Last week I wrote about how so much of the pain I see in patients is not the result of anything they have done to injure themselves, but rather the consequence of little lifestyle choices that gradually start creating negative consequences like pain. We focused on the lower half of the body last time, looking at things like shoes, sitting, and diet all causing lower body pain. Lets move up now to the upper body.
Lets start with everybody’s favorite – computer neck and phone neck. When you are balanced, your ear should be directly over the top of your shoulder. When most people end up in front of the computer for any length of time, they pull their head forward. This head forward posture becomes chronic unless you actively work against it. The problem with this is two-fold. One, when the head is forward, the weight of the head is no longer sitting supported on the spine. Instead the neck muscles have to constantly contract to pull the head back in order to keep the head from flopping on your chest.
Because the neck muscles go from the shoulders to the skull, when they pull your head back, they are also equally squashing your neck bones downward. This compresses the joints causing joint pain and disc degeneration. Eventually you get not only neck pain but also numbness down the arms. In fact, it is this neck compression that is the primary cause of carpal tunnel syndrome. Rarely do I see a true carpal tunnel syndrome anymore, as that comes from repeated force compression on the wrist directly, such as what happens with too much hammering. Modern carpal tunnel comes from nerve compression in the neck causing destabilization of the wrist muscles and irritability of the median nerve in the wrist.
Remedy: pull the computer screen closer to you enough that you want to pull your head back over your shoulders. If this is not possible then wear a pair of magnifying glasses that make the screen look closer. Lift your chest up while sitting and let the neck relax back over the shoulders. Practice in the car while driving – raise your chest up enough that your head naturally touches the head rest. Sit, stand, and walk with your chest held up high.
The second problem with computer and phone use is the fixation of the gaze and head. We are designed to be constantly visually scanning the environment by easily swinging our head right and left. By fixating our gaze right in front of us all the time we deny the stabilizer muscles in the neck the activation feedback that keeps them balanced. Without this we get chronic tight neck muscles – sound familiar? Secondly our gaze is focused on things very close to our face all the time. This generates atrophy in the eye focusing muscles and produces poor eyesight.
Remedy: Every few minutes take your eyes off the screen and do a scan of your environment turning your head fully right and left. Do Bates eye relaxation exercises.
Another bonus source of chronic pain for us is the use of the mouse on the computer and the over use of the thumbs when texting on the phone. Both activities overwork the forearm muscles producing a jamming of the thumb joint and sometimes finger joints.
Remedy: learn to use voice activation dictation for the phone and use an ergonomic mouse. If possible change hands intermittently.
Most of these examples are of stressors to specific joints. But we have a modern lifestyle source of pain that can affect anywhere in the body – our desire to “get fit.” We exercise in insane ways to try to get fit. I can’t tell you how many patients I see because of trying to get fit. This is another modern issue – our sedentary lifestyle. We spend so much time without much movement that our balance and muscle tone degenerates. We then try to fight this downhill slide by going to the gym a coupe times a week for an hour.
The body does not work that way. It needs activity all the time, not just a few hours a week.
Remedy: move, lift, bend, stretch throughout the day every day.
Even worse is the weekend athlete. Here you take someone that has gone downhill all winter without any compensatory training at all that decides it would be a good idea to go water skiing as soon as it gets warm enough in the spring. You can’t go months without activity and expect your body to function well in a high physical stress situation. A similar but unexpected situation takes place in individuals who stay in shape through one preferred activity that then suddenly try to perform well in a completely different activity. Every activity has specific motor patterns and balance skills that have to be trained into place. Being a great bicyclist does not mean you can suddenly play softball without injuring yourself.
Remedy: do lots of different kinds of activities regularly, and if you are going to start a new activity, train for it.
These are all lifestyle choices. We never give these choices a second thought, because after all everybody is living the same way we do. Newsflash – just because everybody is doing it does not make it a good idea. Yes, I love pizza just like everyone else, but I never eat normal pizza because I know the cost in pain and suffering that comes with that delicious pie. I chucked out my shoes and wear loose water socks that allow my feet to still do some work, and I train them regularly on balance boards. I almost never sit for any length of time except to write this newsletter. I make different choices because I really don’t like pain. But even so, I still have to deal with midback pain after I have eaten something even slightly unhealthy. Staying out of pain and striving for health is a lot of work – you might say it is a pain in the butt. So I guess we simply get to choose what kinds of pain we want in our life.