Keep pain away

Your Health

By Dr Gita Mathai
  • Published 13.12.17

Many people suffer from pain in the neck, sometimes radiating down to the shoulders and arms. This used to be a disease of middle age. Now, young adults and even 11-year-olds complain of stiffness and pain.

The human head weighs around five kilograms, approximately 8 per cent of total body weight. Seven neck bones (cervical vertebrae) support this relatively heavy head. These bones are the smallest and weakest of all the vertebrae. They are separated by natural "washers" - little gel-like discs that act as shock absorbers and provide stability, flexibility and motility.

In childhood, the discs are composed of 85 per cent water. As age advances the water content decreases. The brittle discs can then break open, herniate or develop cracks. Damage heals poorly as the discs do not have good blood supply. The vertebrae come closer and the alignment is disturbed. The nerves to the shoulders and arms come out from between these bones. They can become pinched, causing pain and stiffness.

In people over 40, 60 per cent of X-rays show degenerative disc disease. Not everyone is, however, symptomatic. Pain can appear gradually or suddenly. It is usually sharp like an electric shock and runs down the arm.

The doctor makes a diagnosis from a physical examination, X-rays, and CT and MRI scans. Vitamin D, calcium and phosphorous levels should be checked to see if the problem started due to bone weakness.

Treatment involves pain relieving gels, heat and ice. A soft neck brace can be worn intermittently, especially during travel. Physical therapy is the mainstay of treatment. It helps to strengthen the neck muscles so that the bones are held in place even if there is degeneration. Flexion and stability exercises improve the function of the neck. Traction, massage and manipulation may be used. Pain relievers, anti-inflammatory drugs and anti-spasmodics can be tried. Surgery to remove the offending disc is usually the last resort.

School-going children with neck pain often have faulty posture while sitting in school, studying at home, watching television, or using cellphones and computers. They slouch, lean too far forwards, sit sideways, refuse to use the tables provided and manage to strain their neck muscles. In addition, they carry heavy schoolbags, often slung asymmetrically on one shoulder. As per government guidelines, the weight of a schoolbag - including all books - should not exceed 1.5kg before Class III, should be 2-3kg for classes III to V, 4kg for classes VI and VII, 4.5kg with regard to Classes VIII and IX and not more than 5kg for Class X. Unfortunately, these guidelines are seldom followed.

In young adults, the commute to college or workplace may be a long one. While seated on a bike, the back should be straight. In a car, the distance between the seat and the steering wheel should be adjusted so that the arms are slightly flexed. While using a computer or watching television, the screen should be at eye level.

Taking these precautions could save your neck.

To prevent neck strains, pains and degeneration

Maintain ideal body weight (height in meter squared X23)

• Do regular flexion and stretching exercises. Yoga is ideal.

• Maintain good posture while sitting and standing with shoulders straight and feet flat on the floor.

• Do not use a high pillow while sleeping.