back of the skull and lifts the shoulder joints. This muscle is often the seat of spasm-producing pain at the back of the neck.

Exercising the shoulder joints and the chest helps in keeping the neck in good shape.

Specific manoeuvre and manipulations should be done only under the guidance of an expert and may be harmful if done without proper advice.

As mentioned above, stress plays a very important role in producing spasms of the muscles and consequently the neck pain. Various stress-relieving measures should be taken in the form of yoga, meditation, pranayama (Breathing exercises). Tranquilisers should be the last resort for this purpose.

Simple pain killers can be used for a few days but in case of pain lasting longer than a few days and getting worse by neck movements, medical help should be sought and depending upon the advice use of cervical collar or traction by a physiotherapist along with heat treatment can be helpful in breaking the cycle of the pain and the spasms.

Finally if you are witness to an injury involving the neck, even if you do not belong to the medical profession, the neck should be immobilised before moving the person. This may be life saving.

Pain in the neck is least desirable. We should try to prevent it or at least delay its onset.

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