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Neck Pain - Chronic / Acute
A large percentage of the population suffers from chronic neck pain. There are many actors that are involved in the cause of this pain, and it is very common that a person has more than one cause for their neck stiffness, ache or pain.
Basically, your neck supports your head. Your head weighs about the same amount as a women’s bowling ball. Imagine holding that bowling ball in your hand all day long. Your arm would get very tired and stiff. Consequently, the first cause of neck stiffness to consider is faulty posture. Is your head being held forward of your shoulders? We see this posture in many people as they age, but it can be found in teenagers as well.
Posture begins all the way down in your feet. If your arches are dropped, you will have a torqueing of your lower leg, which twists your upper leg and then causes muscle tension all the way up to your neck.
The pelvis and low back muscles are important for your neck because if they are weak, and you begin to slouch, your head will shift because of the change and the neck muscles will tighten.
If you are round shouldered, then your head is thrust forward and again you will have tight neck muscles. Aside from these postural problems, temporomandibular joint (your jaw joint) imbalances have been shown to cause increased tension in your upper neck muscles.
A good example of the factors just discussed is a person who has been in an auto accident. During the accident, their head would be thrown violently forward and back, injuring the supporting muscles and ligaments of the spine. While the head is being moved violently, if the mouth is open, the jaw gets twisted, injuring the muscles of the temporomandibular joint. This causes increased contractions in the upper neck muscles.
If it is the driver, their hands would be on the steering wheel and the force would cause an injury to the shoulder joints, causing contractions in the neck muscles, especially the trapezius on the top of the shoulders. While braking, the leg at impact would push the pelvis back against the seat and cause an injury that again would cause muscle tension up the back and including the neck. As you can see, one accident can create multiple causes of neck pain.
The next consideration is prior injuries. These include not only severe injuries, like an auto accident with its resultant whiplash, but also repetitive stress injuries that can occur in sports and in daily life. Just as doing repetitive tasks damages wrists and shoulders, the same type of repetitive stresses can permanently damage the small joints in your neck. These stresses don’t have to be active trauma like hitting your head, but can include simple activities like reading in bed with your head supported on three to four pillows.
The examination of the neck must take into account all of these possible causes. By palpating the muscles, the doctor gains an understanding of the quality of the contraction of the muscle. Testing of supporting muscles reveals weaknesses that require increased contractions of other muscles to hold and move the neck. X-rays are used to help understand the length of time that the condition has been going on. It takes time for arthritic spurs and disc degeneration to occur. In general, the more degenerative the findings, the longer the problem has been going on.
Treatment must be aimed at normalizing your posture, strengthening any weak muscles, decreasing any contracted muscles, stretching any shortened muscles and reestablishing normal coordinated motion in your neck and spine. In addition, lifestyle changes may be needed. These might include changing the height of the pillow you sleep with, changing your work environment so that your neck is not stressed, changing your posture driving a car, and many other items like these.
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