TEXT NECK: THE PAIN OF TECH­NOL­OGY

DR. RAVEES RAJA (PT). MPT, DRT, CKT, CDNT.

Airports India - - CONTENTS - Dr. Ravees Raja (PT). MPT, DRT, CKT, CDNT is a trained phys­io­ther­a­pist and re­ha­bil­i­ta­tion ther­a­pist. You can con­tact him at [email protected]

Walk down a busy city street and try to find some­one that makes eye con­tact; you are more likely to lit­er­ally bump into some­body walk­ing to­wards you so en­grossed in their smart phone world that their walk­ing is slow, au­to­matic and inat­ten­tive and they are at risk of ac­ci­dents. This ap­plies to peo­ple of all ages. A re­cent study shows that 79% of the pop­u­la­tion be­tween the ages 18 and 44 have their cell phones with them al­most all the time—with only 2 hours of their wak­ing day spent with­out their cell phone on hand. The so­cial im­pli­ca­tion of this epi­demic is al­to­gether an­other topic, but of con­cern in the modern era is the po­ten­tial mus­cu­loskele­tal con­se­quence of this be­hav­iour. We of­ten text with our head down and chin pok­ing out. It re­sults in se­vere pain from ex­ces­sive use of hand­held de­vices. This in­duces a pe­cu­liar prob­lem – Text Neck – from look­ing down at your cell phone or other wire­less de­vices too fre­quently and for too long.. Text neck may cause se­vere neck pain, up­per back pain, chronic headaches and per­ma­nent da­m­age to the cer­vi­cal spine.

Text neck is of spe­cial con­cern as it is seen in an in­creas­ingly younger pop­u­la­tion. Mo­bile users fre­quently adopt a pro­longed for­ward head pos­ture. Text neck di­rectly af­fects the spine as it flexes the head at vary­ing an­gles – when the head tilts for­ward at 15 de­grees, the forces on the neck surge to 27 pounds, at 30 de­grees it is 40 pounds, at 45 de­grees it is 49 pounds, and at 60 de­grees it is 60 pounds, and at 90 de­grees it is game over. This is­sue is a ma­jor con­cern with chil­dren since, their heads are larger in re­la­tion to their body size than adults, and thus may cause al­tered cur­va­ture of the spine and early on­set of arthri­tis in the neck.

RISKS:

t &BSMZ XFBS BOE UFBS BOE TUSBJHIUFOJOH of the cer­vi­cal spine’s nat­u­ral curve. t $ISPOJD OFDL QBJO t $ISPOJD OBHHJOH VQQFS CBDL QBJO UP se­vere up­per back mus­cle spasms. t 4IPVMEFS QBJO BOE UJHIUOFTT SFTVMUJOH in painful shoul­der mus­cle spasms. t " QJODIFE DFSWJDBM OFSWF SBEJBUJOH

pain and neu­ro­log­i­cal symp­toms, through your arm, into your hand. t &ZF TUSBJO t )FBEBDIFT

TIPS TO AVOID TEXT NECK:

t .BLF BO FČPSU UP TUBZ JO OFVUSBM po­si­tion so that your ears are aligned with your shoul­ders. t 4JNQMZ IPME ZPVS QIPOF UBCMFU PS

lap­top high up, at eye level, in front of your face, keep­ing your head straight. t *G ZPV XPSL JO BO PĎDF NBLF TVSF UP

sit up straight in your chair, and that your screen is set up so that when you look at it you are look­ing for­ward, with your head po­si­tioned squarely in line with your shoul­ders and spine. t "WPJE TQFOEJOH BMM EBZ IVODIFE PWFS

com­put­ers and phones. Take fre­quent breaks and set an alarm that re­minds you to get up and walk around ev­ery 20 to 30 min­utes, and phys­i­cally stretch or re­lax the neck mus­cles. Many peo­ple don’t know this, but you need to have strong core mus­cles—the ab­dom­i­nal and lower back mus­cles—

to sup­port your up­per body, in­clud­ing your neck. Your core mus­cles usu­ally do not get enough ex­er­cise dur­ing nor­mal daily ac­tiv­i­ties, so you need to do spe­cific ex­er­cises to tar­get these mus­cles. You also need strong and flex­i­ble mus­cles in the neck to min­i­mize strain on your cer­vi­cal spine and help sup­port the weight of your head. Again, your neck will not get suf­fi­cient stretch­ing and strength­en­ing dur­ing nor­mal daily ac­tiv­i­ties, so it is best to learn spe­cific neck ex­er­cises with the help of a health pro­fes­sional.

HOW PHYSIOTHERAPY CAN HELP:

A good phys­io­ther­a­pist will usu­ally fo­cus on get­ting rid of any mus­cu­lar im­bal­ances, stiff­ness, mus­cu­lar tight­ness, in­flam­ma­tion and re­liev­ing the com­pres­sion. He will try var­i­ous soft tis­sue ma­nip­u­la­tions, joint mo­bi­liza­tion and strength­en­ing tech­niques. They in­clude: t .ZP GBTDJBM SFMFBTF PG OFDL NVTDMFT

in­clud­ing sub oc­cip­i­tals mus­cu­la­ture. t 4USFOHUIFOJOH PG EFFQ OFDL ĘFYPST CZ chin tucks. t .BJOUBJO BO PQUJNBM length of mus­cles around the neck, by stretch­ing of mus­cles such as Up­per trapez­ius, Ster­n­ocleiodomas­toid, le­v­a­tor scapu­lae, Scalenes, pec­toralis mi­nor, etc. t 4FUUJOH ZPV FYFSDJTFT GPS

strength­en­ing of scapula sta­bi­liz­ers, rhom­boids, mid­dle and lower trapez­ius and shoul­der ex­ter­nal ro­ta­tors.

If you head to a pro­fes­sional, a trained ther­a­pist who can mas­sage and ma­nip­u­late the cor­rect neck mus­cles, not only does this pro­vide pain re­lief, it is crit­i­cal to the re­ha­bil­i­ta­tion. De­creas­ing the tight­ness in the mus­cles, and re­align­ing your neck, can al­most in­stantly re­duce your stiff­ness.

A phys­io­ther­a­pist can help you per­form mo­bil­ity ex­er­cises such as look­ing to­wards ceil­ing and down a few times and look­ing to­wards your shoul­der tip while main­tain­ing nor­mal cur­va­ture of cer­vi­cal spine and try­ing to touch your ear lob­ule with your shoul­der on the same side.

You need to im­ple­ment an ex­er­cise pro­gram at home to help your pain and re­hab ap­pro­pri­ately. Ex­er­cis­ing will help to re­duce the stiff­ness that you feel, and will en­sure that any ma­nip­u­la­tion you had is main­tained. A strong neck is a healthy one. Range of mo­tion ex­er­cises are of­ten nec­es­sary at the be­gin­ning. Gen­tle stretch­ing ex­er­cises, iso­met­ric, and other low im­pact neck strength­en­ing ex­er­cises can be im­ple­mented.

In ad­di­tion to stretch­ing, any form of low-im­pact aer­o­bic ex­er­cise, such as walk­ing, is of­ten help­ful in re­liev­ing any type of stiff­ness. Even if walk­ing does not di­rectly in­volve the neck, it helps cir­cu­late oxy­gen to the soft tis­sues through­out the spine, which in turn pro­motes heal­ing.

These ba­sic ex­er­cises are help­ful but if

your con­di­tion is not re­lieved by this and you also have symp­toms such as dizzi­ness, fever, nau­sea, headaches, fa­tigue, mood swings, con­sult a doc­tor im­me­di­ately, as it could sig­nal a se­ri­ous ill­ness.

Some peo­ple may also ben­e­fit from a more com­pre­hen­sive treat­ment plan, such as com­bin­ing man­ual ad­just­ments with mas­sage ther­apy and cold-hot laser ther­apy. Rest­ing is the first step to al­low any in­jury to heal, and it is no dif­fer­ent in this case. En­sure that you give your body enough time nat­u­rally to de­crease the in­flam­ma­tion and pro­mote the heal­ing process. Any ex­er­cise or ac­tiv­ity such as use of the mo­bile de­vice that ag­gra­vates the neck, or repli­cates the symp­toms, should be stopped im­me­di­ately. Some­one who swims may want to avoid cer­tain swim strokes that in­volve lots of head twist­ing for a few days. How­ever, it is rec­om­mended to limit rest to one or two days, as too much in­ac­tiv­ity can lead to a weak­en­ing of the mus­cles, and weak mus­cles have to strug­gle to ad­e­quately sup­port the neck and head.

Set­ting up a work­sta­tion to be er­gonom­i­cally-friendly, lift­ing heavy items with the legs rather than the back, or sleep­ing on the back or side with an er­gonomic pil­low and be­ing aware of pos­ture through­out the day can keep the spine nat­u­rally aligned and min­i­mize stresses on the neck.

A home rem­edy and very sim­ple to do is al­ter­nat­ing be­tween hot and cold packs on the af­fected area to re­duce the pain and in­flam­ma­tion. 20 min­utes is a good time to work by, and you can get packs that you can heat and cool.

Lastly, if the symp­toms and the pain is se­vere, then med­i­ca­tions be­come nec­es­sary. As much as you love to de­crease your pain nat­u­rally, of­ten it is im­por­tant in neck treat­ment to use some form of pain and in­flam­ma­tion med­i­ca­tion (NSAIDS). They can help to re­duce pain ini­tially. Some­times, dry nee­dle ther­apy or in­jec­tions may be help­ful, but these should only be last-ditch mea­sures.

Although it now seems rather clear that repet­i­tive tex­ting or sim­i­lar ac­tiv­ity while us­ing a for­ward flexed neck po­si­tion, may lead to neck pain or text neck, what is cur­rently un­known is whether this poses a risk for in­ter­ver­te­bral disc de­gen­er­a­tion and con­se­quent cer­vi­cal spondy­lo­sis. Per­haps of even greater con­cern is the po­ten­tial risk to the de­vel­op­ing spine, con­sid­er­ing the young age at which cell phones are now used by chil­dren.

The most com­mon cause of this painful con­di­tion called Text neck is poor pos­ture. Few other fac­tors that con­trib­ute to this type of pain are poor sleep­ing habits, poor sit­ting habits, cold drafts, stress, etc. The 20-20-20 rule which means ev­ery 20 min­utes take a 20 sec­ond break and fo­cus the eyes on some­thing at least 20 feet away is rec­om­mended prac­tice in or­der to avoid mus­cu­loskeltal prob­lems re­lated to text neck. The cor­rect pos­ture to pre­vent text neck syn­drome is the ears aligned with the shoul­ders and the shoul­der blades.

Most im­por­tant of all, don’t slouch while us­ing mo­bile de­vices. The bot­tom

line is to avoid look­ing down with your head bent for­ward for ex­tended pe­ri­ods through­out the day. Spend a whole day be­ing mind­ful of your pos­ture—is your head bent for­ward when you drive? When you watch TV? While read­ing? Any pro­longed pe­riod when your head is look­ing down is a time when you are putting ex­ces­sive strain on your neck. Straighten the mid-back and lift the chest and head through­out the day. This also ap­plies to sit­ting, where slouch­ing seems al­most au­to­matic. Sit straight on the butt, not on the lower back, and main­tain the lum­bar curve by sit­ting back in a chair with a lum­bar sup­port. Keep the chest and head held high. And learn­ing to stand straight can also be a chal­lenge. You fi­nally un­der­stand that you had al­ways been lean­ing for­ward when you find it feels un­nat­u­ral to stand straight against a wall—with butt, shoul­ders/up­per back, head touch­ing the wall and knees slightly bent. If the back of the head doesn’t touch, do not force it and do not tilt it back; but straighten ex­ces­sive curve of the up­per back, if it is still flex­i­ble, with a deep breath, which will bring the head back, and fix the shoul­der blades in the proper pos­ture with the cor­rect move­ments. The longer good pos­ture is main­tained, the more nat­u­ral it feels and the stronger be­come the pos­tural sta­bi­liz­ing mus­cles. Main­tain­ing good pos­ture is dif­fi­cult; but do­ing it strength­ens pos­tural sta­bi­liz­ing mus­cles (the Core), which in it­self is le­git­i­mate ex­er­cise.

SCALENES STRETCH

PECTORAL STRETCH

STERNOCLEIDOMASTOID STRETCH

LE­V­A­TOR SCAPU­LAE STRETCH

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