Why looking downward can give you neck pain!

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My name is Doctor Brian Prieto from Yorba Linda, California and welcome to our video series called “Questions That Patients Ask Us”.

Today's topic is about is about neck and upper back pain caused from the forward head posture position. We see a lot of patients with complaints in the lower neck and the upper back area. Why is this a problem? Because when our head is too far forward when sitting at a desk or when looking downward at our electronics the neck and upper back muscles can become tense and will have to counterbalance the head. When your head is in the neutral position and centered over your shoulders your neck and upper back muscles don't have to work as hard. When the head is in the flexed position or in the downward position for long periods of time, then the neck and upper back muscles are going to have to work a lot harder to counterbalance the head, and over a period of time that's going to create symptoms of neck and upper back pain with headaches.

There was a recent study by New York spine surgeon Kenneth Hansraj performed assessing the incremental effects of a forward-tilted head posture on your cervical spine. His conclusions, published in Surgical Technology International in November 2014 were summarized as follows:

"The weight seen by the spine dramatically increases when flexing the head forward at varying degrees. Loss of the natural curve of the cervical spine leads to incrementally increased stresses about the cervical spine. These stresses may lead to early wear, tear, degeneration, and possibly surgeries. While it is nearly impossible to avoid the technologies that cause these issues, individuals should make an effort to look at their phones with a neutral spine and avoid spending hours each day hunched over."

He talked about the weight of our heads being approximately 10 to 12 pounds, and when leaning forward the weight becomes heavier on our neck and upper back. Well, that's approximately the same weight as a bowling ball. So, if you are holding a bowling ball centered and balanced over your arm and your arm representing the neck see how long you can hold that position? Probably you can hold it for a while as long as the bowling ball is balanced over your arm. However, if you lean the bowling ball to one side or the other you won’t be able to hold it for very long because your arm will get fatigued right away and it's going to start cramping. Yes, this is just an example, of a bowling ball, but over a period of time if your head is in the forward head posture for sustained periods of time then your neck and upper back will end up giving you symptoms.

So, the key thing is, is try to keep your head in the neutral position for as long as you can when you're on your electronics or on your computer and to get up and take a break for there is not a buildup of tension in the neck and upper back muscles.

Until next time, thank you for visiting.

What Position is Best to Sleep In?

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My name is Doctor Brian Prieto from Yorba Linda, California and welcome to our video series called “Questions That Patients Ask Us”. Today's topic is about sleeping posture. It's a very common question in our office. "Hey doc, what position is the best position to sleep in?" Well, let's talk about that. We're going to start off on the first position that's not good, and that's sleeping in the prone position, or sleeping on your tummy. When sleeping on your tummy your head has to go to one side or the other, so it's not going be really good on your neck if you're sleeping like this for five, six or seven hours a night. Also, in your lower back area it’s going to create a little tension here as well because the back will be in the extension position, and that can create some back issues in the lower back especially if you're dealing with lower back pain.

The best position, however, is sleeping on your back. We call this a very neutral position. When your body is in the neutral position, your head is on a pillow, as long as it's not a very thick pillow, so to remain in the neutral position, and then your legs can be straight. Should you have a lower back problem, it would be best to put a little pillow underneath behind your knees and that can open up your spine a little bit, create a little flexion in the lower back. So that's a really, really good position to sleep in.

The next best position to sleep in is the side posture position. You should use a thicker pillow for your head and neck and you can use a pillow underneath your legs as well. The reason why we need a thicker pillow if you are a side posture sleeper, because you need the pillow to be the distance between your ear and your shoulder, because if you don't, if you have a small pillow, then your neck's going to be titled downward,  or if you have too big of a pillow then your neck will be tilted upward. So it kind of depends on your size distance between your ear and your shoulder, so you'll rather have a thicker pillow if you're sleeping on your side. And if you're a back pain sufferer, then you can put a pillow underneath your knees for your leg doesn't go over and put a lot of tension on your lower back.

So those are two great little positions here that we recommend that you sleep in. Until next time, thank you for visiting us.