Why does neck pain last so long?
When working with patients suffering from neck pain, one of the most frequently asked questions I get is “why does it hurt” ,” is it just because I’m getting older” , “is it my posture or is it because I’ve lost the curve in my neck”. Often they’ve spent a minor fortune on machines to do traction to their neck, expensive pillows that they bought on late night TV because they couldn’t sleep ( that overpromised and under delivered). They’ve had massages, chiropractic visits, tried home remedies, and some have even had muscle relaxers, injections or surgeries all without much long term success. So “why” is a very fair question to ask especially if their chronic neck pain or chronic migraines have been going on for 6 months or longer. While neck pain can strike at just about any age, most people experience neck pain as they enter their 40s, 50s and early 60s. Why?
Reason Number 1
Years of habits have led to this point. Let’s face it, modern lifestyle, especially what we’ve been going through the last couple of years has not made the problem of neck pain any better. Whether it is the spine’s “kiss of death” sitting position on the couch(you know, when you sag into the couch to binge “This is Us”) especially if you’ve kicked your feet up or if you’re scrolling through instagram with your phone in your lap and head down, or simply the position of your computer at work is not right. These have all made it so the front of your neck is tight while the back of your neck muscles are overstretched, knotty, and tired. You can press on the base of your skull, the tops of your shoulders, or between your shoulder blades and find tight and tender knots. Some of these knots(especially at the base of your skull) are enough to trigger migraines or tension headaches. Other knots are enough to send pain, numbness, or tingling down your shoulders, arms, and hands. Posture wise, the head likes to be in a position where the ears are directly over the shoulders. When we are sagging into the couch, working on a computer that is not at eye level, or scrolling through Facebook feeds with our phone in our lap, we are placing extra stress on the back of our neck. Now, this is not necessarily bad but...when we’ve been doing it for years(without much work on our necks in the opposite direction), we are setting ourselves up for end of day headaches, stiff necks, bone spurs, or arthritis in the neck as our body tries to stabilize the neck and make up for the fact that we are trying to hold a position for way too long.
Reason number 2
We haven’t been as active as we used to be. Whether it is your personal quarantine, trying to bounce back from Covid, or the loss of time when the kids were at school and you could sneak away and get some yoga or gym time, our routine that helped us stay mobile and strong hasn’t bounced back quite the way we had hoped. That combined with the fact that we’re sitting all the time and you’ve got a recipe for stiff achy necks, tight shoulders, and if you’re prone to them, headaches and migraines.
Reason number 3
The next most common question I get is “should I buy a new pillow and what kind”. Some people, when they describe their pillows to me are able to fix the problem by using fewer of them while others have a pillow so thick and firm that their chin nearly touches their chest when they are lying on their back or their head is tilted when lying on their side. Ideally, no matter which position you sleep in, your neck should stay in a pretty neutral position i.e. the pillow supports the neck with a slight curve, a c-curve from your shoulders to your skull with the open side of the C facing the pillow. This will place your ears directly in line with your shoulders when on your back or on your side, keep your spine straight. Otherwise, the side that is bent the wrong way eventually becomes tight and tender as it gets overstretched. Often when this is happening, you’ll wake up with a “crick in the neck” or a morning headache along with a trip to the shower to try to get it to ease.