Neck
Neck
In ancient times, people thought the soul lived in the base of the neck. They wore amulets there to ward off evil. Over the years, the amulets turned into necklaces. They lost their soul connection; they turned into the jewelry industry.
Yet the base of the neck is an apt place for the soul. Isn''''t that where we get choked up with emotion? And a beautiful sunset or a touching look can take our breath away.
| Beauty Mistreatment? The doctor was baffled. Michael Weintraub, M.D., clinical professor of neurology at New York Medical College in Valhalla, had seen five women who all showed symptoms of stroke--and all from an unknown cause. All reported severe dizziness, numbness in the face and a sense of imbalance. Then he found out what they had in common. Each woman said the symptoms first occurred in the beauty parlor, when she bent her head backward over a sink. Since he first published his findings, Dr. Weintraub has learned of about 75 more cases--all in beauty parlors and hair salons when women were getting shampoos. When you bend your head backward, that angle compresses certain arteries in the back of the neck. That slows the passage of blood to the brain. The symptoms described by Dr. Weintraub''''s patients could pass quickly, but if they last a long time, it could mean that the decreased blood flow (ischemia) is severe enough to potentially cause a mild stroke (infarction), he says. Beauty parlor shampoos aren''''t the only triggers. Other activities that put the neck in that extreme position, such as painting a ceiling, could produce the same effect, Dr. Weintraub says. Are you at risk for beauty parlor stroke? You might be if you are developing hardening of the arteries (atherosclerosis) or arthritis in your neck or if you were born with an underdeveloped (hypoplastic) artery. So if you know you have any of these conditions, avoid bending your neck back beyond a 15-degree angle, says Dr. Weintraub. He recommends bending your head forward over the sink when you''''re getting shampooed. |
Even today, the neck can still use some celestial protection. Consider the burden it carries--a whole head, weighted with brain matter, eyeballs and other odds and ends. "It''''s like a 14-pound bowling ball on a thin pole," says Annie Pivarski, orthopedic physician''''s assistant and ergonomics and injury prevention program supervisor at St. Francis Memorial Hospital in San Francisco. "It''''s subject to the forces of gravity, and it''''s a difficult area to keep stable."
Besides holding up your head, the neck has a lot of other important assignments. The muscles in your neck help you move your mouth and jaw. It is also a conduit for essential organs and vessels, including the vocal cords, the larynx and the major blood vessels that lead to the brain.
The slender column of the neck is the most vulnerable part of your spine, says Louis Sportelli, D.C., director of public affairs for the American Chiropractic Association and a chiropractor in Palmerton, Pennsylvania. "The neck is just seven small cervical bones--vertebrae--supported only by muscles and ligaments."
Like the rest of the spine, the neck has spinal disks nestled in the facet joints between each cervical bone. "Those joints are designed to move," says Scott Haldeman, M.D., D.C., Ph.D., associate clinical professor of neurology at the University of California, Irvine, and adjunct professor at Los Angeles Chiropractic College in Whittier. "The joints get nutrition through movement. The cartilage in the joints doesn''''t have a blood supply of its own, but the ligaments and the bone have a blood supply bringing nutrients to the joints. The flow of nutrients increases when the joints move."
Basic Neck Rules
We sometimes move our necks all wrong. And when we''''re deep in concentration, we don''''t move them at all. That''''s often how we end up getting a pain in the neck.
"Don''''t let an episode of neck pain alarm you," says Jeffrey Susman, M.D., member of the U.S. Public Health Service Agency for Health Care Policy and Research and vice-chairman of family medicine at the University of Nebraska College of Medicine in Omaha. "The good news is that 90 percent of the time, you''''ll be well again within a month. Neck pain does tend to recur, but it''''s not disabling; it almost always resolves spontaneously. And it''''s not something that needs extended treatment or evaluation."
Here are two things that you can try to avoid that first episode--or to prevent a recurrence.
Don''''t stick your neck out. You stick your neck out hundreds of times a day, says Wayne Rath, P.T., co-director of Summit Physical Therapy in Syracuse, New York. "You get up in the morning, and you poke your head up out of bed. You brush your teeth, and you poke your head forward over the sink. When you eat, you poke your head forward, too."
| Some New Nods for a Nimbler Neck You''''re being cruel to your neck if you hold it in one position too long or keep it under strain. Try this exercise recommended by Annie Pivarski, orthopedic physician''''s assistant and ergonomics and injury prevention program supervisor at St. Francis Memorial Hospital in San Francisco. She suggests that you do it to keep your neck limber--and at the end of every day to relieve stress. 1. Use a mirror and look straight ahead, with your ears aligned over your shoulders. 2. Slowly drop your head toward your chest and hold for 30 seconds. Then return your head to starting position. 3. Slowly rotate your head to the left as far as you comfortably can, and hold it there for 30 seconds. Return to the starting position. 4. Rotate your head to the right side and hold for 30 seconds. Return to the starting position. 5. Slowly drop your left ear toward your left shoulder; hold for 30 seconds. Return to the starting position. 6. Drop your right ear to your right shoulder, hold for 30 seconds and return to the starting position. |
Then, if you sit at a desk or work over a table, you round your shoulders and tilt your head and neck forward again. That angle plays havoc with the ligaments in the back of your neck and upper back, as they strain to hold their unnatural position. No wonder your neck protests--with stiffness, pain or a crick.
To prevent that protest, remember that the neck is least stressed when you have your ears aligned over your shoulders, not in front of them. Whenever possible, try to keep your head lined up in that position to avoid neck ache, suggests Rath.
Move it. You''''re caught up in a movie, a Scrabble game, a book. You don''''t move a muscle. But not moving is a bad move, too. In addition to slouching and sticking our necks out, "holding a static position is one of the worst crimes that women commit against their necks," says Pivarski.
When you don''''t move your neck, the ligaments tighten and your neck stiffens up, says Dr. Haldeman. The lubrication to the joints of your neck begins to decrease. Parched, the tissue fibers stick together and move only grudgingly. So whatever you''''re doing, take a break now and then to mobilize your neck and get the fluids flowing again.
Kicking the Cricks from Desk Work
Most of the desk work we do is a period of purgatory for our necks. In fact, people who spend their days behind a desk lose about 30 percent of their neck strength, according to research findings of Wayne Westcott, Ph.D., national strength training consultant for the YMCA.
All neck experts recommend a regular neck break for people who work at their desks all day. "It''''s important. Take a five-second break, sit up straight and go through two or three flexibility motions," says Philip Paul Tygiel, P.T., owner of Tygiel Physical Therapy in Tucson, Arizona.
In addition, here are some other ways to make your desk work more neck-friendly.
Prop your papers. While some head movement is desirable, you don''''t want to pivot your head and rotate your neck all day long. You can buy devices that clip onto your computer to hold your documents at eye level so you don''''t have to tilt your neck. Or use a slant board, which raises the papers so you don''''t have to tilt your head as much.
Pivarski thinks that the best technique is to position your documents between the keyboard and the computer monitor. "Then you can just glance up at the screen, instead of rotating your head to one side all day."
Eyeball the computer. While some experts believe that looking down may be easy on your eyes, others think it''''s easier to look straight ahead because you maintain the alignment of your neck. The idea is to keep the head in a relaxed, neutral position, according to Dr. Susman.
Stretch the other way. If you do turn your head to one side frequently--to sip a drink, look out the window or grab the phone--make sure you also turn your head in the opposite direction from time to time, says Pivarski. If you have a water bottle on your right, for instance, swap it to the other side of the computer for half the day. Or, if you just automatically turn to the right a lot, take a break, turn your head to the left and hold for 30 seconds.
Pillow Talk
Since most of us sleep on pillows, we need to entrust our necks to reliable ones. Some pillows are neck nightmares. Sleeping with no pillow is reasonable if you''''re sleeping on your back, according to John E. Dunn, M.D., clinical professor of orthopedic surgery at the University of Washington School of Medicine in Seattle.
The best sleeping position mirrors--horizontally--the best standing position. When you lie down tonight, notice whether each ear is directly lined up with each shoulder. That''''s the way it should be. It''''s important that your head is aligned with your shoulders and body, whether you''''re lying on your side or on your back, says Dr. Dunn.
Try sleeping on your back with a pillow beneath your knees. That''''s the most comfortable position, says Edward Hanley, M.D., chairman of the orthopaedics department at Carolinas Medical Center in Charlotte, North Carolina. "If you can, look at yourself lying down. Your body should make a straight line down the mattress. Just make sure that your pillow doesn''''t cock your head up, the way some large, foam-filled pillows do."
Here are some other ideas to make your neck more comfortable all night long.
Coddle your head. Pillows made especially for neck comfort and support come in a number of variations. Some full-size pillows have separate sections to support both the head and the neck. Others have elevated neck-roll sections or indentations for the neck.
Audition a neck pillow. For easy neck rest when you''''re sitting in a car or plane, check out the curve-shaped pillows that hold your neck in place. With one of those, even if you doze off while you''''re traveling, your head won''''t fall over to one side.
| Are You Rubbernecking at Work? It is said that every parent favors one child over the rest. But why do you favor one eyeball over the other? Turns out, most of us have left-eye or right-eye dominance, according to Emil Pascarelli, M.D., professor of clinical medicine at Columbia Presbyterian Medical Center in New York City. Unless you recognize which eye is dominant, you could be causing neck or shoulder pain without even knowing it. If you are right-eye dominant, you should avoid reading from pages placed on the left side of a computer terminal, says Dr. Pascarelli. You''''ll be constantly over-twisting as you try to bring that page into view. It''''s the over-twisting of your neck that can lead to shoulder pain as well as neck pain, he says. To find out whether you are right- or left-eye dominant, try a simple test described by Dr. Pascarelli. Holding both arms straight in front of you, press the index fingers and thumbs of each hand together to form a small, square hole. Bend your arms and "pull" the hole towards your eyes, while gazing at a single object. Whatever eye your hands go towards naturally is your dominant eye. If you do this test and find that you''''re right-eye dominant, you may be able to reduce shoulder and neck pain by placing your reading material to the right side of your computer, says Dr. Pascarelli. If you''''re left-eye dominant, place the material to the left. That way your dominant eye is closest to the material and neck twisting is reduced to a minimum. To avoid the risk of whiplash, raise the headrest to the position shown--so it meets the back curve of your skull. In this position the headrest is too low and won''''t prevent your head from snapping backward in a collision. |
Where to shop? Many catalog companies that specialize in bedding (such as the Company Store) offer neck pillows. They''''re also available in medical supply stores or from sources such as Backsaver that specialize in back devices. Or you can make your own by rolling up a towel in cylinder shape. Experiment with different sizes and thicknesses until you find the most comfortable and supportive size.
Getting Stiff-Armed by Stiffness
Every once in a while, out of the blue, you wake up with a stiff neck. It''''s like a fly in the house. How did it get in? What''''s it doing here?
If you like quick, sure answers, better not hold your breath. Doctors aren''''t sure what a stiff neck is, much less what causes one.
"The traditional orthopedic thinking is that stiff necks happen when muscles spasm so hard that they tear some of the fibers. But to be honest, I''''m not really sure about that," says Dr. Dunn.
Experts have made some good guesses, however. They suspect that bad posture (especially at a desk), an awkward sleeping position and stress are possible causes.
Whatever is prompting your stiffness, here''''s what doctors recommend for relief.
Wait it out. "It won''''t last long," says Dr. Dunn. "If the pain is killing you, take aspirin or acetaminophen to break the pain spasm cycle." Just follow the directions on the label.
Wash that crick right out of your neck. A long, hot shower may provide a balm of relief, as long as the pain is not acute. Just stand under the shower head and let it rain warmth on your neck, suggests Pivarski. "It relaxes the muscles in the neck."
Or go cold. "There''''s a lot of controversy about whether to use ice or heat for neck pain," says Dr. Hanley. If the pain gets worse, you might try an ice pack or an ice bag wrapped in a towel. "In general, acute pain responds better to ice."
Wrap a bag of ice or an ice pack in a towel and press it to the sore area of your neck for about ten minutes. Take 20-minute breaks between treatments, so your skin doesn''''t get numb from the cold, adds Dr. Hanley.
Whipping Whiplash
Jokers call it "litigation neurosis," but whiplash is no joke if you have it. If you get rear-ended in a car accident, there''''s a good chance that you''''ll end up with the tender, swollen neck and the pain that come with whiplash. It happens when the violent motion of a collision throws the neck forward and backward, usually straining or spraining the muscles and ligaments in the neck area.
But you can give yourself whiplash, too--and sometimes it doesn''''t take much. Trying to look cool, for instance: "When young boys started wearing their hair long, they''''d flip their heads to get the hair out of their eyes and strain the neck muscles and ligaments similar to a ''''whiplash,'''' " recalls Dr. Sportelli.
Marilyn Kassirer, M.D., assistant clinical professor of neurology at Boston University School of Medicine identified "head bangers'''' whiplash," caused by eighth-grade dancers jerking their heads to and fro at a dance marathon. Most of the teenage whiplash cases--nine out of ten--were girls, and Dr. Kassirer thinks that is because they had longer hair to whip.
Fortunately, "about 80 percent of mild whiplash pain resolves itself in 1 to 12 weeks," says Dr. Sportelli.
Women wind up with more whiplash than men, though, says Randolph W. Evans, M.D., clinical associate professor of neurology at the University of Texas Medical School at Houston. "The ratio is about 70 percent to 30 percent. The reason might be that women have narrower necks than men." A smaller neck means less muscle mass--so there''''s simply less support for all the weight of the head.
If your doctor says that you have whiplash, she might prescribe anti-inflammatory medication, limited use of a neck collar and neck exercises to build up strength and flexibility.
Of course, it''''s best if you never get whiplash. One way to avoid it is to properly adjust the headrest in your car.
To avoid the risk of whiplash, raise the headrest to the position shown--so it meets the back curve of your skull. | 
In this position the headrest is too low and won''''t prevent your head from snapping backward in a collision. |
A headrest isn''''t something to rest your head against when you''''re stopped at a red light, Dr. Evans points out. Its original name was "head restraint," and that''''s exactly what it''''s meant to do--restrain your head in case of an accident. A properly adjusted head restraint can reduce the incidence of neck pain by 24 percent, according to Dr. Evans. "But 75 percent of all head restraints are left unadjusted, in the down position. And they don''''t protect a person of average height." To position the restraint correctly, raise it so the back curve of your skull is against the head cushion. If the cushion is pressing against the upper part of your skull, the restraint is too high, and if it''''s poised at the nape of your neck, it''''s too low. Just remember to readjust it when you''''re a passenger, too, suggests Dr. Evans.
Better Luck with Neck Time
You can tell a woman''''s age by her neck, says Seth Matarasso, M.D., assistant professor of dermatology at the University of California, San Francisco, School of Medicine. "The fat below the skin on your neck atrophies as you age. That skin gets paper-thin and starts to wrinkle. Sun exposure causes fine lines, too." His advice is to be just as diligent about applying sunscreen on your neck as you are about spreading it on your face or shoulders.
Another way to keep your neck looking younger is to use an exfoliant cream or lotion, such as the prescription drug tretinoin (Retin-A) as a "facial peel." Any products that contain glycolic acid, such as Avon''''s Anew creams, will "peel" the top thin layer of dead skin cells from the surface of your neck, which minimizes fine lines and makes age blotches or freckles less prominent. "There is some evidence that exfoliants thicken the skin, too," says Dr. Matarasso.
See also Muscular System, Nervous System, Skeletal System
