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Johns Hopkins Health Alert

A Pain in the Neck

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This Health Alert is intended for readers interested in learning about the prevention, diagnosis, and management of back pain.

Chronic neck and shoulder pain are common complaints. But the good news is that with good posture and exercise it's possible to undo the effects of years of slumping and neck tension.

For many of us, "a pain in the neck" is more than just a casual cliché. In the Health, Aging and Body Composition study, 11.9% of the more than 3,000 participants reported neck pain lasting one month or longer and 18.9% reported shoulder pain. White women had the highest prevalence of neck pain (15.4%), while black women had the highest prevalence of shoulder pain (24.3%).

Because neck pain can spring from a wide variety of conditions, some of which are serious, chronic neck pain warrants medical evaluation and treatment. In many instances, however, neck pain is not caused by illness. Instead, it’s the result of years of poor posture and chronic muscle tension.

Consider how most of us spend our free time: driving, reading, watching television, and talking on the phone. At work, we may be at the computer. Unless we have perfect posture, we can often be found slouching or hunched over. Years of slumping leads to rounded shoulders and kyphosis (an exaggerated curve in the thoracic spine).

Another culprit is what’s known as forward head position. The average head weighs 12-15 lbs. When that weight is carried forward of the central line of the spine, the muscles of your upper back and neck have to do extra duty, and they tighten in the attempt to hold your head up. Eventually, these muscles become overstretched and tired. And once again, your thoracic curve becomes exaggerated.

The combination of forward head position and kyphosis has consequences throughout the entire body. Tension headaches are common, as are bursitis in your shoulders and rotator cuff problems. You may also experience lower back problems, as the rounding of your thoracic spine sets off a cascade of actions -- as your chest collapses inward, your lungs press against your diaphragm, moving it downward against the abdominal wall. This weakens the abdominal muscles, causing problems in your lumbar spine.

The Solution: Exercise -- There is good news: It is possible to undo the effects of years of slumping and neck tension. However, it takes time and patience.

If you just have garden-variety neck pain and mild kyphosis, you will need to address a series of muscle imbalances. A physical therapist or a yoga teacher who is experienced in therapeutic yoga can provide you with safe exercises. Be sure to practice slowly and gently -- years of misalignment can’t be cured overnight.

Posted in Back Pain on May 16, 2008


Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer


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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.


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