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The neck bones are a continuation of the spine. The top seven vertebrae are called cervical or neck vertebrae. The seventh one makes the prominent bump that you can feel where your back joins your neck. The upper-most vertebrae, the Atlas, holds up the skull. The second vertebrae, the Axis, has a vertical peg around which the head turns. The entire neck is more flexible than the back. It bears less weight but also is less well protected by thick muscles. The disc spaces in the neck can get narrow, bony spurs can form, and nerves can get caught and compressed, just as in the low back. Arthritis such as spondylitis or rheumatoid arthritis can affect the neck, and rheumatoid arthritis is particularly likely to affect the top two vertebrae, allowing the head to slip forward and backward.
Excess tension in the neck muscles can cause neck pain as well, and is probably the most common cause of neck pain. Here the pull on the ends of the ligaments causes pain in the back of the head where the neck attaches to the skull, and this pain can often shoot forward and be interpreted as a headache.
Usually, as in the low back, a neck problem is minor and will be self-limited; however, injuries do take some time to heal. Healing depends on natural healing processes. Excessive neck movement tends to slow the healing and has the possibility of causing re-injury.
Rest the neck and listen for what the pain message tells you not to do. You can fold a bath towel lengthwise so that it is a four-inch-wide strip, and wrap the neck with it, securing it comfortably with a safety pin or tape. Now you have a soft neck brace to wear at night, and this will clear up nearly half of all neck pain problems. If pain persists, use the soft collar during the day as well or buy a commercial soft collar to wear. You want some support from the collar, but more than that you want a little reminder not to turn your head too far or too fast.
Common sense says to watch out for things that aggravate the pain and to avoid them. Watching a tennis match is obviously not a good idea because of the repeated head turning required. You probably engage in other activities that require head turning and are just as damaging. For example, some people get help by wearing their glasses while reading because this enables them to be farther away from the book. Try to sit back farther from your work. Don’t reach or look over your head to get objects; use a stool.
Keep painkillers and muscle relaxants to a minimum or avoid them altogether. Aspirin, acetaminophen, or ibuprofen is all right but probably won’t make you feel better.
Sleep on a good firm mattress. Don’t sleep on your stomach, and if you sleep on your side, place a pillow so that your neck is in a neutral position, not propped up or hanging down. When sleeping on your back, use a small pillow, and place it beneath your neck as well as your head.
The time for exercise begins as the pain subsides, usually after five to seven days. Don’t rush. There are two types of exercises, stretching and strengthening, and you should do some of each. They are designed to help prevent recurrence. Start stretching exercises with gentle stretches and increase the stretches slowly, day by day. There are three maneuvers: chin toward chest, ear toward shoulder, and looking to the side. The last two should, of course, be done in each direction. Do them twice daily, each maneuver three times gently.
Strengthening exercises can begin at the same time and should start with three repetitions, twice daily. Slowly work up to ten repetitions. If you have been having recurrent neck problems, these exercises are a worth-while lifetime habit. Here are three:
1. (Shoulder shrug) Raise both shoulders towards ears, hold for two seconds, relax, repeat.
2. Take a deep, deep breath, hold for five seconds, release, repeat. The neck muscles are “accessory muscles of respiration” and breathing exercises involve the neck muscles.
3. While standing with both hands behind your back, grab one thumb with your other hand. Flex your head way back. Press down with your hands. Take a deep breath, relax, repeat. This exercise can be done lying on your stomach as well, after you get good at it standing up.