Jean’s Neck Pain
Jean’s Neck pain
Jean attended the clinic a few months back with right sided neck pain. Jean’s story is all too familiar, a 3 year history of intermittent neck and upper shoulder pain which hurts when working at the PC, driving her car (especially reversing) and whilst out socialising with friends. An MRI had shown wear and tear in the lower neck discs with a slight bulge in the C5 disc which was bulging more to the right. She had tried ant-inflammatories which gave her some relief.
Examination of Jean identified the following:
- A forward head position – head is carried forwards on neck
- The right shoulder blade was rotated downwards (imagine turning a clock on a wall in a clockwise direction)
- The right shoulder blade was additionally lower than the left
- Neck rotation to the right was limited compared with the left
- Repositioning of the right shoulder blade by rotating it anti-clockwise and lifting upwards and supporting, increased her rotation to the right equal to the left
Jean was taught to reposition her shoulder blade and practice holding in the new position. She was also taught to turn her head to the right while keeping her shoulder in this new position and instructed to keep her eyes level so as not to lean her head and neck to the right as she turned. She was given exercises to improve the activation (switching on) and strength of serratus anterior, upper and lower trapezius muscles (shoulder blade muscles) as well as exercises to improve the control of the deep neck muscles. Jean worked as an accounts manager and most of her day was in front of a PC. As such an ergonomic work station assessment was conducting using photos that she sent to us via email. From this we were able to make product recommendations that would improve her working environment and positioning while at the desk.
Jean was seen 9 times over a 3 month period each session involved progression of exercises and some hands on to loosen some restricted joints and tight muscle. At her 9th session Jean was 90% better, she was able to drive and socialise pain freely and only had pain if sat at her desk for too long (our advice being to take short 1-2 minute breaks on a more regular basis).
In conclusion, despite Jean having a bulging disc and wear and tear (like many of us) changes to her posture, movement patterns, muscle support system (in this case the muscles supporting the shoulder blade) and her working environment and habits improved her symptoms. She will always have wear and tear and a bulging disc but clearly this was not the cause of her symptoms otherwise she would still have them.
For all the geeks out there that want more information about muscle dysfunction in subjects with neck pain please check out the November 2012 Kinetic Control blog.