Neck Pain FAQ | Dr. Prem Pillay, Singapore
COMMONLY ASKED QUESTIONS ABOUT NECK PAIN or NECKACHE
Q: What Are The Causes Of Neck Pain?
A: The roots of neck pain lie in our modern lifestyle . At the workplace, prolonged sitting and many hours of computer use can cause neck pain. Travel with the carrying of hand luggage and laptops all contribute to neck pain. Recreational exercises performed improperly or without adequate warming up, massages with neck manipulation , poor posture etc can cause wear and tear of the cervical spine resulting in neck pain and shoulder discomfort. Most patients with neck pain have varying degrees of spinal disc degeneration.
Q: How Can I Prevent Neck Pain?
- Proper posture
This is especially important for those who use computers for long hours. This involves proper placing of the computer monitor such that your head is in a neutral position when viewing the computer screen; a proper chair with lumbar support and an arm rest such that your elbows are resting 90° to your work surface and your keyboard.Stand up and take short breaks every 20 – 30 minutes, doing neck stretches and back stretches before resuming your work.Another bad habit is talking on the phone with the receiver tucked between the neck and shoulder. This should be avoided as it puts a lot of strain on the neck muscles. Invest in a hands free device instead.
Neck strengthening exercises help but should be taught to you by a trained physiotherapist.
- Neck stretching exercises and neck strengthening exercises should be taught to you by trained physiotherapists.
- Exercising Intelligently
Exercising irregularly and without proper warm-up can put a lot of stress on your spine muscles.Jogging or aerobics on a hard ground (high-impact activities) without proper shoes is also stressful to the spine. Remember there is an equal upward thrust on your spine for every downward step.Swimming though a good form of an aerobic exercise, may actually aggravate neck pain especially strokes like the breast stroke and front crawl. In these strokes, the head is moved up and down or sideways to breathe.
However, specially designed exercises like Aquatic therapy (by trained physiotherapists ) is beneficial as it is specially designed to strengthen the spinal muscles.
- Hot Packs, and/or a warm shower can help in relaxing the neck muscles.
Q. When do I need to seek medical attention for neck pain?
A: We recommend that patients with neck pain/discomfort consult a NeuroSpine Specialist for a thorough neurological evaluation and an MRI scan of the cervical spine before embarking on any therapy The medical evaluation will include an assessment of sensation, strength and reflexes. X-rays alone are inadequate as they cannot show spinal cord or nerve compression. Your spine specialist can then recommend the various options for treatment depending on the severity of the disc disease and any nerve compression.
Q. When does surgical intervention become necessary?
A: Surgical intervention, such as microsurgery with disc replacement, becomes necessary when pain is not relieved by conservative (non-surgical) treatment or when there are neurological deficits such as weakness in the arm or hand. This is associated with the MRI showing moderate to severe nerve impingement that may be caused by a degenerated /prolapsed disc/discs, thickened ligaments, and overgrowth of bone.
The decision for surgery should be made by you and your neurosurgeon. New and advanced technology is available for the replacement of discs but there is no technology available to replace or repair damaged nerves in the spine. We therefore advise patients not to not wait until their nerves are permanently damaged. After a microsurgical intervention, patients will still need to be put through a proper and organized spine therapy program. This is for long term spine strengthening and preventing relapses. We have found in our experience that a combination of aquatic therapy with physiotherapy works best.
SURGERY MAY BE THE TREATMENT OF CHOICE IF :
- Conservative therapy is not helping
- Your symptoms are progressive in your arms and legs
- Your hands are becoming more clumsy and weak
- There is difficulty with walking and balance
- Its preventive – prevents furthur nerve injury
- You are in good health
Based on the Guidelines of the American Association of Neurological Surgeons.