MR. GOODEMOTE: I have had neck pain for years. It started when I woke up with a crick in my neck. I couldn't turn to my right at all and I was in agony. A chiropractor helped me recover from that episode, but now it seems like I have to go to him every time my neck gets sore. Is there something I can do on my own?
ANSWER:?First of all, thanks for the question. This sounds very familiar, and I will base my answer on what is most likely causing your pain.
Matt Goodemote demonstrates a retraction exercise.
If you have had a recent injury to your neck, including a car accident, a major fall or some other significant trauma, you need to consult a physician for X-rays before trying anything I suggest. Likewise, if you have any other medical conditions that might be a factor, it is important to speak to your doctor before trying anything I suggest.
The crick in your neck is likely the result of what I would call mechanical neck pain. This essentially means the spine joints themselves are responsible for the loss of motion. Typically, I verify this through a simple movement screen. I ask my patient to look left and right, side bend left and right, bend her chin to her chest and extend and look behind.
When you have the crick in your neck, let's say, on the right side, then it will be difficult to turn to the right. This generally means the joints, not the muscles are responsible for the pain. Often, people feel their symptoms in the muscles, so they assume that is the source, but more than likely the source is in the joints of the spine and the muscles are merely guarding (in some cases in spasm) to protect the joints and stop you from moving and injuring your joints further.
Muscles will typically hurt in the opposite way. For example, if you have right-sided muscle pain, then turning left will result in increased symptoms.
The first thing you can do at home is the most boring thing and what most people know but rarely actually apply - using proper posture. The joints of our spine are designed to support our actions and when we have good posture, our joints are strong and resilient.
The most common posture I see is a "forward head" posture, which can eventually lead to a "flattened cervical spine." The neck is supposed to have a slight curve known as lordosis, which is the same curve direction as the lower back. The curve should be inward, so when the neck is "flattened" it essentially means we have lost that inward curve.
The easiest way to find the correct posture is to sit in a chair that is one or two inches away from the wall and physically lean your back against the chair so that your gently head touches the wall. This is a "neutral" position, which means your have a slight lordosis and your joints are over one another in proper position. To do it standing up, I find the best way is to imagine you have a balloon on top of your head lifting you up. Imagine it is lifting you off the ground a little bit.
To resolve the crick, it is important to restore your motion fully. To do this in the easiest and safest way: Sit in a chair with your bottom against the back of the chair and your back leaning against the chair. Often people sit up away from the back of the chair, thinking they are sitting straight but when your attention drifts onto some other topic, your muscles will start to fatigue and you will start slouching. So it is best to sit back against the chair. The slogan I typically use is "sit tall, or don't sit at all."
Next, imagine someone is coming to try and give you a kiss, but you don't want the kiss, so you lean your chest and shoulders back away from the person trying to kiss you. This is called a retraction. So you retract away, but remember to keep your eyes forward or else you won't see the kiss coming.
Perform this exercise with five to 10 repetitions and recheck your painful motion. If you notice improvements in motion or symptoms it is important to continue. Never force a movement and never continue if your symptoms get worse and stay worse. This is supposed to help reduce pain and restore motion. When you are having symptoms, it is best to do this exercise frequently. To me, that means five to 10 times per day, with five to 10 repetitions each time.
Also remember that when you are feeling good, you can try to prevent this from coming back by paying close attention to your posture and by performing these retractions.
Good luck, and let me know how it works for you.
Gloversville native Matthew Goodemote is the owner of Goodemote Physical Therapy in Saratoga Springs and Community Physical Therapy & Wellness in Gloversville. Readers may write to Goodemote at LeaderQuestions@gmail.com.