Neck, Marathon sitters and computer operators
Marathon sitters and marathon computer operators who sit and work in front of the computer all day are the most at risk group of work athletes to suffer from chronic (long-standing) spinal problems. It appears that the cervical (neck) spine is mostly affected followed by the lumbar (low back) and the thoracic (upper back) spine.
Such patients often complain of persistent mid to lower neck pain, spreading down to the upper thoracic and interscapular (between shoulder blades) areas and/or the upper trapezius (side of the neck) and posterior (back of) shoulder areas. If severe, pain, aches, paraesthesia such as numbness and pins and needles could often radiate down to the fingers. Onset is often insidious (unknown) and worsen by prolong sitting, concentrating, working in head down position and by sitting in front of the computer, stress and tension. Neck movements may or may not be restricted. X-rays may show some degenerative changes in the mid cervical spine but otherwise fine. Neurological (nerve) tests are usually negative. The patients are otherwise fit but symptoms could be very irritating, affecting their work, sleep and other activities of daily living. Normal physiotherapy treatments such as traction and electrotherapy often fail to alleviate their symptoms. In despair, patients run around to seek treatments from different acupuncturists, bonesetters, chiropractors, herbalists, masseurs and osteopaths without success.
Signs of such symptoms could be subtle and could only be revealed by detail palpations of the spine. Intervertebral (between vertebrae) movements of the affected level/s are often hypomobile/stiff. Soft tissues around are often thick and tender. Muscle imbalance could be obvious, often with tightness to the neck extensors and upper trapezii (muscles at the side and at the back of the neck) and weakness in the deep neck flexors (muscles in the front of the neck). Patients often have a typical forward head and back slouching posture with prominent cervico-thoracic (neck and upper back) junction and kyphosis (slouching) of certain level/s of the thoracic and/or lumbar spine. The very first and most important advice I give to these patients is that they are the best doctors/therapists for their problem. They must learn to treat their own neck and back. The best treatment for a butcher who keeps chopping his own hand is not just the nice stitches but to advise him how to avoid chopping himself again! The usual postural, mobility, stretching and strengthening exercises are not difficult to do but it is extremely difficult to raise patients' awareness of how such simple spinal motions and positioning could be their best cure.