Question
I don t know if you can answer this, however my family doctor has not been able to. Randomly, on my right side of the back of my neck, I will get this fuzzy feeling like it s about to go numb, only twice has it ever gone numb. It hurts afterwards, though not severely. Should I be worried or see a specialist?     The fuzzyness occures almost daily, however the numbness and pain almost never, not even monthly. The pain lasts for a few minutes, kind of like that when your leg goes to sleep. When this first started I can not think of anything that may have caused it. The only thing that comes to mind is rough housing with my peers while swimming. The area affected is from the base of my skull, down into my shoulder, but does not affect the entire shoulder; and sometimes it travels down between my shoulder blades. It usually affects me while I m sitting at the computer for long hours working. I tend to have to walk away or stop typing for it to stop. There are no headaches however.

Answer
Dear Jessica,

It sounds like you may have a postural abberation that was exacerbated by your rough housing.  Let me explain.  What you describe is not a focal injury or blunt trauma with a specific cause.  Because of that, I don't have much information on what may be the biomechanical or physiological mechanism for your symptoms.  Therefore it leads me to a muscular and ligamentous type of soft tissue injury that is most likely caused by overuse, postural distortions, and problems of ergonomics such as when you are on the computer.  I am not thinking of nerve injury because you have very little pain, it does not travel into the arms, and you have few headache symptoms.

When the structure of the spine is stressed for any period of time, small deformations in the ligaments will allow the normal structure to falter. This is an example of the viscoelastic properties of soft tissue structures. For instance older people often have "humped backs" with their heads forward of their bodies.  This is the direct result of chronic long term poor posture.  It starts as a small problem which progresses as we age if not addressed.  In relation to your situation, you most likely have this starting and were then subject to stress and strain from your social activities in the pool.  

The way to determine this for sure is to have a cervical spine examination performed by a Chiropractic physician.  Chiropractors are musculoskeletal specialists and have specific training in these types of conditions.  To check the underlying structure, the doctor will have to take a minimum of two x-rays of the neck, anterior to posterior view and a lateral view.  The doctor should also check your range of motion, posture, do orthopedic tests, and examine your neck and upper back for muscle spasms.  Any chiropractic physician is qualified to perform this examination, but one certified in structural rehabilitation will be the expert on determining if your underlying neck structure is a factor in the problem.  Find one by searching the www.idealspine.com website.  

In addition you need to address your computer workstation.  Many of us spend the majority of our days at a desk, computer or workstation.  We need to consider and modify our workspace carefully.  Adding a support for the lumbar spine (low back) reduces disk pressures.  A seatback angle of 5-15 degrees from vertical will reduce low back muscle activity and disk pressure.  Proper desk height is approximately 30 centimeters from the seat of the chair.  Arm rests are important in limiting strain on the upper muscular complex of the back and neck to include the trapezius, rhomboids, and levator scapulae.  The shoulders should be able to relax with the elbows bent at 90 degrees while the hands rest on the desk surface.  Frequent breaks to rise from the chair as well as multiple seated positions should be utilized throughout the day to alleviate chronic stress patterns.  All of this will reduce neck tension as well.

Forward movement of the head on the neck is extremely problematic. For every inch forward the head moves in relation to the neck and shoulders, the compressive forces on the lower neck increase by the entire weight of the head, 10-16 lbs. Think about the difference in holding a bowling ball close to the body, or away from the body. This illustrates the differences in muscular work needed to support the weight of the head and the ligamentous strain.  Computer monitors should be elevated so that the center of the screen is at eye level while looking straight ahead.  This will reduce eye strain and further reduce muscular tension of the neck while limiting forward flexion of the head, therefore reducing the abnormal loading of the ligamentous complex.  

The most important thing Jessica, is to check into this further.  The fact that you aren't having much pain, is a good sign, but remember pain is the last symptom to manifest and the first one to resolve.  It is a poor indicator of dysfunction.  If your underlying structure has been compromised, it is important to fix it before chronic degeneration and future problems arise.

I wish you luck.  Respectfully,
Dr. J. Shawn Leatherman