I have been noticing a lot of patients experiencing tingling or numbness down one or both arms lately. For even longer, significant numbers of folks are showing their neck sliding forward. This pattern is important because it creates degeneration of the lower neck vertebra and lots of discomfort and loss of function over time.
Although I adjust this area back to normal position when I see you in the office, this is a postural pattern that will just come back if you do not change the postural stresses acting on the neck. There are specific changes you can make at home to save yourselves a lot of grief down the road.
I focus on this myself, as I have had issues with arm numbness for years – mostly at night. When my arm starts tingling in the middle of the night, I reach up and manually push the involved vertebra back into place to relieve the problem. At the same time, during the day I am constantly applying an effort to correct my head posture to release the neck stress.
Why does this happen? There are several causes we need to address with this issue. Of course these are lifestyle issues we won’t really want to change. Like many lifestyle concerns, the immediate consequences don’t seem important enough to warrant the effort to change the behavior. But the long term consequences can be devastating. For instance, the immediate consequences of eating sugar seem negligible, but the long term consequences of diabetes and heart disease are devastating. By the time you get the terrible consequences, it is too late. You had to make the changes 20 years earlier to avoid the negative outcomes today.
So what things are we doing to create this long term concern? Computer and cell phone use are the number one issue. We pull our head forward or down when using these devices. The head is a 13 pound ball balanced on a stack of tiny blocks held in place by lots of tiny muscles. The weight of the head does just fine when it is perfectly balanced on top of those tiny blocks, but if it is sitting forward of center, those muscles have to tighten up to keep the head from falling forward into your chest. But notice the muscles that do this are not behind the head pulling straight back, but under the head pulling mostly down and a little bit back. For every ounce of pull backward, there is 2 to 4 ounces of pull squishing the neck downward. It is this downward squish that compresses the joints and nerves producing inflammation and degeneration. It is this squish that creates the nerve pain/tingling/numbness down the arm and the arthritic changes to the discs and joints.
As a potential remedy for the computer use, I suggest to people that they buy a pair of simple magnifying glasses at the grocery store to make the screen appear several inches closer. This will tend to make you hold your head back instead of leaning forward as you work. I have not come up with a good answer for cell phones yet. Any ideas?
Another problem I see this time of year or during allergy season is people using pillows that are too high for their necks because they are trying to help their sinuses drain. For these people I tell them to get a wedge shaped pillow that will raise them from their mid-back and not their neck, or to put blocks under the head of their bed to slant the whole bed up just a bit. Better still is to heal the sinus issues when possible using an herbal medicated sinus rinse and a sinus spray that rebuilds the integrity of the sinus tissue.
The ultimate cause and issue however is brain aging. As the brain ages, the portion of the brain that maintains the tone of the back muscles degenerates faster than the portions for the muscles in the front of the body. This is why old people stoop forward in their posture. This is the cause of the Dowager’s Hump at the base of the neck where the shoulders start. Any of you noticing a bit of that hump starting to stick out there?
Brain degeneration, or lack thereof, is a function of amount of use. The more you use your brain, the less it degenerates. Normally you lose 10,000 to 50,000 brain cells every day, but only gain a few hundred. To compensate we grow more connections between the cells that are left. But that only happens in response to active use. One of the very best ways to stimulate the brain to form new connection is physical exercise. A few years back there was a craze to do puzzles like Sudoku or crosswords to stimulate the brain. Unfortunately this has not been found to be helpful. For mental activity to build the brain, the activities have to be novel. Embracing the new and different stimulates the brain, not simply using old pathways. Physical exercise does not seem to have this limitation.
Where I am going with this should be obvious by now. What activities can we do to improve our posture to slow down or prevent the gradual degeneration of the lower neck vertebra? What can we do to prevent carpal tunnel symptoms, arm tingling, and shoulder pain? (Yes, most carpal tunnel these days is actually a neck issue, not a wrist issue.) How can we stop the formation of the dreaded Dowager’s Hump that makes us look so old?
Raise & Roll
Good posture is the constant battle against the perpetual pull of gravity. Gravity wants to pull us forward and down until we are about 6 feet underground. Perfect posture that has been habitually trained actually takes less effort than most other postures. But lifestyle, sinus, and brain issues fight good posture, so we have a constant effort confronting us. Just like eating a healthy diet is a constant effort and maintaining good muscle tone through regular physical exertion is a constant effort, so too is building good posture. I catch myself pulled forward dozens of times every day and make a correction right then and there.
What correction am I suggesting? I call it the Raise & Roll. First you raise your sternum or breastbone and then you roll your shoulders up, back, and down. From this held position your head will naturally slip back into a balanced position over the spine. If you want to go full body, you can also tuck your bottom under slightly and let your knees bend slightly. Let your body find a relaxed balance point in this posture. These slight posture shifts
open up the low back and relieve the compression and forward slippage in the neck. It will also open up your breathing allowing you to get more oxygen into your body.
In these pictures of Susie, #1 is a typical posture for many folks – head forward and back rounded. #2 is when most people think they are standing up straight, but notice the head is still forward causing excess tension in the muscles in the back of the neck. # 3 is what happens when you raise your chest up – the head naturally pulls back into postural balance over the shoulders. #4 is the posture we want to train into, with the chest up and rolling the shoulders up and then back.
As I am driving I will consciously raise my chest up and roll my shoulders up and back to bring my head into light contact with the headrest. With good posture your head should always be within 1 inch of the headrest. Where is your head? I do the same thing while I am in front of the computer. I have to constantly re-position my head while working on patients because bending forward to do my work pulls me out of
postural balance. The only answer I have come up with so far for the cell phone is to use the phone while sitting in a chair with arm rests that hold my arms up enough that viewing the phone does not bend my neck.
The hope is that if I do this enough it will become automatic for me. It hasn’t become automatic yet. Being happy helps as my chest naturally raises up compared to when I am feeling down. Hummm, maybe feeling up and down is really about our chest being up or down.
I know this subject sounds really “old school” – posture, posture, posture. But they knew what they were talking about. They made the connection between good habits now building health in our later years.