Question
Hello,

I've had pain in my upper back and neck for years and a couple of months ago I had breast reduction surgery, which I though would take care of those pains. The pain in my upper back and shoulders has diminished greatly, but my neck is still a big problem for me. A couple of years ago chiropractor did xrays and told me I had a reverse curvature in my neck. I try to keep a good posture, but I constantly feel like my neck is not straight and very strained. When I look at myself in pictures, I see my bad posture (my head is too in the front of my body and I have a slump in the back of my neck). Also, my neck constantly pops, especially in the morning or if I've been in the same position for a while. What can I do about my situation? The chiropractor that told me about the reverse curvature told me that I should lay in my bed facing the ceiling and let my head and neck hang to the floor. What else can I do, I am tired of the pain and of looking like this. Also, is it dangerous that my neck (and lower back) pop so much? I'm talking about 5 times per hour or I feel really uncomfortable.

Answer


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Hello C.,

Your neck and head positions are often structurally referred to as 揳nterior head carriage.? It is very common in the population.  Your breast reduction surgery will help to an extent.  Your head and neck compensate into this position when your shoulders are rolled forward too much and your mid-back rounds forward.  Your breast reduction surgery will make it easier for you to keep your shoulders back, thus making it easier for your head to stay above your body.  Unfortunately, it may be too late in the game to reverse the neck changes, but anything is possible.  At the very least, you can now try to prevent it from getting worse as you age, which I think is a fair goal for you.  To do that, there are some exercises that may help you.

You want to strengthen your neck and the muscles that support a normal C-curve.  If the muscles that cause normal spinal curves are in balance with proper tone, then it抯 easier for your spine, including your neck and head, to remain in the proper position.  A good exercise to help fight the anterior head carriage is a chin slide, seen here: http://images.drcheriesmith.com/local/475/chin2.png  In this exercise, you抮e basically just tucking your chin in.  You can supplement your chin slides with other good neck exercises seen here: http://www.bodyscenes.com/newsletter_files/mar_apr_2003/nwsltr34038.htm  (You can skip the pushups).

In addition, the more erect and less-rounded your shoulders and mid-back is, the easier and more natural it is for your neck to follow suit and stay above your body instead of in front of it.  To help with that, you will want to focus on stretching your chest muscles (as seen here: http://www.exrx.net/Stretches/PectoralisMinor/Doorway.html ) and strengthening your mid-back muscles with exercises as seen in the top two sets of pictures here: http://www.fitstep.com/Misc/Newsletter-archives/issue28-back.htm

Because everything is related, it is also a good idea to work on strengthening your abs.  This indirectly can affect the neck only if curvature changes are made to your lower back, which is much easier said than done.

All of these exercises and stretches are just the tip of the iceberg with many variations and supplemental stretches and exercises that can be added to help.  These exercises are correct in theory.  However, making the kinds of changes you desire can be difficult in actuality.  That抯 why when I go over these things with patients, I heavily emphasize how important it is to focus on these exercises to prevent your situation from worsening rather than reversing it.

I hope you find this helpful and best of luck!
Dr. J.R. Strecker, D.C.