Question
Hello, I am a 21 year old active male who has been suffering with a stiff feeling neck over the past 6 months. I have just finished up 4 years in college studying computer science. Most of my days were spent slouched at a desk and my nights sitting or lying in bed with my laptop. I would also sleep on my stomach with my neck twisted to one side. I will admit my posture was awful. Seeing as there was no trigger event to my neck pain I can only assume that this may be the root of my problem. I have taken measures to improve my posture. Now to the pain itself:

I cannot rotate my neck right to the same extent that I can rotate it left. It feels stiff as if something is stopping it. I can get about 70% - 80% rotation, past that I get a pain/stiffness along the back-right side of my neck for top to bottom.

I cannot tilt my head so that my left ear touches my left shoulder, the right side of my neck is too tight to allow my head to tilt all the way. When I compare tilting my head to the right then to the left I can see a noticeable difference; when I tilt left I can see muscles/ligaments protruding out further on the right side of my neck, they are tenser and feel contracted.

After a day at the office, the muscle around my right scapula feels fatigued mostly towards the bottom of the scapula.

When I sleep on my side (either side) I wake to a sore/stiff right shoulder and if feels hunched up towards my neck. My right pectoral also has a forgine feeling to it when flexed. I need to stretch them out and loosen them up and the stiffness feeling goes away after a while.

When I rotate my neck to the left I get a slight pain in my right side, this pain is more in the lower back-right region of my neck and just at the upper right region of my back.


I have gone to a physiotherapist about this and he as stretched, massaged, heat treated and preformed acupuncture on my neck. This all helps the soreness to go away but it just comes back after a few days.

I am looking to get a long term solution to this problem and would like some advice, would a more specialized doctor be a better option than a physiotherapist, would an MRI help, etc.


Thanks


Answer
Mark,
 From your description it sounds like you are doing the right things by stretching your neck, seeing a PT for massage and acupuncture.  The one big missing piece is strengthening your scapular muscles.  You stretch out your pecs and neck muscles which  is great, but within a day or so the tightness and pain probably returns.  You need to start working on your scapular stabilizers, mainly your lower traps, rhomboids and external rotators of the shoulder.  Two of the best exercises you can do to help jump start the healing process are Y's and T's.  Lying face down on the floor with your neck in a neutral position, have your arms out in front of you with your elbows straight and thumbs up to the sky. Lift your arms up to the sky, actually it will be more like 5-6 inches off the floor.  Repeat for 3 sets of 15 reps.  Then take your arms out to the side like you are making a T, lift them up and squeeze your shoulder blades together. Repeat for 3 sets of 15 reps.
  Throughout your day at the office you need to be stretching your pecs and biceps.  That will help offset the positions that you are in during the day that are causing the pecs to shorten.  The other thing I would look into is a PT with OCS credential.  PT's with this credential have the manual skills and know how to train you to help strengthen your weak side.  I hope this helps.

Martin