Brad’s post Probability, Aging and a Pain in the Neck got me thinking about the very common complaint of neck pain that my students often share with me. Neck pain can arise from a myriad of circumstances and causes, from something as commonplace as sleeping the wrong way on your neck to traumatic events such as car accidents. It can be a result of longstanding postural changes, such as sitting with your head forward in front of the computer screen (I just corrected my own posture!) to doing seemingly beneficial activities like riding a road bike, where your head is often lifted into extension to view the road ahead. There are familial tendencies towards certain neck problems; both my dad and one of my brothers suffered rupture of one of the intervertebral discs in the neck. And there is the simple process of aging and its wear and tear effect on the bony structures and soft tissues of the head and neck area. I have even had some one-sided problems that stem from holding a violin tucked under one side of my jaw since I started playing at age five.
According to medical experts at the Mayo Clinic, the most common causes of neck pain include: muscle strains, especially from overuse of the neck muscles; wear and tear resulting in osteoarthritis of the bones in the neck; nerve compression as a result of stiffened discs, herniated discs or bone spurs; injuries such as whiplash from car accidents; pain secondary from other illnesses or diseases, such as rheumatoid arthritis, meningitis or cancer.
Perhaps part of the reason why the neck is so vulnerable to painful conditions lies in its structure and anatomy. The top portion of the spine is called the cervical spine, and it spans from the top of the thoracic spine, where the ribs attach to the spine, up to the base of the skull. Relative to the bones below it, the cervical spine vertebrae are smaller and have small cushioning discs between them. Granted, the cervical spine only has to balance the weight of the head above it, so its bones don’t need the bulk of, say, the fifth lumbar vertebrae that has the entire head, torso and belly to hold up. But given the weight of the head, which is between 10-15lbs, and the amount of movement that the cervical spine allows (a lot in all directions), those smaller bones and discs along with all the muscles and ligaments have a constant and challenging task. And there are nerve bundles and important blood vessels traverse this small region that can also be affected if things are not in proper working order.
It can be helpful to work with a friend to find out if you can reclaim this vertical line in your body. One way to assess your overall posture and the cervical region in particular is to have your partner stand to one side of you as you do Mountain pose. Have your partner hold a yoga strap or rope in line with the center of your ear, allowing the rest of the strap to fall down to the floor, in line with the side seam of your body. This is referred to as the “plumb line,” and can give you valuable information about not just your neck area, but your entire spine and legs as well. In this case, you are particularly interested in the span between your ear and the center of your upper arm bone. If the rope falls in front of your humerus bone’s center point, you may have developed the Head Forward position so common in our culture, which puts high demands on the muscles at the back of the neck and can lead to overuse neck strain. If the rope falls behind your shoulder point, there may be flattening of your natural cervical curve, which should normally mirror the curve in your lower back. This situation often occurs following trauma to the neck, especially with whiplash injuries accompanied by muscle spasms in the neck. For each of these different scenarios, a well-balanced asana practice can help bring your neck back into healthier alignment and may help to resolve the pain and limitations that are present at the start of your journey.
