Hey guys.
We will talk about neck pain today. Not just treatment options like PRP, Prolotherapy but lifestyle changes.
Its a very common pain, and hard to treat once it becomes chronic, because we are not aware of the simple do's and don'ts.
As this article is about what to avoid and what to do, I'll not go into the details of correct diagnosis and medical treatment. That article will come later.
Neck pain can be primarily caused by three things
Improper sleeping posture.
Improper posture during the day
Injury
Pain due to sleeping posture
This pain is the easiest to diagnose but I see many patients unaware about this. They get diagnosed as having spondylitis and then keep correcting their chair and table and laptop. Of course, those should be proper, but focusing on them may lead to missing the root cause. So, make the correct diagnosis first. All yourself this question. Is your pain more in the morning or evening? Are you waking up due to pain? Do you go to bed without pain but pain develops at night, not letting you sleep?
If this pattern matches your pain then in all probabilities your pain is caused by your pillow. Correcting your pillow will lead to an improvement within a few days.
But how should your pillow be? Well, the short answer is, no pillow, however expensive, however scientific or whatever big promises it makes, is good for everyone. A pillow made of the best memory foam with the most ergonomic support may increase your pain. And it is because everyone sleeps differently and has different proportions of head, neck and shoulders.
So I will not advice to buy some specific pillow, but just give you broad guidelines. You need to do some experimentation and listen to your body to come to the right pillow.
Number 1, do not sleep on your stomach. Sleeping like that would mean that you rotate your head to one side, putting more stretch on one side. Very few people may sleep like that and not get any pain. Its ok for them, but not for you if you have pain. So change that first.
Sleeping on your side is better than sleeping face up, but both are acceptable. The rule is to support the head such that there is no unequal stretch. Sleeping on the side will require a thicker pillow than sleeping on your back.
Since every one has different proportions, no single pillow is for everyone.
There is a simple hack for this problem. Take a medium firm pillow and some towels. Fold the towels on the pillow and see which height is comfortable to you. This may take a few days of experimentation but eventually your body will give you the answer. Try getting a pillow of that height. Once you get the correct pillow, take it with you everywhere, at least for a couple of weeks. Try to sleep on only that pillow as much as possible. This will gradually make you pain free
Pain due to improper posture during the day.
If you get up relatively pain free but gradually developed a neck pain as the day progresses then something in your daily routine is causing it. Looking at your phone for long times, working on a laptop, PC monitor too low, keeping the phone between your head and shoulder while talking, a heavy helmet, commuting on bad roads. The list of potential causes is long and its hard to talk about everything. You would have to focus on your daily activities to see which activity causes or increases pain. Anything that makes you look down for long has to be avoided. A screen that you need to look at should be at a proper height. It should generally be at such a height that the upper edge of the screen is at the eye level, but you can raise or lower it a bit according to your comfort. Work with your elbows supported. Remember, listen to your body more than your doctor.
Keep your car seat straight. Looking straight with the backrest pulled back is like looking down. Keep your seat at a comfortable distance from the steering wheel.
A very good hack for supporting your neck while prolonged reading or computer work is to get a chair where you can sit backwards and place your head comfortably at the backrest. It would generally feel great for reading but working would be tough because your hands would have to go around the backrest. Making a custom chin support would be tricky but a very effective way out of neck pain
Looking up for long times can also cause pain but it is uncommon.
Pain due to injury
A fall, sudden jerk, traffic accident or any other injury can cause neck pain. These are generally self healing. May take weeks to months but get much better. When they don't, it is because they are due to ligament injury. Liagaments are poor in blood supply. Pain in middle of the spine are generally ligament injuries, the on the side are facet joint or muscle injuries. The guiding principles are the same. Avoid anything that increases pain. But these pains require some type of targeted treatments to get better.
So, we have covered the don'ts, let us look at the dos.
There is only one, correct exercise.
Some amount of stretching exercises will help, but these are temporary reliefs. Lasting only a few hours maybe.
The one exercise that really helps is a strengthening exercise. It builds up muscles, this off loads the joints and ligaments and gives lasting relief. And how do you do strengthening? Simple, look at the bodybuilders. They do this exercise. It is simple and requires only a weight plate or a heavy book and a bench. You can get many videos here on YouTube or go to a good gym and ask a trainer. Start with low weights but increase gradually. By the time you reach around 10kg of weight, the pain will be mostly gone.
There is one caveat, if you get an acute pain at your painful point, just stop this exercise, it is not for you because it is stressing your painful ligament. You need to talk to a pain doctor for modification of this exercise.
Remember, stretching exercises are safer, but they don't do much. This strengthening exercise is a bit scary in appearance, but it is not if you start at 1-2 kg and gradually increase
Cervical collar, massage, heat, ultrasound, all these work in acute pains, not in chronic. Only strengthening works.
Prolotherapy, PRP etc also does micro strengthening, they are worth a try too. I'll get into their details in another article.