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A Cervical Sprain or Cervical Strain in the Neck ?

A cervical strain/sprain injury can happen many ways- a fall, whiplash from an accident, a quick turn, even sleeping in an awkward position. You often here that someone suffered a sprain/strain type of injury- what does that mean exactly and what is the difference between a strain versus a sprain?

• Cervical Strain
  
  A strain mostly refers to the muscle and tendons. A strain occurs when that muscle or tendon over stretches and contracts suddenly beyond its normal limits. This overstretching can cause microtears along the muscles. In acute conditions this can happen in one motion. For instance, during a violent sneeze or checking your blind spot quickly. Symptoms of an acute cervical strain can involve pain, muscle spasms, loss of strength, and limited range of motion in the neck. A strain can also occur overtime with such activities that involve repetition. These type of chronic strain injuries gradually build up from overuse or repetitive stress such as long hours on the computer, poor ergonomics or talking on the telephone with your neck bent constantly.
  
  
• Cervical Sprain
  
  A sprain injury refers to the stretching or tearing of ligaments or joint capsules. Joints capsules provide stability to vertebrae. Ligaments are thick bands of tissues that connects bone to bone. Sprains often occur when a joint is forced beyond its normal range of motion. It can lead to instability, bruising, swelling, pain, limited range of motion and inflammation. This can occur in the neck when one turns too much beyond their normal movement.

However, it’s virtually impossible to have one without the other. You may strain a muscle like your trapezius, but that trapezius attaches to other muscle, bone, and joints; this is where you have connective tissue.

When a muscle of a joint is strained or sprained it can then affect spinal alignment. This will lead to pressure on the nerves and therefore pain. Not to mention inflammation which also creates nerve pressure. In addition, nerves come through muscles, which is why you may have tenderness in that local region of the body.

One of the best recommendations for this kind of injury is some gentle neck traction which will help restore neck alignment and alleviate nerve pressure. Ice following the neck traction can help as well to reduce any possible inflammation.

Additional Reading Resources

• Why Do I Always Get Crick In My Neck
• The Neck Pain Relief Kit
• Reasons for Neck Pain And How to Correct Them: The Top 10
• Treating Osteoarthritis and Rheumatoid Arthritis in the Cervical Spine Naturally
• Forward Neck Posture And How It Will Work Its Way Down The Spine…

Stiff Neck for Red Sox Pitcher Matsuzaka

Last week, Daisuke Matsuzaka, the starting pitcher of the Red Sox issued a statement that he was not able to play because of a stiff neck.

A stiff neck can affect an athlete quite seriously. Somehow when we have a stiff neck we make do- We turn our whole body to check our blind spot or toss and turn in bed constantly because we cannot get into a comfortable position.

Well the neck muscles and upper back muscles are key in being able to pitch in baseball. So when Matsuzaka stated that he was having neck pain- he was out and not able to play at all.

"I didn't throw live BP today due to stiffness in my neck. As for my schedule going forward, I'm going to see how I feel tomorrow, meet with the coaching staff and decide at that point."

His manager, Terry Francona said that Matsuzaka threw a handful of pitches before feeling pain in his neck. "It kind of spasm'd on him. "We'll go kind of day to day on it," Francona said. "We'll wait and see how he shows up tomorrow and when he feels good we'll repeat what we where going to do today. I don't whether that would be tomorrow, the next day, the next day. We'll just see how he feels."

The Sox don't seem to think this latest issue is related to sore lower back Matsuzaka had during training camp.

"I don't think it's anything besides a stiff neck," Francona said. "I don't know that we need to be conservative as long as he's OK. But if he's not comfortable, that wouldn't be a good thing. We'll just see when it goes away."

At this point, the Red Sox are't even thinking about when Matsuzaka will be ready to pitch once the regular season starts. It has been obvious for a while now that he'll be on the disabled list to start the season.

The Red Sox are not going to take any chances with any type of neck injury. The pain is real, and it can affect the outcome of the game. Plus they don’t want Matsuzaka to get worse.

Getting a stiff neck as an athlete can definitely affect ones performance. At the high level of baseball that Matsuzaka is playing, it is a big deal. So without resorting to medications, surgery, or injections- what are his choices for getting rid of this stiff neck?

• Movement- this is very important- Just because you have a stiff neck, doesn’t mean you should put on a cervical collar and prevent any movement at all.
  
• Drink water- this is important for so many functions in the body. Water facilitates body functions- one of those is lubricating joints
  
• Stretching out the neck- doing daily neck stretches even if only through a small range of motion, this can speed up recovery
  
• Take a hot bath with the addition of epsom salts, and let your muscle relax. Alternately, you can also use a hot pack for 10-15 minutes on your neck and upper back area.
  
• Chiropractic- Misalignment in the neck and upper back can be a cause for stiff neck. A chiropractor can give you an adjustment, do gentle mobilization techniques and do modalities of heat and ice in course of treatment to help you get neck pain relief.
  
• Massage - this therapy can help in breaking up muscular adhesions and getting rid of tightness in the muscles of the neck and upper back area. Using deep kneading strokes to relax and release any areas with trapped nerves or muscle tension can make a huge difference
  
• Acupuncture- There is an acupuncture point called Luo Shen located on the hand that works great for stiff neck. Specifically, it is located On the dorsum of the hand, in the depression just proximal to the second and third metacarpophalangeal joints. Also, using a technique of Cupping or Gua Sha helps to release muscle spasms from the neck and upper back area. Similar to a deep tissue massage, this can cause some bruising but can be very effective at getting rid of the stiff neck.
  
• Sleep Comfortably at night- Using a cervical support neck pillow can help one to sleep in the proper position (on the side or back). One of the most common culprits of a stiff neck is sleeping in an awkward position or sleeping with too many pillows.
  
  Source: Update on Matsuzak’s Pain in the Neck
  
  Picture Source: Daily News
  
  Additional Reading Sources:
• Are Your Severe Neck Pain Symptoms the Result of a Cervical Radiculopathy?
• Remedies for A Stiff neck
• Choose the Right Neck Pillow for Proper Comfort and Support
• Can Foward Head Posture Cause Pain?
• Tampa Bay Lightening Goaltender suffers from Stiff Neck, not Concussion

Upper Back Pain when I Turn my Neck!

The nerves of the lower neck are what mainly control the muscles of the upper back. What muscles are we referring to- your trapezius, rhomboids, shoulder muscles, and neck or upper back paraspinal muscles.

The paraspinals run along the spine up and down the length of it. Your rhomboids are basically from your spine to your scapula, otherwise known as your shoulder blade. Shoulder muscles that can often be affected are your deltoids and rotator cuff muscle. The trapezius muscle essentially covers the back of the neck and upper back.

Keep in mind that the spine is all connected and works together. So, for example, turning the neck to a certain degree will also involve rotation of the upper back or thoracic spine.

The good news with this is that if you improve neck alignment it will also help restore upper back alignment.

Not only that, when we do this we take pressure off of nerves … and this in turn helps improve muscle tension and range of motion.

Picture Source: Active Care Chiropractic

Additional Reading Resources

• Decreasing Tension in the Neck and Upper Back
• Pain In the Upper Trapezius
• Neck Muscles Most Responsible For Your Stiff Neck And Trigger Points: The Levator Scapulae & Trapezius
• Sally and her stiff neck: Solutions for neck pain relief
• The Neck Pain Relief Kit.com

Spinal Stenosis and Neck Arthritis. What is the Connection?

Spinal stenosis is often a condition that is caused by the changes that occur from arthritis.

Spinal stenosis refers to a narrowing of the space around the nerve that exits from the spinal cord. This decrease in space causes compression to the nerve. The stenosis can occur at the spinal nerve level or at the spinal cord level.

What are the signs and symptoms associated with Spinal Stenosis?
This pressure on the nerve can cause pain, weakness and incoordination, muscle changes, and sensory changes (such as numbness and tingling). The numbness can occur in the back, neck, shoulders, or arms. It is worthy to note that with spinal stenosis in the neck, pain is not always present.

Arthritis of the cervical spine refers to changes in the bone and this can lead to spinal stenosis. Arthritic changes can be seen with the addition of bone spurs (outgrowths from the bones), decrease in disc space, deformation of the bone (jagged edges), calcification of spinal ligaments, and thickening of the joint tissue because of inflammation. All these arthritic changes can lead to spinal stenosis.

Additional Reading Resources

• Neck Pain Relief That Does Not Include Surgery
• The Causes of Severe Neck Pain Resulting from a Cervical Radiculopathy
• Treating Osteoarthritis and Rheumatoid Arthritis in the Cervical Spine Naturally
• Neck Exercises for Chronic Neck Pain
• The Neck Pain Relief Kit

Preventing Neck Pain with Ergonomics

Daily body positions and habits are important when it comes to preventing and healing neck pain.

Let’s start with your work station or computer setup. The majority of people I know work at a desk with their computer and phone close by. Having a computer keyboard and/or screen that’s not at a comfortable position can severely strain your neck.

For example, if it’s too high, too low, too close or too far it can be a problem and create neck problems. Having a screen that’s not in a good position can cause you to crane your head forward for hours and hours. The same holds true for your keyboard; having this in an awkward position can strain your whole body, including your neck.

Your phone setup is similar. If you are always on it, make sure you can reach it and have a light weight headset. Avoid holding that phone between your neck and shoulder; I’ve seen too many people strain their neck doing this as well as three other things at the same time.

The next daily thing we do that often relates to neck pain is sleeping. Using a good neck pillow can correct your posture and relieve neck pain while you sleep.

Lastly, daily activities that may affect neck posture can cause neck pain. Learning some basic neck stretches and keeping hydrated will help prevent neck muscle strain. So, if you work in one position most of the day or have to be in a position that puts some stress on the neck, make sure you do this.

Additional Reading Resources

• Exercises for the Neck
• Have Good Neck Posture While Sitting at A Desk
• The Neck Pain Relief Kit
• Remedy for A Stiff Neck
• I don't have Neck Pain, But my Arm and Hands Fall asleep All the Time

The Handbag Dilemma- One Stylish Cause for Neck Pain...

We talk about heavy backpacks for kids these days, what about women and their handbags? I cannot tell you how many times I have picked up one of my patients purses and it felt like she had 3-4 bricks inside. Carrying this on one shoulder? No wonder so many women with heavy bags come experience neck pain, headaches and upper back pain. Even celebrities have taken carrying the large purses to another level!

Carry a large purse over one shoulder can set a woman up for neck pain, upper back pain, shoulder pain, arm pain, headaches and sometimes even tingling in the arms and hands. It throws the posture off thereby causing an imbalance of the muscles and compression of nerves in the neck and shoulder area. This can cause tightness, pain and soreness. These days we are high tech society and we love our gadgets- With carrying laptops, blackberry’s, water bottles, wallets and other objects, the weight of a handbag can even get up to 16 lbs.

Yes, I know these bags are stylish. I know they are the hip thing to wear these days. For me to suggest that one use a knapsack and carry it on both shoulders would be a little impractical. Knapsacks don’t exactly go with high heels (another potential cause for lower back discomfort). This past weekend, my best friend came to visit me from Boston She is avery smart, stylish and practical gal - and I noted that she had this awesome purse that she carried over and across her shoulder- also known as a messenger bag. The bag was small to medium size and she had her essentials in there- including I noticed: a water bottle, makeup, a large wallet, gloves. I was amazed at what came out of this bag ! With the long wide strap she was able to wear the purse across her shoulder, thereby distributing the weight evenly. Also, the purse was kept close to her body which also made it more more comfortable. We went shopping for a few hours and she was as comfortable as could be.

So ladies, next time you complain about your neck pain look to your stylish purse as one potential hazard.Consider getting a purse that you can carry over your shoulder if you are going to be on your feet for awhile. If you must carry “the purse” then consider lightening the load. Also instead of carrying it on your shoulder, just hold it by the straps and use your hands. Switch sides often. Then you can carry that large handbag without pain and soreness !

Additional Reading Resources:

• The High Heels Controversy: Do they Really Cause Low Back Pain?
• The Things that Make You Say “Oh my Neck !”…
• The Neck Pain Relief Kit
• Neck Posture
• The Perfect Posture Program

 

Natural Pain Relief for the Neck that does not Include Surgery

I get daily emails from patients who suffer from neck pain, stiff neck and often times headaches. More times than not, I find myself re-assuring the patient that yes we can help. Yes, there are other things that they can do that are not surgery. Recently, I heard from a patient with chronic neck pain, diagnosed with moderate to severe degeneration in his neck. I could hear the panic in his voice when he stated that the orthopedist had suggested surgery for his neck.

Well, surgery is an option- but it’s not the first option for sure. Let’s discuss some things that may be effective for dealing with chronic neck pain:

• Neck Stretches- For too often a patient works in an environment that involves them bending their head forward. This poor posture causes joint dysfunction, degenerative changes and muscles to become shortened and tight. With a chronic neck pain patient- the stretches should be done gently, not to the point of pain- only to the point of feeling a stretch. Start slow in the beginning and work your way up to taking your neck into into its natural ranges of motion (flexion, extension, lateral flexion and rotation)
  
  
• Chiropractic Adjustments- Helps to increase range of motion, increase proprioception and decrease pain. There are many techniques in chiropractic these days and getting your cervical spine properly aligned plays a key note in how your nervous system functions.
  
  
• Muscle Therapy- Don’t forget about the muscles in your neck that allow you to check that blind spot while driving. With poor posture, being in pain, not sleeping properly can put a lot of added stress to the soft muscle tissue of the neck. There are great techniques for muscle pain such as ART and trigger point therapy.
  
  
• Nutrition / Topical Creams- Bromelain: an anti-inflammatory protein that comes from pineapple may be useful for inflammation-related pain and sports injuries. Another great herb is ginger. Topical preperations such as cayenne cream may be beneficial for arthritic joints. Also try peppermint oil which works to quiet the nerve endings that transmit pain signals. Another great natural pain reliever that is topical in nature is biofreeze natural pain relieving gel; when used in conjunction with ice, it can have a great effect on painful muscles.
  
  
• Therapy and Support for the Neck- Ice has its place, heat has its place- if it’s a chronic condition often time heat will be more effective. Other tools such as ultrasound and tens electrotherapy can also be quite effective. Even traction for the neck can yield a lot of pain relief. Finally, using a cervical support neck pillow will allow you to sleep more comfortably and ensure that your head and neck are in a proper position for rest.
  
  
• Posture Check- Your Doctor may say you have a “Military Neck,” “Loss of Cervical Curve,” or maybe “Hypolordosis seen in cervical spine”. With chronic neck pain often comes poor neck posture. Especially when sitting at a computer for a prolonged period of time. Muscular imbalances can occur in the neck flexors, in the deep neck muscles (Longus Colli and Longus Capitus). Studies have shown that through proper neck exercises that involve training the above muscles- neck pain patients were able to maintain a neutral cervical posture during prolonged sitting. Finally, examining your computer station and work area and making sure you are ergonomically set up will make a big difference as well.
  
  
• Neck Strengthening Exercises- Once you address the muscular imbalances in the neck, and correct the neck posture, you can start to strengthen the neck muscles that we mentioned above. By using isometric exercises with resistance bands and involving the entire body- working to strengthen the neck muscles will play an important role in lessening the chances of neck injury and create better posture.
  
  Did you know?- Nearly 1 in 5 Americans over the age of 60 take medication for chronic pain, but of those, a quarter suffer from side effects, according to a recent NIH report. Common NSAIDs such as aspirin or ibuprofen can be a problem for some people- as it can cause stomach bleeding! Look to alternative ways of treating chronic neck pain first.
  
  Sources
  • FALLA D, et al. Effect of neck exercises on sitting posture in patients with chronic neck pain. Physical therapy, April 2007; 87 (4): 408-417.
  • Sidhu, Jaspar. “Managing Chronic Neck Pain: Screening and Exercise Problems.” Dynamic Chiropractor Feb. 2010; 23.
  
  
  Addtional Reading Resources
  • How to Check Your Own Neck Posture
  • A Neck Pillow Does More Than Support the Neck
  • Walk Your Pains Away
  • The Neck Pain Relief Kit