Did you wake up in the morning and you can’t turn your head? You just drove your car for several hours or you got cold by an open window and now your feel pain behind your neck? Do you feel pain in the cervical spine through the shoulders? Does the pain shoot into your head or arms or you feel like you have a migraine? You don’t know what you can do to help yourself? We have several tips how you can help yourself and get a relief from pain.
Find at home gel packs, which you can warm up in water or microwave oven. Warm them up to a temperature which would warm up your muscles deep inside the tissues (about 40 - 60°C). You should feel the warmth well enough, but the temperature should not be too high, so that it wouldn’t burn your skin. We recommend to place a cotton cloth between the pack and your skin, or any other type of textile, so that you would be protected from possible burning.
If you do not have gel packs, we recommend you to place aluminium foil into a towel (of a size at least 70 x 40 cm) and warm it up with iron. Place the towel on your nape, shoulders and upper part of the chest. The aluminium foil will cause that the towel will produce heat for longer period of time. If you do not have aluminium foil at home, you can warm up just the towel with iron, but the warmth will quickly run out.
In physiotherapy we use methods of Dr. Alois Brügger such as „hot towel”, for which you need a towel in size of approximately 70 x 40 cm. Fold the towel to the size 70 x 20 cm. Roll the towel into a firmly tightened roll, 20 cm on height. Boil water in a kettle, and then carefully pour the water into the prepared roll into the height of about 10 cm (you have to hold the remaining part of towel). Pour the water slowly, because tightly rolled towel would not absorb the water fast enough if you would pour the water too quickly and you could end up burning yourself. Then slowly unwind the part soaked with hot water and apply it to the affected area on the nape, upper part of the thoracic spine, beneath your skull and on the surrounding muscles. Be careful so that you wouldn’t burn yourself. If the soaked water is still too hot, wait a short while till it gets cooler. The goal is again to warm up the skin, subcutaneous tissues and muscles.
I would most definitely recommend to use heating pad, which after you plug it into electricity creates constant warmth. You can set how warm you want the pad to be with a remote. This way of warming up is safe and without a risk of getting burned. If you don’t have the pad yet at home, we strongly recommend you to get one, you never know when you may need it. Handling the heating pad is definitely very easy and safe, you just need to place the pad into the affected area of the nape, shoulder and thoracic spine.
There is a common rule applied, that the nape hurts the most in the morning and with the day the intensity of pain subdues. Therefore try to move as much as possible, warm up your muscles and don’t let them get cold and „stiff” in the neck brace, which is often prescribed during pain of the cervical spine.
Instead of neck brace, i highly recommend to use scarf made out of unpleasant itchy material (nylon, wool etc.). Not only will the scarf protect you against getting cold, which significantly worsens the painfulness of acutely blocked cervical spine, but thanks to the gamma motor neuron the muscle dysbalance would be corrected, in the areas where occur acute blockages.
MANUAL TECHNIQUES FOR RELIEVING THE MUSCLE TENSION
Frictioning the skin and subcutaneous tissues against the bone is very painful, however the same principle of shifting the single layers of the tissues against each other is in physiotherapy very important technique of the soft tissues.
- Place your hands on the shoulders and the nape. You have to place your whole palm on the area, with slightly opened fingers, your hand should be touching the area gently but also with confidence. Lightly press and at the same time move the skin and muscles around the cervical spine as if you’d be turning muscles around the spine. The pressure on the skin should be areal, i.e. with the whole palm and fingers. The intensity of the pressure should not cause higher pain, the pressure should feel pleasant (usually the pressure of the hand responds to its weight.
- Try to find in especially painful areas in the muscles (which feel like hardened small balls, which cause significant pain). Such trigger points have to be massaged. Press your thumb/finger against the trigger point continually or press first and the release. What can be pleasant as well is when you rotate the finger against the point, and at the same time you increase decrease the intensity of the pressure.
Each blocked segment can hurt differently and in a different area. Pain can by each individual shoot into different directions. It is therefore very difficult to advise exercises which should relieve you from a specific type of pain. The most common and ideal exercise is stretching the muscles of the skull and shoulders and thoracic spine. Slightly bow your head to forwards and backwards and to the sides as well, and rotate the head. If some of the positions suit you, stay in the position and while you breathe in, think about the pain, on the force and position, and with exhale „blow” the pain away. Such psycho-relaxing technique is in physiotherapy often used.
HOW CAN WE HELP YOU WITH PHYSIOTHERAPY?
If you feel that your muscles and condition is only getting worse or that it is stagnating, we recommend you to visit a physiotherapist as soon as possible. Fur such acute cases we have developed very effective procedure, which we have called Physiotherapy All-Inclusive, which uses classical techniques of the physiotherapy and also option of treatment with radial shock wave. During a damage of soft tissues (intervertebral disc, joint capsule etc.) we use the option of using focused shock wave therapy, which is in combination with physiotherapy called FOKUS All-Inclusive. Our flexibility enables us to have very short ordering time with acute cases (the same day or till the second day etc.).
Here you can look on a look on a small example of physiotherapeutic techniques and methods, which we use in came of problems with cervical spine, which often relates to the headaches and tinnitus (hearing a sound when no external sound is present) and migraines.
HOW CAN DOCTOR HELP YOU?
Orthopedists, neurologists, doctors etc. will send you to a standard X-ray examination. This examination may reveal rotation and shift in the single vertebrae against each other or against the skull bones - it will prove whether there is a blockage in the cervical spine, but the X-ray does not have any responding value by the possible damage of the soft tissues (for example intervertebral discs). It is therefore worthless to undergo X-ray examination.
Doctor will prescribe you drugs against headaches and pain in the nape, as well as drugs relieving the muscle tension in form of tablets, ointments and gels. Alternatively the neurologist may use an injection to relieve the affected area. It is in doctors competence to recommend you also peaceful regime and give you FT coupon for outpatient physiotherapy (applicable only in Czech republic). In case of serious blockage of the damaged soft tissues (for example: result of recent injury or overload), you may be recommended with hospitalization.
- Headaches, migraines, ringing in ears (tinnitus), lights in front of the eyes (scotoma)
- Pain in the cervical spine - muscle imbalance
- Blocked cervical spine - acute pain of the neck
Examples of exercises during pain in the cervical spine:
- First aid during pain in the neck and nape
- Exercises during pain of the neck and nape
- Exercises during pain of the neck and nape with needed help of a second person
- Exercises during pain of the neck and nape with exercising tool
Author: Mgr. Iva Bílková, FYZIOklinika physiotherapy Ltd., Prague, Czech Republic
Source: Clinical experience from a private practice in a physiotherapeutic field, FYZIOklinika