Evidence for the positive effect of a simple educational and physical program on neck pain and headache
Monday, July 26, 2010 at 10:54PMI woke up the other day with something my patients generally refer to as a “crick in my neck.” My neck has never bothered me. I assume that the source of it is spending too much time on a computer with this blog and related activities (or maybe it because of my kids).
In a mood to address neck issues, I read a study by Mongini et. al published in the Journal of Headache Pain.[1] The study was interesting in that it looked at a simple intervention delivered to a large cohort of regular office working folks. The results of the intervention were dramatic, with frequency of pain symptoms and medication usage reduced by 40% at 6 and 12 months post-intervention.
So, what did this “simple” intervention entail? Not weeks of physical therapy. Not repeated injections or new medications. Rather, the group was gathered together, given instruction on how to do a few exercises and then turned loose to follow-up on the recommendations (not a whole lot more work than goes into reading this blog).
The intervention involved the following basic elements[2]:
- Relaxation exercise: once or twice a day sit down in a comfortable armchair in a quiet room. Let your jaw drop completely for 10-15 minutes and apply warm pads to your shoulders.
- Posture exercise: every 2-3 hours do 8-10 repetitions of the following:
- Stand upright with your heels, hips and neck against a wall. Without moving the rest of the body move the shoulders into contact with the wall and then release rhythmicall
- “With your body and head against the wall, make horizontal movements of the head forward and backward
- “Cup your hands behind the neck. Stretch your head backwards against counter pressure from your hands. Relax 2-3 seconds.”
3. Visual feedback: Place red labels in strategic sites to remind you to avoid excessive contraction of head and neck muscles
There is a sea of recommendations out there for headache and neck pain. It is hard, even for a physician treating these kinds of things every day to sort through what works and is practical for patients.
As I read this study, there are a few useful “take-home” points. First, posture modification is I believe an essential component to most any symptom of neck pain or even headache. These authors provide some basic exercises. It is worth thinking about ergonomics and other factors. Second, relaxation exercises are oft forgotten in Western health traditions. Breathing exercises, meditation, or simply sitting in an armchair in a quiet room as this study suggests would likely do us all a world of good. Finally, visual reminders can help to change long-standing bad habits. We use sticky notes for everything else, why not a reminder to get out of the chair or sit up straight.
[1] J Headache Pain. 2010. June 20.
[2] J Headache Pain. 2010. June 20.
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