MATTERS
twisted to one side and stuck in that position. This is known as acute torticollis, and is caused by injury to the neck muscles. Exact cause? Could be allsorts, such as bad posture, sleep- ing without adequate neck support, or carrying heavy unbalanced loads – for example, carry- ing a heavy bag with one arm, or slinging it repeatedly over the same shoulder. Acute torti- collis can take up to a week to get better, but it usually only lasts for 24 to 48 hours.
Herniated disc or foraminal stenosis: More commonly known as a pinched nerve, herni- ated discs or bone spurs in the vertebrae of your neck can press on the nerves branching out from the spinal cord. Evidently the type of neck discomfort caused by pinched nerves is relatively easy to identify, as it will often be accompanied by tingling in the arms, and possibly hands. Treatment in most cases involves physio and manipulation.
Muscle strains: Overuse, such as too many hours hunched over your computer or smart- phone – and not infrequently, many hours at the wheel of one’s taxi or PHV – often triggers muscle strains. Even minor things, such as reading or gritting your teeth, can strain neck muscles. This category is termed medically as cervical foraminal stenosis, and is com- monly referred to as ‘wear and tear’ in the neck brought on by such repetitive activities or positioning.
the hands and legs. Symptoms can be improved with motion exercises and manipu- lation. It is important to seek medical help for any neck pain that persists, but especially this type of degenerative complaint, as it becomes harder to treat the longer you leave it.
Other health problems: Apart from the types of discomfort directly related to the structure of the neck as described above, other not so obviously related health prob- lems can affect the neck as well. These include laryngitis, airway obstruction, vocal cord polyps, mumps, mononucleosis, or possibly throat cancer.
Your neck pain may have a more serious cause if it is persistent and getting worse, or you have additional symptoms such as: a lack of co-ordination, problems walking, loss of bladder or bowel control, a fever, or unex- plained weight loss. We would not attempt to expand on these additional complications here, as we’re not medical practitioners; however, any concern whatsoever about a persistent complaint in the neck region – as anywhere else, come to that – wants report- ing to your GP, sooner rather than later.
RehabilitationREHABILITATION
This type of complaint was behind the advent of the headset, intended for use so that one didn’t continually hold the telephone between one’s shoulder and chin whilst multi-tasking, especially at the computer. Several in-depth studies looked into this matter, and conclud- ed that the use of a headset reduced neck pain by 31 per cent, as well as significant reduction in headaches and back pain. How- ever, if repetitive work postures do cause neck pain, medical treatment may be advis- able, and is likely to include both painkillers and possibly injections.
Worn joints: If the pain is more pronounced at the start and end of the day, it may well be a sign of neck arthritis. As with other joints in the body, your neck joints tend to wear down with age. Osteoarthritis, or in this region cervical spondylosis, causes the cushions (cartilage) between the vertebrae to deteriorate, and typ- ically it is more common in people over the age of 60. Nearby nerves can also be squashed, resulting in pain that radiates from the arms, pins and needles, and numbness in
OCTOBER 2015
The goal of rehab for neck pain is to help indi- viduals manage their symptoms, primarily by decreasing pain, and to increase their ability to function. As already discussed briefly, the combination of painkillers, possible applica- tion of heat packs, and physiotherapy comprises the usual programme of rehabilita- tion. Managed, supervised exercises are encouraged (despite initial discomfort) as they promote improved circulation to the involved soft tissues, and are intended to reduce the discomfort. Initial exercises may include isometrics, stretching, and gentle range of motion.
Prevention beats cure any day PREVENTION BEATS CURE
The stress caused by focusing intensely on driving can contribute to neck pain. You can avoid neck pain by adjusting what you do before you start your drive and changing the way you drive.
• Start with good driving posture. The best angle for the back of your seat is at 100 degrees, which is just shy of straight. Place your hands in the 3 and 9 o’clock positions on the steering wheel and elbows comfort- ably on the armrests.
• Support your head. Adjust your headrest so that it touches the middle part of the back of your head.
• Support your lower back. If your car seat
offers lumbar support, adjust it to fill the space at your lower back; if not, a small pil- low placed against the bottom part of your seat back will maintain the right shape from tailbone to neck. Also, make sure your seat is close enough to the steering wheel so that you don’t have to lean forward.
• Adjust your mirrors. Give yourself the widest field of vision with all your mirrors so you don’t have to move your head around to see properly.
• Avoid eyestrain. Driving with poor vision can lead to eyestrain and cause you to crane your neck forward, which puts pres- sure on your neck muscles. If you’re straining to see while driving, you need to get your vision checked. It sounds obvious, but make sure your windscreen is clean to help you see clearly. If you’re driving in bright sunlight, use sunglasses with at least 99 per cent UV protection.
• Cruise along roads. If you’re driving on long stretches of road, cruise control allows you to rest your feet on the floor and take some pressure off your back.
• Take a break. If you start to get a stiff neck, are feeling neck pain, or better yet want to prevent it, pull into the next rest stop. Do some stretching and walk off the kinks.
So there you have it – another trip round the anatomy for your amusement and edification. Yes, we try to keep things relatively light- hearted in this column, but it was suggested that we run these features in the first place (a) so the whole paper is not just talking about taxis and PHVs all the time; and (b) because members of our industry are plagued with various health issues from time to time, and we’ve fielded an awful lot of medically related questions over the years.
Maybe you were one of those who asked a question... hopefully we will have answered it, and more, for the benefit of all our readers. Hang in there! – and con- sider giving up the headbanging and bungee jumping...
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