Poor posture (featured on the right) is a major contributor and cause of neck pain. It is a vicious cycle wherein the habitual poor posture since childhood going into adulthood, causes ‘wear and tear’ and leads to premature development of degenerative changes (spondylosis) in the spine. In the relatively younger group, there may not be any radiological evidence of spondylosis but still there are many who suffer due to poor posture. Patient can present with pain anytime during this process.
Wear and tear in the neck can cause a number of issues as it progresses. It may start with general stiffness and ache, however, when coupled with poor posture a number of secondary conditions may develop.
If a person’s posture is such that their head has drifted forwards, this means that the vertebrae are also sliding forwards on one another. This means that the facet joints at the back of the vertebrae become very closely packed and stiffen. So, rather than gliding nicely over one another during movement, they become stuck and the patient will begin to move using only the upper cervical vertebrae. Many people may do this for years and have no pain. However they are at risk of further degeneration at their neck. This can impact on the integrity of the disc space between the vertebrae and can cause disc bulges and compression of the nerve roots which exit the spinal cord at the neck and supply the patient’s arms and shoulders.
So we know that not only can this affect the patient’s joints and soft tissue, but also their nerves.
One of the best exercises we have found to treat this condition is an exercise called ‘cervical retraction’ which can be seen below. This exercise on its own may be sufficient to help mobilise ‘stuck’ vertebrae at thebase of the neck and relieve stiffness and pain and also help improve posture and alignment.Cervical Retraction Or Chin tuck exercise
Cervical Retraction with Overpressure
When it comes to the secondary disc and nerve root elements however, we have found that adding in cervical extension alongside retraction is particularly effective at centralising the disc bulge and thus offloading the nerve root being compressed.
This exercise is featured in the below.
The exercise is effective because extension following retraction opens up the anterior joint space reducing the pressure on the front area of the disc whilst at the same time, it closes down the posterior joint space which squeezes the disc bulge back into place and allows the disc to heal. This however does not happen instantaneously, it requires time, diligence and persistence from the patient.