Take care of yourself to avoid kinks in your neck and spine, and treat these problems carefully when they do occur. Here are our answers to your questions about these painful conditions.
Q: Sometimes I wake up with a crick in my neck that makes it painful to turn my head. Should I buy a new pillow or train myself to sleep in a certain position? Should I apply ice or heat to get rid of the crick?
A: Anything from poor posture to sleeping “wrong” to sitting at a computer desk—even reading too long—can contribute to painful kinks in your neck. Chances are it’s a combination of a few of these factors and the chronic misalignment of your back and neck over time.
Take these preventive measures:
• Do core-strengthening exercises that will reduce tension and strain on your back and neck. These are:
Push-ups: This is the most important exercise of the three. Get in a classic push-up position with your hands on the floor at shoulder width apart, your back straight, and your toes or knees on the floor. Lower yourself until your chest nearly touches the ground and push back up. Resist snapping your elbows in the up position; leave them slightly bent. Look 3 inches above your fingertips so you don’t overextend your neck. Do them until you can’t do any more. If you’re not strong enough to start with standard push-ups, start with modified push-ups on your knees or even put your hands on a stair step and graduate to standard push-ups. When the push-ups become too easy, increase the number of repetitions and change the position of your hands by moving them closer together or farther apart. Tailbone Lifts: While lying on your back, place your hands—with your fingers laced—behind your head like a pillow. Lift your legs, keeping them as straight as you can above your hips. While holding this position, lift your tailbone off the ground 1 inch and slowly step it back down. Make sure to keep your chin a tennis ball’s distance from your chest; compressing your chin will add additional strain to your neck and back. Do this 25 times. Side Crunches: Lie on your back and rest your head in your hands as before. Drop your bent knees down to the left, resting your right leg on your left. Next crunch your upper body, keeping your chin a tennis ball’s distance from your chest. Focus on pulling your belly button toward your spine. Do 25 times on each side.
• When working at a desk, sit in a relaxed but upright position. Take frequent breaks and pull your head back and in to create a double chin. Feel silly? A little desk embarrassment will save your spine from becoming disrupted from long periods of slouching.
• Improve your posture. Switch from slouching to an overly erect posture. Do this as soon as you notice your bad posture and repeat the motion about 15 to 20 times every few hours throughout the day.
• Sleep on only one pillow; more can strain your back and neck. Another option: Try an ergonomic pillow—the one with the wavy profile. One of these sleep positions is best: on your back (minimizes twisting) or with a pillow under your knees (keeps body aligned).
• Avoid falling asleep in sofas, armchairs or anyplace that could harm your neck.
To relieve the crick, start with ice to reduce inflammation for 20 minutes at a time—ideally for a total of four times a day (but at least two times a day). After 24 to 48 hours, switch to heat to relax muscles; apply for 20 minutes—ideally four times a day, but at least two times a day. You also can lie with your back flat on the floor with a towel in the small of your back or neck to stretch and relax your muscles. It takes 15 minutes to realign and stretch your back muscles with this position.
If your neck keeps tightening, we suggest massage therapy or acupuncture to reduce stress and strain.
Q: I’ve got a slipped disc and terrible pain. I’ve seen two specialists: One recommends surgery, and the other says surgery is so iffy that I’m better off with physical therapy. What do my favorite docs recommend?
A: We hate to say this, but you probably don’t have a slipped disc—or as we docs say, a herniated disc. It is fourth among the five likeliest causes of back pain behind muscle pull or tear with swelling, a nerve moving against a torn tendon or ligament, and swelling of soft tissue in area near a nerve root. No. 5 on our list is a bone infection or an infection near a joint.
Physicians typically can’t use an X-ray or MRI (magnetic resonance imaging) to definitively assign blame for back pain. That’s because the images can show discs in abnormal positions in people with and without pain. So if your X-ray or MRI shows an anomaly, you might have had the herniated disc before the pain and it may not be causing the pain. This makes back pain one of the most difficult conditions to diagnose.
A herniated disc occurs when the disc (the cushion in spaces between the spinal bones, or vertebrae) ruptures or moves out of place. The injured or misaligned disc tissue can rub against nerves, causing debilitating pain, numbness or tingling in the groin or down a leg. Physical therapy, injections or surgery can help, but doctors do not like removing a disc and fusing the spine because the extra pressure on surrounding discs can cause more damage.
When deciding what to do, check the credentials of your physicians and get second and third opinions. How many patients have they seen with similar problems? What are their success rates?
Although surgery is a less common treatment (only about 10 percent of patients with herniated discs opt for an operation), those who do will often have the best outcome. Surgery is more crucial if the slipped disc causes major weakness, numbing, or nerve damage in extremities or other areas of the body. In this case, surgery will create an optimal healing environment for the nerve and keep the problem from worsening.
If you choose physical therapy, keep a detailed log of your symptoms and progress. If pain or complications increase and you haven’t improved after six weeks, move on to another treatment.
Still in a quandary? Get third, fourth and maybe fifth opinions from qualified back specialists. Inform and empower yourself to make the best decision for your health.