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How to get rid of morning stiffness in the neck & shoulders?

Wednesday, 01 October 2003
Answered by: Hansa Kanuga
Consultant Physiotherapist

Mumbai
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Q. I am a 27 years old healthy man. For the last 3-4 months I have been having the problem of stiff neck and shoulders on waking up. Gradually I end up by getting severe pain in my neck, shoulders, hands, legs and more importantly head by the evening. I guess I have a cervical problem about which I do not know much. Sometimes I have problem of getting sound sleep. Please suggest me some cure. What type of mattress should I use; what exercises are required and do I need to take any medicines?

A.  Since you get up with a neck pain and backache, your mattress is definitely not the right kind. Sleeping - You need a firm mattress to avoid getting your muscles fatigued. The mattress should basically conform to the contours of the spine, or else your spine will get improperly twisted. So use a firm mattress and keep your head level. - Use pillows that do not bend he neck more than 15 degrees. Do not sleep on your stomach. It extends the neck. You can also keep a pillow under your knees. Sleep on your back or on your side. Back Sleeping - The pillow should be across the top of your shoulders, fitting and supporting the natural neck curve, allowing your neck a gentle stretch so that the neck muscles are relaxed. Side Sleeping - Tuck the pillow under your neck, keeping it on your shoulder. As your head lies on top of the pillow, weight of the head is supported and the neck is kept in alignment. You have asked for exercises, but only exercises will not suffice. You will have to exercise a few precautions too: Driving: - When in a car, push the car seat forward, so that your knees are higher than the hips. This lessens the back and shoulder strain. - Use safety belts. - Avoid long drives. - Adjust the speed in keeping with the conditions of the road. Do not speed unnecessarily lest frequent application of brakes should wrench your neck. Daily Routine: - While shaving, do not tilt your head backwards. Hold it straight and shave. Work: - Work at eye level. - Do not work at a stretch. Take frequent breaks. - Try and do the range of motion exercises a couple of times. - Do not try to reach things above your head. Use a step ladder. - Be careful when lifting things. Take several deep breaths and then lift with your legs, not the back. And hold the object close to your chest. Exercises: a) Range of motion exercises - These help to stretch the neck muscles. Sit erect, be relaxed and move gently. - Slowly turn your head to right until it hurts. Hold, return to center and repeat for left side. - Tilt head straight over right ear. Hold, return to center and repeat on the opposite side. - Drop the chin towards the chest. Hold and bring the head to erect position. - Tilt the head backwards till the ceiling is seen. Hold and bring back to erect position. b) Strengthening exercises- - Place one hand against the left side of your head and gently push your head towards the left, but resist any head movement. Hold for 5 counts and then relax. Repeat 5 times and then work on the opposite side. - Place one or both hands on the back of the head, and gently push your head forward with your hands as you use your neck muscles to resist any forward movement. Hold for 5 counts, relax. Repeat 5 times. - Place your hand on the forehead and do as in the above exercise. Medication: any analgesic would help you in case of acute pain but, it is not advisable to take medicines off the counter. You should get it prescribed by your doctor.

A.  Since you get up with a neck pain and backache, your mattress is definitely not the right kind. Sleeping - You need a firm mattress to avoid getting your muscles fatigued. The mattress should basically conform to the contours of the spine, or else your spine will get improperly twisted. So use a firm mattress and keep your head level. - Use pillows that do not bend he neck more than 15 degrees. Do not sleep on your stomach. It extends the neck. You can also keep a pillow under your knees. Sleep on your back or on your side. Back Sleeping - The pillow should be across the top of your shoulders, fitting and supporting the natural neck curve, allowing your neck a gentle stretch so that the neck muscles are relaxed. Side Sleeping - Tuck the pillow under your neck, keeping it on your shoulder. As your head lies on top of the pillow, weight of the head is supported and the neck is kept in alignment. You have asked for exercises, but only exercises will not suffice. You will have to exercise a few precautions too: Driving: - When in a car, push the car seat forward, so that your knees are higher than the hips. This lessens the back and shoulder strain. - Use safety belts. - Avoid long drives. - Adjust the speed in keeping with the conditions of the road. Do not speed unnecessarily lest frequent application of brakes should wrench your neck. Daily Routine: - While shaving, do not tilt your head backwards. Hold it straight and shave. Work: - Work at eye level. - Do not work at a stretch. Take frequent breaks. - Try and do the range of motion exercises a couple of times. - Do not try to reach things above your head. Use a step ladder. - Be careful when lifting things. Take several deep breaths and then lift with your legs, not the back. And hold the object close to your chest. Exercises: a) Range of motion exercises - These help to stretch the neck muscles. Sit erect, be relaxed and move gently. - Slowly turn your head to right until it hurts. Hold, return to center and repeat for left side. - Tilt head straight over right ear. Hold, return to center and repeat on the opposite side. - Drop the chin towards the chest. Hold and bring the head to erect position. - Tilt the head backwards till the ceiling is seen. Hold and bring back to erect position. b) Strengthening exercises- - Place one hand against the left side of your head and gently push your head towards the left, but resist any head movement. Hold for 5 counts and then relax. Repeat 5 times and then work on the opposite side. - Place one or both hands on the back of the head, and gently push your head forward with your hands as you use your neck muscles to resist any forward movement. Hold for 5 counts, relax. Repeat 5 times. - Place your hand on the forehead and do as in the above exercise. Medication: any analgesic would help you in case of acute pain but, it is not advisable to take medicines off the counter. You should get it prescribed by your doctor.

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