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Do you suffer from constant pain in your upper back, neck and shoulders?  Do you constantly have knots between your shoulder blades or in the muscles in your shoulders?  If so, you are not alone.  According to the National Institute of Health, back pain affects 8 out of 10 people at some point in their lives.  It once seemed that elderly people were the most affected by this, but now it is affecting the younger population as well. 

Since the advent of the computer/cell phone era, most people spend the majority of their day in front of a computer or texting on a cell phone, either for personal or business use.  This phenomena causes the user of these devices to move their head into a forward position for long periods of time which can result in a decrease of the natural curve in the neck.  This natural curve is vital in maintaining homeostasis in the musculo-skeletal system.  As the curve in the neck straightens, the head which weighs approximately 10-12 pounds in the average adult is not balanced properly on the spine which causes a cascade of events that can lead to long term, degenerative conditions.

1.     When the neck curve is straight and the head is in an abnormal forward-flexed position, the muscles in the back of the neck, shoulders, and upper back have to work extra hard to keep the head upright.  This means that these muscles will be in constant contraction, which causes fatigue.  A tired and over worked muscle is more susceptible to injury.  Sometimes that injury can come from something as a simple as the way you sleep, a sneeze, or turning your head.  This often results in tightness in the neck, upper back, and shoulders and those oh so painful knots.

2.     A straightened neck also puts unnatural stress on the vertebrae of the spine and the discs that lie between each vertebrae.  The natural curve acts as a shock absorber which distributes force equally through the vertebral bodies and discs.  As the neck curve straightens, the force is directed down the front of the vertebral bodies and discs.  This abnormal force, if not corrected, can lead to Degenerative Joint Disease (osteoarthritis) of the neck.  This condition is characterized by bone spur formation and wearing away of the discs between the vertebrae.  If the discs degenerate the spine will lose flexibility and the cushioning between each vertebrae.  It can also lead to disc bulges or herniations that can be very painful if they occupy the space where nerves leave the spine. 

Treatment Options

1.     Chiropractic adjustments to keep the vertebral segments mobile, thus relieving pain and allowing the head to move with less pain. 

2.     Specialized traction designed to reintroduce the curve to the neck, which will slow the degenerative process.  Research shows that significant curvature in the neck can be regained in as little as 10 weeks. 

3.     Adjunctive therapy or rehabilitation of the musculature of the neck, back, and shoulders to provide strength to hold the head in its natural position.

4.     Heat to soothe and relax sore muscle and ice to control inflammation.

5.     Some providers may suggest the use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) such as Ibuprofen.  Careful attention should be given to the possible side effects when using these drugs.

6.     Activity modification is sometimes needed to correct postural abnormalities.  If your job requires sitting in front of a computer for long periods of time, talk to you employer about improvements in ergonomics, ie:  optimal keyboard, monitor and mouse placement; also sit in a chair that is the correct height for you and provides proper lumbar support.  Take breaks if you spend long periods of time texting. 

7.     Consciously be aware of your posture.  If you feel that your shoulders are slumped over, or your head is forward, bring your shoulders and your head back. This may be awkard at first, but the more you establish a correct posture, the more natural it will feel.

Key points to remember

·        You don’t have to live in pain.  If you fit into this category, there is help other than just dealing with it or taking medication.

·        If you do suffer from this condition, it most likely will not resolve on its own.  Interventions such as chiropractic care, acupuncture, or adjunctive active  therapy may be required to slow down the degenerative process.

·        Take control of your posture.  Be aware of slouching or forward head placement and sit up straight.  To this date, there is no such thing as a spine transplant, so take care of the one you have.

Eric W. Goodman, DC
Greenapple Sports and Wellness

References:

www.nlm.nih.gov/medlineplus/backpain.html.

www.spine-health.com/conditions/arthritis/cervical-osteoarthritis-neck-arthritis

http://cbppatient.com/what-is-cbp/what-is-chiropractic-biophysics

http://annals.org/article.aspx?articleid=1033288

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