Neck Pain, Headaches and Posture
Neck pain and headaches are common problems. Approximately 20% of recurrent benign headaches have of cervicogenic cause
Physiotherapy assessment and treatment tries to find links between the patient’s posture and the presenting complaints. A common, and all too often precipitating factor is the patient’s neck and upper trunk posture. The abnormal neck posture most frequently seen, is the head forward, with the chin jutting out, shoulders rounded and thorax kyphotic.
This posture places the upper cervical spine into the extended position, the mid cervical spine has an increase in the natural curve, and the cervical thoracic junction in flexed or kyphotic (widow’s hump). This abnormal posture is aggravated by excessive poor sitting positions.
The extended sub-occipital region, leads to shortening of the sub-occipital muscles, and lengthening and weakening of the anterior deep neck flexors. The upper cervical joint movement can become restricted. These pathomechanics can irritate the sub-occipital nerves (C1-3), causing referral of pain into the head, face and TMJ region.
The stiff cervical-thoracic region, can affect the mechanics of the scapulo-thoracic region and shoulder girdle. Secondary problems can arise in this region.
The mid-cervical joints, stuck between two stiff segments, have increased compression and torsion forces placed on them and often become hypermobile and wear faster. The excessive movement can increase disc degeneration and joint degradation. Neurogenic pain is often secondary to these problems.
Physiotherapy treatment aims at:
1) Improving the joint mobility of the stiff joints
2) Stretch the shortened, tight sub-occipital muscles
3) Strengthen the weak anterior neck flexors
4) Reduce the neurogenic provocation signs
Once the joint motion has improved the muscle function is normalized we can proceed to:
5) Postural Re-education and correction
6) Stressing home maintenance program
Good improvement in neck pain, headaches and upper limb discomfort is often achieved with the above treatment protocol.
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