How my client fixed his neck pain AND a herniated disc in his neck

Here is something you never want to experience. Pain down you arm that doesn’t go away (or at least very minimally in certain positions) and sleepless nights. It is one of the most painful conditions I see in the clinic.

A client came to see me; he was on vacations and woke up with pain in his left arm. He had no idea where this had come from. He had not fallen over, strained it in any way or used his shoulder in any other manner than was different from how he uses it normally. In other words, he hadn’t just been painting the ceiling of his 5000 sq. ft. house. What he did know however, is that his pain was now going from his shoulder down into his fingers and it would not stop. He was taking painkillers and anti-inflammatories that weren’t doing a thing. He hadn’t slept for the past 3 nights and he was utterly miserable.

Remember, a nerve generally gets pinched or pressed on by 3 ways:

1. a large trauma to the neck
2. an accumulation of micro traumas to the neck
3. sustained positioning

Let me explain these 3 briefly.

The first one is simple; if you have a large trauma or accident it can cause damage to your neck and herniate your disc.

The second one is from repeatedly putting your head in the forward head position which I have talked about before in ‘why does my neck hurt?’ Eventually after time, the ligament that surrounds your disc loses its integrity from constantly being strained and the disc finally goes back far enough to push on the nerve causing anything from pain, numbness and /or pins and needles in the shoulder and arm. The harder the nerve is pressed on, the further down your arm you will feel your symptoms. In other words, if you have pain only down to your elbow your nerve is not impinged as much as someone who has symptoms down into their fingers. If it is bad enough you can start losing strength to your arm, hand or fingers.  For example, let’s say a person has to constantly look down in their work and rather than keep the chin slightly retracted to do this they continually have their head craned forwards when looking down. This causes the vertebrae to squeeze down on the front of the disc pushing the back of the discs backwards towards the nerves. At the beginning you may just have pain that is there when you do the activity or only lasts for a while afterwards but then like a bolt out of the blue it can come from no where and put you in misery. An easy way to remember correct neck posture is:

It is a condition that is completely avoidable.

The third condition is where someone is not doing repeated actions but is remaining in the aggravating position for a period of time. This is extremely common for people who sit at a computer (nearly all of us these days). How many of you are reading this with a slouched posture? You should be sitting up straight retaining the small inward curve in your lower back to stop the same thing happening to your discs in your lower back causing sciatica. Also, if your lower back posture is not good (slouching) you can’t possibly get your neck into proper position. So sit up straight. I like to think to myself to sit ‘tall’, if I imagine myself being gently pulled by the top of my head towards the ceiling everything aligns nicely without having to think about curve angles, positioning etc.

So if you retain a poor position like this for long enough the same thing eventually happens to the discs and ligaments as in number 2.

If you have suffered from this condition before you know what I am talking about. I had asked my client if he had been sleeping with more pillows or larger pillows than usual because if you sleep on your back this can push your head into a protracted/chin forwards position which can push on the nerve. He told me this was not the case; he had in fact been sleeping on a very flat pillow. He was a tall man, about 6 foot 3 inches and I explained to him about how this condition can occur. He could think of nothing that could have exacerbated this although he told me that his physiotherapist where he lived had told him his head was too far forwards and he had been working on his posture for this reason. Then suddenly he remembered. He had to drive from Panama City to Boquete in a small rental car for 7 hours in torrential rain. This is what did it. Not only did he have to keep his head forwards to avoid hitting his head against the roof of the car because of his height but also it was extremely difficult to see out of the windshield so he had his neck craned forwards to see better FOR 7 HOURS! I told him for future reference, it is best to bring the car seat forwards so that he can see out of the windshield more easily which will save his neck-and lower the seat.

So now it was time to fix the problem. First of all, now that my client knew what positions and postures would exacerbate his condition he would now be able to avoid them so that the area could heal. It’s a bit like if you cut your elbow, if you keep bending it the cut won’t heal, likewise with his neck he would need to keep a more ‘retracted’ position to allow his neck to heal. The next thing we needed to do is to get him stretching out his pectoral muscles and his trapezius muscles to help him be able to assume this position easily. If they are too tight it is very difficult to do this. Also, we needed to give him the neck exercises 1 and 2( double chin and tennis in the sky) to start pushing the disc forwards to get it away from the nerve. I asked him to do these every two hours (6-8 times a day).

At first he could not do the second exercise because it was too painful to do this so I asked him to wait for a day and try again. He continued with exercise 1 and when I saw him the next day he told me that initially with the exercise he felt a slight increase in pain but it quickly abated. I told him that this was very common and quite normal. He also said that his symptoms were still in his arm but were not as severe. He told me that he did not have the problem in his fingers anymore. I said to him that this was a positive sign that the exercises were working because as the pain or numbness reduces in his arm and hand it shows us that the exercises are working.The less severe his symptoms become in his arm tells us that his nerve is not getting as compressed like therefore it’s a ‘green light’ to continue with the exercises. If however, he would have told me that the exercises were making his arm pain worse and/or it was now affecting him further down the arm that is a ‘red light’ to stop with the exercises and try again the following day. If there was still no relief at all from the following day then I suggest that you get a professional to check your neck.

My client was told that he could expect a continual improvement if he kept with the exercises before and soon his arm pain should be gone when the nerve is no longer affected. Once the arm pain is gone there will usually be just some localised pain at the base of the neck for a couple of days and then he should be pain free again.

a week later i spoke to my client and he was completely pain free