PAIN MANAGEMENT

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NECK

Looking down at your phone, spending long hours using the computer and other modern practices are some of the main causes of neck pain. However, people fail to understand the severity of neck pain, believing that time or a massage can take it away easily. Can neck pain be that serious? Are we ignoring the pain signal that our body is telling us?

Neck pain is a symptom. When a patient comes to a doctor presenting neck pain, there are a few diseases that need to be considered. The mechanism of neck pain can be categorized into 2 sections: 1. Diseases due to the cervical spine such as Cervical Spondylopathy and Atlantoaxial instability 2. Diseases due to the muscle, tendons and ligaments at the neck area such as Stiff Neck, Neck Sprain and contusion, myofascitis. As a majority of cervical spinal problems are due to age related degenerations, it is most commonly observed in people at the age of 40 and above. However due to certain lifestyle and posture habits in recent times, it is observed that more and more younger people are seeking treatment for neck pain that is due to cervical spinal problems. Diseases due to the muscle, tendons and ligaments, on the other hand, can happen to anyone.

What are the causes of neck pain?

1) Chronic Fatigue and poor postures.
Bending down your head to do work, spending long hours using the computers, sleeping on pillow that is too thick or thin, sudden sharp movement of the neck can result in chronic fatigue of the neck. This will result in the muscles in the neck area to be under constant strain and spasm, affecting the blood and fluid circulation of the area, over time there will be a buildup of inflammatory elements that results in the soreness of the neck. If not treated well, it will result in muscle tissue degeneration, hypertrophy, and the formation of fibrous nodules

2) External Injury
The physiological range of movement of the neck area is big, this means that the cervical spine will have to depend highly on the muscles of the neck to provide more stability. When there is an external force on the neck, the muscle, ligaments and joints are easily strained, cause localized swelling. For many people, the formation

3) Long Term Exposure to External Cold Wind Damp Pathogen
Long exposure to the humid weather of Singapore as well as the coldness of the air conditioned indoor environment will result in the stagnation of qi and blood in the body and cause pain.

4) Developmental Disorder
Depressed skull base, congenital vertebral fusion , root canal stenosis, and so on are congenital abnormalities. Asians as compared to the Europeans and Americans to have smaller spinal root canel volume hence they are more prone to cervical spondylosis myelopathy .

What are the symptoms for neck and shoulder pain?
Neck and Shoulder feels sore and pain, the muscles of the neck is stiff, dizziness, hand numbness. If you have the listed symptoms you might be experiencing neck and shoulder pain.

How to prevent neck and shoulder pain?
1) Choosing the right pillow

pillow1 a) A good pillow can provide good support to our neck allowing the neck, shoulder, hip bone and heels to be on the same equilibrium line.
pillow2 b) If the pillow is too thin, it will cause the head to move away from the equilibrium line, resulting in straining of the neck , over time, it will lead to pain and discomfort. Due to the weight on the should joint, stiffness and discomfort of the joint follows.
pillow3 c) If the pillow is too thick, it will cause the head to move away from the equilibrium line. This will cause the neck to be strained as well as narrowing the airway causing snoring problems.

2) Postures Adjustments

Maintaining good postures is very important to the health of the cervical spine. Whether you are sitting down or standing, it is good to maintain with a head upright, shoulders straight and balanced. For working people that have to be at the computer the whole day, the following are the things to take note of:
1. Tilt the body a little backwards for better support on the neck to prevent fatigue.
2. Place your arms on arm supporter to allow the shoulders to relax.
3. Adjust the chair’s height to make it on the same height as the keyboard.
4. The computer screen should be at eye level.

3) Keeping the neck area warm
It is important to keep the neck area warm to prevent the wind, cold and damp external pathogen from affecting the qi and blood flow at the neck area.

4) Neck Exercises
a. Look towards your upper left directions until the rotation of the head it to its maximum. Maintain in this position for 3-5 seconds. You will feel a stretch on your right. Do the same for your right upper direction.
b. Look to your left lower direction, looking at your left feet. Maintain in this position for 3-5 seconds. Do the same for your right lower direction.
c. Turn your head until the right ear is close to the right shoulder, extend it to the maximum and maintain in this position for 3-5 seconds. Do the same for the left
*Patients with severe Cervical Myelopathy, dizziness or cervical radiculopathy should do this exercise with care

5) Acupoint massage

jianjing
a. Jian Jing
This acupoint is located on the shoulder and at the midway between dazhui and the acromion

fengchi 

b. Feng Chi
This acupoint is located below the occipital bone, parallel to fengfu and in depression between the upper portion of m. sternocleidomastoideus and m.trapexius or at the midpoint between Yifeng and Fengfu or at the upper part of the trapezius on both sides with the thumb and index finher parallel to the external occipital protuberance.

houxi
c. Hou Xi
When the hand is slightly clenched, the acupoint is located on the ulnar side, proximal to the fifth metacarpophalangeal joint, at the end of the transverse crease and the junction of the red and white skin​