Neck and shoulder pains have become extremely common as a result of lack of exercise and a stressful lifestyle. A new term repetitive strain injury or RSI has been coined for this epidemic of neck and shoulder pain in young individuals. Neck pain could be nagging in milder cases or severely disabling, interfering with sleep at night and daily activities. The pain may be in the upper limb, shoulder, hands along with tingling and numbness in these areas. Moreover, many patients experience symptoms that vary at times from severe neck and shoulder pain ranging from headache, pain on lying down, etc to dizziness. which interfere with day to day activities.
The causes for all these problems could range from
1.Cervical Disc prolapse with muscle spasm- This may require an epidural injection of steroid followed by IMS or may need surgery .
2. Irritation of facet joint with muscle spasm muscular spasm, or or a frank arthritis of facet joints in older people. This may need facet injections or RF Radiofrequency ablation of nerves to the facet followed b IMS
3. Non specific neck pain: Is a condition where no specific cause can be foud for precision diagnosis. At Ashirvad, we find that it is usually purely a muscle spasm. The most common cause of neck pain RSI ( repetitive strain injury etc. ) The muscle bulk of neck is quite high ( 3-4 times the bulk of bone and other tissues). This bulk is a design of nature to support as well as move the head up to 180 0 range in 3 directions. The weight of the head is considerable ( roughly supposed to be about 1/6 the body weight). If you wish to have an idea of what this means. Just try to carry a similar weight in your hands and you will see how soon you get exhausted and have to drop the weight. Neck muscles carry this weight for hours together at a stretch and over a lifetime. So what is surprising is not why neck problems arise but why more people do not get neck problems! . When these powerful muscles go into spasm they can cause very severe pain. Please also remember that these muscles are still carrying that weight while crying out in pain. As you can see, whatever the pathology causing the neck pain, muscle spasm is a common factor. Unless this is addressed the problem rarely goes away for good.
Hitherto the neck muscle spasm has been addressed by referral to a physiotherapist. This is very useful if the problem is of a mild and temporary nature and the problem goes away only to return after a few months or years. But where the problem is moderate to severe or is recurrent PT alone cannot help .It is then that something else is necessary. Hitherto there was no tool to remedy muscle spasm trigger injections have been tried but again, have a temporary effect
IMS alone done scientifically can achieve a restoration of neck muscle health that can be easily maintained by regular exercise.
Conditions treated in Neck pain:
• Cervical discs causing neck pain and pains radiating down to the forearm
• Cervical facet joint pains - mainly neck pain that radiates to shoulder occasionally the arm
• Cervical muscle spasm- mainly neck pain that radiates to shoulder and elbow
• Pain persisting after neck surgery
At Ashirvad we lookat this problem from a holistic point of view. As in the treatment of low backache, treatment ranges from,
We look for and correct deficiencies,
Simple posture correction, Physiotherapy and non-invasive modalities.
Trigger injections and IMS of neck, shoulder and upper extremity.
More invasive procedures like epidural injection, facet joint procedures.
More sophisticated procedures like RF (radiofrequency ablation of nerves to facets).
The treatments mentioned are usually followed by IMS to maintain the results.
Physical therapy; is essential to achieve as well as sustain the pain relief. At Ashirvad we have adapted and incorporated many yoga practices as part of physical therapy.
The dizziness especially on changing positions of the head gets labeled as
1. Insufficiency of flow in vertebrobasilar blood vessels but vascular studies rarely confirm the insufficiency.
2. Inner ear problems
3. Cervicogenic vertigo.
In most patients, the problem lies in the neck muscles. It is the neck muscles that that hold up the head and thus determine any tilt or angling of the head which in turn determines the position of semicircular canals. Correction of the spasm with restoration of suppleness to the neck muscles invariably resolves the cervicogenic vertigo.
The only way to correct this is by restoring a normal length to the shortened muscles of the neck that tilt it just so. At Ashirvad we treat them with IMS with very gratifying results. The severity comes down dramatically even with the first session followed by a complete resolution of the problem with subsequent sessions.
In some patients Epley’s Manouevre helps and we practice it along with the dry needling when indicated.