Friday, June 25, 2010

What a pain in the neck

St. Luke’s Health Watch


An estimated 66 percent of the U.S. population will experience neck pain at some time. When your neck is bothering you, the choices for treatment are so vast that it can be hard to know whom to turn to. Options include general practitioners, chiropractors, physical therapists, acupuncturists, spinal surgeons and energy healers. We are fortunate to live in a community where highly trained professionals are practicing in these specialties, as well as in other fields that might be beneficial in treating neck pain.

If neck pain is sudden and traumatic, or if neurological symptoms surface, it's best to have X-rays taken to prevent further injury that can be caused by leaving certain types of fractures untreated.

But what about a general, nagging pain in the neck? Uncomplicated neck pain is generally related to posture, muscle imbalance, stress, habitual patterns or some degree of arthritis. Does that mean that you just need to learn to live with it? Certainly not. Most neck pain can be alleviated or at least significantly reduced by a combination of treatment, education and self-care.

Consulting with your primary health-care provider can be a good first step. He or she has typically evaluated your condition, knows you personally and is often familiar with treatment options in the community. However, direct access is available in Idaho to physical therapists, as well as to a variety of other practitioners. When considering a practitioner, conduct an interview first to gain information about experience, education, philosophy of care and cost. You will also get a sense of your general level of comfort when talking with him or her.

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Since most of your time is not spent in treatment, the provider you choose should give you tools that you can use at home. These may include specific exercises or simply a different way of understanding your condition. For example, the idea of using your neck as if it consists of 24 vertebrae (the number in the entire spine), rather than just the seven cervical vertebrae, can be helpful. The benefit is the spreading of forces over a larger area, thus decreasing strain on the neck.

Try an experiment: Keeping your pelvis, low back, ribs and upper back facing forward, turn to look over your right shoulder, turning only your head and neck. Now try the same movement, letting the rest of your back, ribs and pelvis become involved in the turning. Notice how the strain in your neck is decreased because the movement is disseminated over more joints and muscles. Methods such as Feldenkrais, Alexander and yoga can assist in learning such awareness.

Other aspects of education addressed in the treatment of neck pain may include breathing, relaxation techniques, aerobic exercise, posture, rest position, sleep, and habitual patterns of physical, emotional and energetic movement. Notice that this list does not focus on the neck, but on the person as a whole.

Breathing is especially important to address. Breathing shallowly is a natural reaction to both pain and stress. When this occurs, we use our upper respiratory breathing muscles, which attach to our neck, thus increasing strain and pain there. Shallow breathing is also more rapid, thus revving up the nervous system and increasing the state of general arousal and irritation. Learning to use a fuller breathing pattern can decrease direct strain on the neck, aid in calming the nervous system, and lead to improved overall health by the constant massaging of the organs in the abdomen created by the movement of the diaphragm.

Successful treatment of any health condition relies on a partnership of the patient and the provider. You may be surprised by the simplicity or depth of changes and participation necessary on your part to achieve your goals. No one can want your health for you more than you want it for yourself.

Mary Kay Foley is a physical therapist and Feldenkrais practitioner with 24 years of experience, including work at St. Luke's Elks Rehab. She is also coordinator of the Integrative Therapies Program at St. Luke's Wood River Medical Center.

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