Neck Pain

WHEN TO SEE YOUR DOCTOR

* Your neck pain persists for more than three days or keeps coming back.

* You suffer from neck pain after a fall or accident.

* Pain radiates from your neck down your arms or legs.

What Your Symptom Is Telling You

Follow your instincts and you may be on to something. But allow your body to follow your chin as you sit, stand or walk, and you're probably in for some neck pain.

If you go about with your shoulders slumped and your chin thrust ahead, your head is no longer balanced properly atop your neck. Instead, the ligaments and other soft tissues of your neck have to deal with much as 18 pounds of improperly distributed weight—definitely the wrong way to use your head!

"We think the big problem with the neck and the rest of the spine is that the joints are held at an extreme position for a long period of time, and that abnormal stress and strain eventually leads to pain," says physical therapist Wayne Rath, co-director of Summit Physical Therapy and senior lecturer of the McKenzie Institute International (U.S. Headquarters) in Syracuse, New York, and clinical assistant professor in the Department of Physical Therapy at Thomas Jefferson University in Philadelphia.

Various structures in your neck can give rise to pain. A ruptured disk—one of the rubbery, doughnut-shaped cushions between your vertebrae—can cause difficulty. So can problems with the muscles, joints or ligaments in the neck. Any of these can be hurt during an injury. The most common, whiplash, usually happens when a car is rear-ended. It makes the neck snap violently back and forth. The gradual degeneration of any of the structures in the neck from aging or overuse can also cause neck pain.

Symptom Relief

Perched above your back, your sore neck may seem like it's an island of pain unto itself. But in fact, your neck will respond to many of the same pain-relief treatments that work for your lower back. (For those feel-good techniques, see Lower Back Pain on page 323.) There are, however, several specific remedies that can help provide fast relief for neck pain.

Collar your pain. Some people report that cervical collars, available at medical supply stores and most drugstores, may provide temporary relief by keeping your neck immobile, says Philip Paul Tygiel, a physical therapist who serves as a consultant for the University of Arizona University Medical Center Back Pain Clinic in Tucson. But it's not a good idea to keep your neck immobile for too long a time, he says. Wearing a cervical collar for more than a couple of days can weaken your neck muscles, making you susceptible to further injury, he says. If your pain continues for more than three days, see your physical therapist or doctor.

Wait it out. "Research shows that roughly 80 to 90 percent of the people who suffer neck pain and choose to do nothing are over their pain within two to three days," says Rath.

Improve your posture. "Poor posture isn't just how you sit and stand. It's how you hold your body when you function—moving, sitting, standing, bending, lifting, playing golf, whatever. It's how you hold your body while you are active or inactive," says Rath. And poor sitting posture, he says, is the worst offender of all.

"Think of your neck as a golf tee and your head as a golf ball. What happens if the tee is inserted at a 30-degree angle? Take a look at how people hold their necks," he urges."What keeps their head from rolling off? All the muscles and ligaments under that strain." To maintain good posture: Sit up straight and tall, raise your chest up, lower your chin slightly and pull your head back so that your ears are directly over your shoulders, not in front of them.

If you suffer repeated bouts of neck pain, ask your doctor to evaluate your posture and, if necessary, recommend someone who can give you training in how to improve your posture.

Control that cough. If you accentuate your coughs and sneezes with a wind-up and delivery that would make a pro baseball pitcher proud, be forewarned: You could injure your neck. Instead, cough or sneeze while maintaining good posture or even while tilting your head and neck slightly back, says Rath.

Hold the phone. Rather than propping the phone between your head and shoulder—which can strain the soft tissues in your neck and the muscles in your upper back—hold the phone in your hand. Or better yet, buy a headset or speaker phone, says Hubert Rosomoff, M.D., D.Med.Sc., medical director of the University of Miami Comprehensive Pain and Rehabilitation Center in Miami Beach. "When you're cradling the phone like that, you're altering your posture and changing your head and neck attitude in an abnormal way," he says. "Don't do it—it's a disaster."

Get hold of a copy holder. Instead of twisting your trunk and neck to read copy while typing at your computer, install a copy holder that's flush with the screen. "That's probably one of the best tools someone can have," says Annie Pivarski, a back-care consultant and personal trainer in San Francisco who helped rehabilitate the back of San Francisco '49ers quarterback Joe Montana following back surgery in 1986.

Check that pillow. The wrong pillow is a common cause of neck pain. But rather than taking someone else's advice, find one that keeps you pain-free. Those filled with barley hulls can be molded to provide neck support when you sleep. But any cervical pillow that provides support to the neck ligaments can be very helpful. Above all, avoid pillows that push your head forward.

Go on a roll. Available at most medical supply stores, a cervical roll is designed to slip under your neck while you're sleeping, reducing strain on neck joints, says Rath.

Neck Exercises Prevent Pain

Everyone knows that exercise strengthens muscles and increases flexibility. Even gently exercising your neck helps lubricate and speed nutrients to the area, says Tygiel. Here are a few neck exercises that are particularly helpful.

Head turns. Move your head up and down by slowly dropping your chin to your chest and then bringing your head slowly back up to a normal position. Repeat ten times. Next, slowly lean your head from the left side to the right side and then back to normal. Repeat this ten times. Now slowly turn your head from side to side and return to the normal position. Repeat this ten times also. Do all of these exercises in the "pain-free" range only. (Don't worry if you hear cracking noises.)

"Most people don't take the joints in their neck through normal motions every day, so this is good therapy," says Tygiel.

Press it. Place the palm of your hand against the back of your head and gently press while resisting with your head. Hold for a count of ten. Repeat with your palm on your forehead. Now place the palm of your right hand against the right side of your head and press, again resisting the movement with your head. Repeat on the left side. Do this set of exercises once a day.

Say no to the spin. Rolling your head around in a circle—as some people do to "loosen" their neck muscles—can actually cause more damage. Avoid it, says Tygiel.

See also Neck Stiffness; Upper Back Pain