Neck pain, shoulder pain, headaches

Neck pain

Neck and shoulder pain is one of the most common complaint presenting in the clinic. In this blog I’m trying to get across some ideas on how to adjust your head position to help reduce neck pain symptoms in the most simple way I can. Simple because not everyone wants to get down on the floor to do exercises, yet changing small things in your daily life can snowball into big changes over the course of weeks, months and years.
Often the most common cause of neck pain and tightness is our posture and the position in which we hold our neck and shoulders. Ideally our heads should be over our shoulders with our ear tip in line with the middle of the shoulder. Our heads weigh an average of 4.5kg ….about the weight of 10 tins of beans. For every inch the head pokes forward of the body it increases the weight of the head on the body by additional 4.5kg. This puts strain through the muscles at the back of the neck and top of the shoulders leading to tightness and pain. It can also contribute to other symptoms like headaches, pins and needles, and numbness in the arms and hand.

The picture shows how much load is put on the neck by the degrees the neck is looking downwards. It makes for some surprising reading. You wouldn’t opt to hang a 18kg weight off your neck but it might just what you are doing now if reading this blog on a tablet or phone.

Checking your head position

Unless you have a picture of you take from a side profile it’s hard to figure out how far in front of the middle of your shoulders, your head lies. But here are some things to try:

  1. The next time you sit in a stationary car, check if the back of your head touches the headrest. If not bring it backwards to touch it. Ideally this is where it should rest. This position can also sometimes give relief from neck and shoulder pain.

2. Stand up against a wall with your heels, bum, and shoulder blades touching it. Is your head touching the wall? Can you bring it back to touch the wall? Can you do it without poking your chin upwards? Other factors like excessive rounding of the upper back can affect your ability to do this.

3. Try the exercise in this video. Place your finger just barely tipping your nose. Only moving your head and not your arm (the finger doesn’t move with the nose) turn your head to the left and right, then come back to the centre. You will find your head has come backwards from the finger. The more clearly you can see your finger then the more your head has come away from your finger and more likely your head position needs improvement. The closer your finger is to your nose, the blurrier and less of it you see…eyesight limitations not withstanding.

Simple things to change your head posture

These are small changes but the more often you do them, the more your body becomes familiar with the new position and subconsciously you start to adopt a good head position. Over the longer term this should reduce pain and stiffness in the neck and shoulder. If you have a very acute pain you might find moving all the way into a good posture may be sore. If that is the case, move your head partly into the correct posture just as far as feels comfortable. As your symptoms improve you will be able to bring your head further into a good posture.

In the car

When stationary in a car bring your head backwards for as long as you can. You may feel a stretch at the nape of the neck as tight muscles here start to stretch.

Laptop / Tablet / Phone

Pay attention to your head position and see if you notice during the day when it starts to poke forward or look downward. If you take a look at the first picture in the blog it shows the more downward you look the more strain put through the neck. Are you looking downwards at something that could be raised up or brought closer to you? Try to correct it and hold this position for as long as you remember.

If you spend the majority of your working day in one location, atwork, or at desk from home, then make this location as ergonomic as possible

  • Use a laptop stand to raise the laptop screen or an external monitor to raise up the screen so you are looking at the top 1/3 of the screen when the head is in an upright position. If you go from meetings to your desk throughout the day develop the discipline to plug your laptop back into the setup – it only takes seconds
  • Bring the screen closer to you, or magnify the zoom, so you see it without having to move the head forward
  • Get an eye test if you think your eyesight may be causing you to peer forward at the screen
Blank piece of Wall

The wall slide exercise is a nice one to do help loosen out the upper spine and help your flexibility. It’s a great exercise to do in in the evening after work or where stuck in a sitting position for long periods such as a long flight. You may find that the range you achieve raising your arms initially is limited. With practice this will improve.

The Gym

When lifting weights in the gym watch your head position. Sometimes when lifting heavier weights particularly to the side, there can be a tendency to poke your chin forward. This can lead to stress particularly a the back of the neck. These are some things to try:Lat pull down behind head increase risk of neck injury

  • If there is a headrest on the machine you are using bring your head back to rest on it.
  • If using free weights to the front or side of the body when standing e.g. bicep curl, deltoid raise, try standing with your back to a wall and the middle of the back of your head touching the wall. See if you can hold this position when using the weight.
  • Perform lat pull downs in front of the body rather than pulling down behind the head
  • Whatever your head position, whether you are lying on a weight bench face up, or flexed forward doing prone rows try to keep your chin in a neutral postition. Neutral means that that it doesn’t poke down towards the chest, or poke upwards to the ceiling. Check your head position before you lift and while working on light weights focus on keeping your head in a good posture.

Initially keeping the head in a good posture may be harder when using heavier weights. If this is the case, lower the weight used so you can adopt a good head position.  Over time build up the weight in parallel to being able to keep the neck in a good position as this removes some poor compensatory patterns that may exist and helps the neck to strengthen slowly.

Pillows

Your pillow choice may be a consideration regarding neck pain particularly if you wake with neck pain, headaches, or pins and needles in the arm in the morning. While the research done on the effect of pillows and neck pain is limited, it has been shown that feather pillows consistently perform poorly in the research studies leading to increase in symptoms. Ideally a pillow should allow you sleep with your neck in a neutral position. If you are a side sleeper this would mean a pillow that doesn’t cause the head to slant upwards if too high, or downwards if too low. If you like to sleep on your back you may need a flatter pillow. While multiple pillows are useful if sitting up in bed reading, remove them for sleeping as pillows that are too high cause the head to flex (chin pointing down) too much. If you sleep on your front, it means you have your head rotated to the side which is not ideal.

Neck & Shoulder Massage

When your neck is tight or stiff it can make adjusting to a new head position feel awkward at first. Massage can be used to target tight areas of the neck, shoulder and upper back making it more comfortable to adopt a new posture. It is very useful to relive neck pain. If you would like to find out more about it you can check out our massage page or contact us on info@www.mapleclinic.ie