Neck Pain has become a recurring problem in the lives of many, and although a common assumption appears to be that it’s due to inherent “poor posture”, deciding on a starting point to address this can sometimes feel like an insurmountable task. A simpler approach can sometimes be to break the big picture into smaller, more manageable pieces, and it is sometimes very easy adjustments that can make a large difference in managing ones symptoms.
Firstly, one needs to look at the various factors which contribute to neck pain. Although there can be acute and chronic conditions, or a combination of both, here we will look at some simple aggravating factors of a few chronic, persistent and ongoing neck problems, which are of non specific origin, ie they have not been brought on by a recent traumatic incident such as a car accident or a fall, or an underlying medical condition.
Many structures can contribute to the sensation of pain; muscles, joints, nerve tissues and bone, to name but a few. Sustained abnormal loading of these structures can cause imbalances to develop in muscle activation patterns, increase wear and tear on spinal structures, and limit normal movements, all of which are ultimately perceived by the body as discomfort and pain. Restrictions in other areas of the body such as the thoracic spine or pelvis, may also place extra load on the structures of the neck.
Many lifestyle factors play a large role in exacerbating these symptoms. Stress, poor mood, poor sleep, a relative reduction or change in exercise and activity levels, can all aggravate underlying imbalances and bring them to the fore.
In today’s fast paced world, where many spend a large portion of their days in front of a screen, work posture plays a large role in chronic neck pain. Even the so called “perfect posture” may cause discomfort after many long hours of the same position. And in the current world where home and work life are largely intertwined, it becomes that much more important to get the basics right.
In setting up your basic workstation, ensure that the chair is suitably designed and at the correct height to support the pelvis and upper legs at a 90 degree angle at the hips, and a 90 degree angle at the knee joint. Feet should be placed flat on the floor. The arms of a desk chair can restrict a person from being able to sit close enough to their desk, make sure that you are able to tuck your chair under the desk so that you can maintain an upright spinal position. Desk height should be sufficient to support the forearms. Keyboard and screen should be placed directly in front of you so that the body is not rotated, and at a height that requires your eye level to look slightly down, and a slight lowering of the chin, in order to elongate the back of your neck. Placement of your notes, reading material and desk phone should also be considered to limit prolonged off centre head positions, even moving these to different positions over the course of a day. There are also many specifically designed office solutions that can assist in optimizing your workstation setup.
Constant texting and reading from a cellphone screen with a hunched posture can exacerbate underlying symptoms, as well as cradling the phone between shoulder and ear. Use of a comfortable headset can assist with limiting the side effects of prolonged phone use.
Carrying heavy handbags and laptop bags can put a lot of stress on one side of the body. Limiting the weight of the bag, as well as facilitating a more even load distribution with a cross body strap, as well as alternating carrying sides can help.
Many people may find themselves behind the wheel of a car for extended periods. Evenings relaxing on a couch, or holding up a book for a period of time can also cause unwanted strain on structures of the neck. Asymmetrical, or end or range sleeping positions, such as tummy sleeping, or a night or two in a different bed while travelling may also play in role in exacerbating symptoms.
Sometimes it may be the smallest change, or added load that tips the balance from functional, into pain and discomfort. Managing repetitive strain type injuries can be challenging, as it may be difficult to reduce the often work related activity that is bringing on your symptoms. But setting yourself up for success with a good starting position is essential. Giving yourself regular small position changes such as rolling the shoulders back a few times, and then re-correcting ones posture over and over again throughout the course of the day can go a long way towards re educating correct muscle movement and activation patterns.
Ongoing, or a sudden increase in pain should however never be brushed aside, and a professional opinion is always recommended to check for any other potential underlying considerations, and to best guide you on the road to managing your posture related neck symptoms.
Michelle Saunders from KPSMC
BSc physio UCT