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How to Prevent Back Pain When You’re Traveling

in Back Pain, Neck Pain, Overall Health & Wellness

Article featured on HealthPartners

Few things can ruin a vacation faster than a sore neck or back. And unfortunately, back pain from driving – especially long distances – is common. (Plus, back pain and flying often come together, too.)Here are a few key tips I give them to avoid back pain from driving, sitting in a car, flying or sleeping somewhere new.

1. Motion is lotion for your body! Even when traveling, it’s important to stay active to prevent back pain.

  • Use the 30-minute rule.

If you are sitting or standing for 30 minutes, change position. Even if it is only a brief change, it can help prevent back pain. Really, I promise, your back will thank you in the long run.

  • Take regular stretch breaks.

Back pain from driving is common. Stop every 60-90 minutes to get out and walk around while traveling by car, or get out of your plane seat and walk the aisle if permitted.

  • Do simple exercises while seated to help keep your back from getting stiff.

You can do something called a pelvic tilt while sitting on a plane or in the car to mimic the sit-to-stand motion.

2. Stress can contribute to the intensity of low back pain. The better you can manage stress, the better you can prevent back pain and the less you will hurt.

  • Don’t hesitate to ask for help.

Make things easier on yourself and let those who offer to help do so. If the flight attendants will help you lift your bags to the overhead compartment, let them.

  • Plan ahead.

Make a list of everything that needs to get done, and allow extra time to do them all in case things don’t go according to plan. That will make it easier to adjust if something unexpected comes up at the last minute (like, traffic or long security lines). If nothing goes awry, you’ll have extra time to relax!

  • Practice deep breathing and other mindfulness techniques.

I recommend giving progressive muscle relaxation exercises a whirl. They can be a less time-intensive alternative to yoga or meditation. And since they can easily be done in an airplane seat, they can be very helpful in counteracting the issues that can come from back pain and flying.

3. There are certain activities that may lead to back pain from driving or flying. So when you’re traveling, make simple changes to what you’re doing to prevent back pain from flaring up.

  • When you’re spending a long time in a car or plane…

Use a rolled up towel, sweatshirt, lumbar roll or a water bottle to give your back the proper support it needs for a long trip. Place the object just below the small of your back, above your hips.

  • When you’re sleeping in a car or plane…

Use a neck pillow – they really do help. Having a neck pillow will keep your spine in better alignment. And that will decrease the stress that resting in an upright position can put on your neck. If you don’t have a neck pillow, roll up a towel, sweatshirt or small blanket and wrap it around your neck.

  • When you’re standing in lines…

Keep your weight equal between both feet, or shift your weight back and forth. When it comes to the issue of back pain and flying, waiting to go through airport security is often a culprit. You can also try propping a foot up on a bag or curb to decrease the stress to your spine.

  • When you’re lifting luggage or heavy items off the ground…

Use a wide stance with your feet and squat down using your legs. Keep your butt back and put your weight into your heels.

  • When you’re picking small objects off the floor…

Try a technique called the “golfer’s lift.” Kick one leg behind you and bend at the hip like a pendulum, keeping your low back straight. Reach to pick up the object with one arm while using the other to hold a stationary object for support.

  • When you’re sleeping in a different bed…

Use blankets to help cushion a hard mattress if you prefer softer surfaces. If you’re lying on your back, prop up pillows under your knees. Or if you’re lying on your side, put a pillow between your knees. This will help you prevent back pain by keeping your spine in a better position.


New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

https://nmortho.com/wp-content/uploads/2022/11/Blog-header-image-how-to-prevent-back-pain-when-youre-traveling-NMO-in-New-Mexico.jpg 300 833 nmortho https://nmortho.com/wp-content/uploads/2015/03/new-mexico-orthopaedics-web-logo-vs7.png nmortho2022-11-08 13:56:582022-11-08 18:27:03How to Prevent Back Pain When You’re Traveling

6 Common Causes of Neck Pain

in Neck Pain

Article featured on Practical Pain Management
The human neck houses incredibly important structures—the airway, the voice box, the food-entry canal (esophagus), all the nerves in the spinal cord, and of course the muscles and bones that “keep our heads on straight.” As a result of this plethora of activity, neck pain can arise from a variety of sources.
Neck pain can imply something simple like a stiff muscle, which can often be worked out with rest, therapeutic manipulation, or exercise. But neck pain can also be a warning sign of a medical emergency, such as in the case of bacterial meningitis (which can threaten one’s life) or cervical myelopathy (which can lead to paralysis). In these situations, seeing a doctor to distinguish the significance of your particular form of neck pain is warranted. Below is an overview of six potential sources of neck pain. See also our diagnosis and treatment sections for each.

1. Muscle Strain:

A strained muscle or group of muscles is often the source of neck pain. Strains can be caused by weight (including obesity), weak abdominal muscles (your “core”), or poor posture.
New studies about “tech neck” or “tablet neck” show that those who put themselves into odd positions while holding handheld electronic devices can also cause neck strain; try to avoid placing the device in your lap, which causes you to flex your neck down to look at the screen. The weight of the head on the spine, normally about 10 to 12 pounds, can increase to 60 pounds of load on the spine when the neck is flexed 60 degrees (See Hansraj, 2014).
Muscle-based neck pain can also occur from over-extending the neck. Sometimes called “belayer’s neck,” this position can be best described as a person standing at the bottom of a cliff and assuming a constant gaze upward to shift ropes and watch out for the safety of a climber. Not only are muscles affected by this position, but the facet joints of the spine are jammed together.
Certain occupational activities, sports, hobbies, and even sleeping in an odd position can lead to musculoskeletal neck strain and pain as well. A fall or car accident can spur muscular neck pain in the form of whiplash, leading to potential long-term damage or disability.

2. Cervical Disc Herniation:

In between the vertebrate in your spine are discs that serve as a cushion to the vertebrate above and below. Sometimes, through trauma or normal age degeneration, the outer hard layer of a disc breaks, and the inner, gel-like nucleus pulposus squeezes out, irritating the nerves behind it. This action is referred to as a herniated, bulging, slipped, or ruptured disc. When discs rupture within the cervical spine—that is, the vertebral column in the neck area, the movement can produce pain. Symptoms can also include pain between the shoulder blades or pain/numbness that radiates down the arm to the hand or fingers.

3. Rheumatoid Arthritis:

For individuals with rheumatoid arthritis (RA), neck pain typically comes years after the diagnosis; over 80% of patients who have had RA for 10 years wind up experiencing cervical spine issues (See Hamilton, 2000) as the disease can lead to damage in the hands, wrists, elbows, knees, and ankles. At higher risk are male patients and those with a positive rheumatoid factor, which your rheumatologist can likely share with you.
The good news is that neck pain is rarely the first known symptom of rheumatoid arthritis. When it does present in the neck, RA usually affects the atlantoaxial joint. This particular joint pivots the head so we can look left and right, up and down. As RA loosens ligaments, erodes bone, or causes thickened tissue around joints, the spinal cord and brain stem can condense, requiring urgent medical attention. Therefore, although rare, RA retains its spot on the list of possible neck pain causes even when there is no evidence of RA in the peripheral joints (eg, hips, knees).

4. Meningitis:

One of the most dangerous sources of neck pain is bacterial meningitis (also called meningococcal meningitis), as a person can go from neck stiffness to death in a matter of hours to days. The three membranes that coat and protect the brain and spinal cord, running through the neck and back, are called meninges. The dura mater guards the outside, the arachnoid mater serves as the webbed middle layer, and the pia mater shelters the central nervous system as the inner layer of meninges.
While the meninges shield our central nervous system (CNS), there are certain bacteria, viruses, and even fungi that can inflame and destroy these layers. Two of the most dangerous bacteria that can threaten one’s life rather quickly are called Neisseria meningitidis and Streptococcus pneumoniae. The bacteria are passed through saliva and the most common symptoms include fever, headache, and stiff neck. If you experience such symptoms, it is important to seek immediate medical attention.
While the highest global incidence of meningitis outbreaks occur in Sub-Saharan Africa, Centers for Disease Control and Prevention (CDC) data show that outbreaks can also occur in communities, schools, colleges, prisons, and other populations around the US. Viral and fungal forms of meningitis also exist, but are often less severe.

5. Tumors:

Since the airway is contained in the human neck, a lifetime of inhaling a toxic substance, such as asbestos, wood, nickel, dust, or tobacco, could mean that neck pain is being caused by a tumor. At least 75% of head and neck cancers are caused by tobacco and alcohol use (See Blot, 1988). Cancers in the neck usually involve abnormal cell growth in the squamous cells, which are the moist, mucosal cells that line the mouth, nose, and throat. Less often, neck cancer originates in the salivary glands or thyroid glands.
Sometimes cancer originates in squamous cells elsewhere in the body and then spreads to a neck lymph node, creating a lump. This cancer is called metastatic squamous neck cancer with occult primary. Symptoms can include pain or a lump in the neck or throat.
Human papilloma virus (HPV) is a growing culprit in oropharyngeal cancers; according to the National Cancer Institute, HPV is the source of 26,000 new head and neck cancers each year.

6. Cervical Myelopathy:

This version of neck pain usually indicates that immediate surgery may be needed. If you notice pain or numbness in your arms or legs, frequent tripping, or sudden bladder incontinence, it may be because the spinal cord is being compressed. Known as cervical myelopathy, the condition can lead to permanent disability or paralysis if left untreated, which is why surgery is usually advised.
Degenerative cervical myelopathy, also called osteoarthritic or cervical spondylosis, occurs when any of a host of degenerative problems occur, such as herniated discs, swollen ligaments, or bone spurs. Bone spurs, also called osteophytes, can grow as a result of osteoarthritis, poor posture, or traumatic injury; changes that are more common with age. Continued degeneration or trauma can lead to cervical stenosis, which means that the space in the spinal canal has narrowed. When this narrow canal pinches the spinal cord, myelopathy, or neurologic deficits (abnormalities in body function), can occur.
Overall, diagnosing neck pain can be tricky, but with the proper medical exams and tests, your doctor can narrow down the cause of your pain to make an accurate diagnosis.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

https://nmortho.com/wp-content/uploads/2021/11/Blog-header-image-six-common-causes-of-neck-pain-NMO-in-New-Mexico.jpg 300 833 nmortho https://nmortho.com/wp-content/uploads/2015/03/new-mexico-orthopaedics-web-logo-vs7.png nmortho2021-11-11 12:00:162021-11-11 12:00:166 Common Causes of Neck Pain

Managing Neck and Lower Back Pain

in Back Pain, Neck Pain

Article featured on Cone Health
According to Dahari Brooks, MD, neck and lower back pain is often caused by muscle strain, degenerative disc disease or arthritis.
“If the pain comes on suddenly and out of the blue, you may have pulled a muscle and can begin with at home treatments,” shares Dr. Brooks.
If you suspect a pulled muscle, Dr. Brooks suggests resting for a day. You can treat pain with over-the-counter anti-inflammatory medications. In the first 24 hours or so, cold therapy can help minimize pain and swelling. Place an ice pack on the painful area for 10 minutes followed by 20-minute breaks. Later, you can consider cold and/or heat therapy for relief. Ease back into exercising with walking and stretching.
“On the other hand, if your chronic pain has worsened over time or you experience a sudden onset of arm or leg weakness, pain or numbness, it is time to make an appointment,” adds Dr. Brooks. “A comprehensive physical examination will help determine the cause of your problem.”
During office visit, you will be examined for issues such as a pinched nerve. You may need to take an x-ray to rule out structural issues. Often, physical therapy or steroid injections can offer improvement. If not, soft tissue imaging can reveal bone spurs or discs that have herniated, degenerated or broken down over time.
“If you are experiencing horrific or radiating pain, weakness or numbness in the neck or limbs or lack of balance, make an appointment to be seen right away,” concludes Dr. Brooks. “These types of symptoms can signal a more serious issue and require more immediate attention.”


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

https://nmortho.com/wp-content/uploads/2021/10/Blog-header-image-managing-neck-and-lower-back-pain-NMO-in-New-Mexico.jpg 300 833 nmortho https://nmortho.com/wp-content/uploads/2015/03/new-mexico-orthopaedics-web-logo-vs7.png nmortho2021-10-19 12:00:102021-10-19 12:00:10Managing Neck and Lower Back Pain

That Tension Headache May Be a Pain in the Neck

in Neck Injuries, Neck Pain, Pain Management, Uncategorized

Article from Brigham Health Hub, Written by Thomas P. Mecke, DC

One very common cause of tension headaches is rooted in the neck, resulting from muscle tension and trigger points.

What causes tension headaches?

At the base of the skull, there is a group of muscles called the suboccipital muscles. They can cause headache pain for many people. These four pairs of muscles are responsible for subtle movements between the skull and first and second vertebrae in the neck.

The suboccipital muscles may become tense and tender due to the following:

  • Eye strain
  • Wearing new eyeglasses
  • Poor posture
  • Grinding teeth
  • Trauma (such as a whiplash injury)

Pain from the suboccipital muscles commonly feels like a band wrapping around the head. Also, tension in these muscles may cause compression of a nerve that exits the base of the skull. This can trigger pain that wraps over the head and above the eyes.

How can you relieve tension headache pain?

Here are some tips to help you manage the cause of your tension headaches:

  • Get an eye exam. If you’re straining to read, or keep tilting your head up and down to use those off-the-shelf glasses, you may need a new pair of glasses.
  • Redesign your workstation. Simply raising your computer monitor or getting a document stand can help reduce repeated head tilting that can strain the occipital muscles.
  • Avoid slouching and practice good posture. Consider trying yoga, Pilates or Tai Chi. All of these disciplines are great forms of exercise and all can help to improve posture. Also, you may want to consult a physical therapist, chiropractor, or movement therapist for exercises that are tailored to your need.
  • Get a 30-minute massage that concentrates on the neck and upper back. This can help relax your muscles and relieve your headache pain.
  • Try applying a hot pack to the base of the head. Do this for 15-20 minute intervals.
  • Stuff two tennis balls into a sock and tie it off tightly. Lie on your back on the floor. Place the tennis balls under the base of your skull and allow your head to compress against them. Gently rock your head back and forth and side to side for a few minutes.

When does a headache indicate a serious health problem?

Most headaches are painful but not dangerous. However, headache pain can be a warning sign of a more serious health problem. Learn when you should contact your health care provider to find out if your headaches are a sign of a more serious problem like a brain tumor.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

https://nmortho.com/wp-content/uploads/2021/05/TensionHeadache.jpg 300 833 nmortho https://nmortho.com/wp-content/uploads/2015/03/new-mexico-orthopaedics-web-logo-vs7.png nmortho2021-06-04 12:00:512021-06-04 12:00:51That Tension Headache May Be a Pain in the Neck
Everything You Should Know About Repetitive Strain Injury

Everything You Should Know About Repetitive Strain Injury (RSI)

in Ankle Pain, Carpal Tunnel, Hand & Wrist, Neck Pain, Stress Injuries

Article Featured on Healthline.com

What is repetitive strain injury?

A repetitive strain injury (RSI), sometimes referred to as repetitive stress injury, is a gradual buildup of damage to muscles, tendons, and nerves from repetitive motions. RSIs are common and may be caused by many different types of activities, including:

  • using a computer mouse
  • typing
  • swiping items at a supermarket checkout
  • grasping tools
  • working on an assembly line
  • training for sports

Some common RSIs are:

  • carpal tunnel syndrome
  • bursitis
  • rotator cuff tendonitis
  • tennis elbow

Keep reading to learn more about this type of injury.

What are the symptoms of RSI?

RSI frequently affects your:

  • wrists and hands
  • forearms and elbows
  • neck and shoulders

Other areas of your body can also be affected.

Symptoms include:

  • pain, ranging from mild to severe
  • tenderness
  • swelling
  • stiffness
  • tingling or numbness
  • throbbing
  • weakness
  • sensitivity to cold or heat

Symptoms may begin gradually and then become constant and more intense. Even with initial treatment, symptoms may limit your ability to perform your usual activities.

What are causes and risk factors for RSI?

RSI can occur when you do repetitive movements. Those movements can cause your muscles and tendons to become damaged over time.

Some activities that can increase your risk for RSI are:

  • stressing the same muscles through repetition
  • maintaining the same posture for long periods of time
  • maintaining an abnormal posture for an extended period of time, such as holding your arms over your head
  • lifting heavy objects
  • being in poor physical condition or not exercising enough

Previous injuries or conditions, such as a rotator cuff tear or an injury to your wrist, back, or shoulder, can also predispose you to RSI.

Desk jobs are not the only occupations whose workers are at risk for RSI. Other occupations that involve repetitive movements and may increase your risk include:

  • dental hygienists
  • construction workers who use power tools
  • cleaners
  • cooks
  • bus drivers
  • musicians

How is RSI diagnosed?

If you have even mild discomfort completing certain tasks on your job or at home, it’s a good idea to see your doctor to talk about RSI. Your doctor will ask you questions about your work and other activities to try to identify any repetitive movements you do. They’ll also ask about your work environment, such as whether you work at a computer or have an ergonomic work station. They’ll do a physical exam as well. During the exam, they’ll perform range of motion tests and check for tenderness, inflammation, reflexes, and strength in the affected area.

Your doctor may also order magnetic resonance imaging (MRI) or ultrasound to assess tissue damage. An electromyography (EMG) may be ordered to check on nerve damage.

For mild damage, your doctor may refer you to a physical therapist. If the damage is severe, they may also refer you to a specialist or surgeon.

How is RSI treated?

The initial treatment for RSI symptoms is conservative. This may include:

  • RICE, which stands for rest, ice, compression, and elevation
  • nonsteroidal anti-inflammatory drugs (NSAIDs), both oral and topical
  • steroid injections
  • exercises, which may be prescribed as part of a physical therapy treatment plan
  • stress reduction and relaxation training
  • wrapping the area or securing it with a splint to protect and rest the muscles and tendons

Your doctor and physical therapist can also suggest adjustments to your work station, such as readjusting your chair and desk if you work at a computer, or modifications to your movements and equipment to minimize muscle strain and stress.

In some cases, surgery may be necessary.

What’s the outlook for RSI?

Your outlook with RSI depends on the severity of your symptoms and your general health. You may be able to use conservative measures to modify your work routine and minimize pain and damage. Or, you may have to stop certain tasks at work for a while to rest the affected area. If other measures don’t work, your doctor may recommend surgery for specific problems involving nerves and tendons.

Tips for preventing RSI

If you sit at a desk, follow the traditional advice from parents and teachers: Sit up straight and don’t slouch! Good posture is the key to avoiding unnecessary stress on your muscles. This takes practice and mindfulness. There are also many exercises you can do to improve your posture.

  • Adjust your work station to promote good posture and comfort.
  • Sit in a chair that gives you support for your lower back and keep your feet flat on the floor or on a foot rest. Your thighs should be parallel to the ground, and your hands, wrists, and forearms should be aligned. Your elbows should be in line with your keyboard to avoid strain.
  • Avoid sitting cross-legged.
  • If possible, spend some of your computer time at a standing desk. Slowly increase the amount of time you stand, aiming for 20–30 minutes each hour or more.
  • Place your computer monitor about an arm’s length away from you. The screen should be at eye level so you’re looking straight ahead.
  • If you’re on the phone a lot, use a headset to avoid straining your neck, shoulders, and arms.

Taking frequent breaks from your desk throughout the day is as important as having an ergonomic workstation.

  • get up to stretch or walk around
  • do shoulder stretches at your desk
  • march in place
  • wiggle your fingers and flex your wrists

Those may sound like little things, but mini breaks can make a big difference in preventing RSI.

If your work is not at a desk, the same principles apply. Maintain good posture, figure out the least stressful positions for the repetitive tasks required, and take frequent mini breaks. If you have to stand a lot, use an antifatigue mat. Use extension poles for cleaning tools to avoid straining your arms, and lift heavy loads properly. If you use tools, take breaks throughout the day to stretch and flex your fingers and wrists.

Most occupations have been studied in detail and have guidelines for reducing worker stress while doing specific tasks. The National Education Association, for example, has a handbook on RSI that provides tips for teachers, drivers, food workers, custodians, and others.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

https://nmortho.com/wp-content/uploads/2020/06/Everything-You-Should-Know-About-Repetitive-Strain-Injury.jpg 300 833 nmortho https://nmortho.com/wp-content/uploads/2015/03/new-mexico-orthopaedics-web-logo-vs7.png nmortho2020-06-24 15:25:002020-06-24 15:25:00Everything You Should Know About Repetitive Strain Injury (RSI)
When to Worry About Neck Pain … and when not to!

When to Worry About Neck Pain … and when not to!

in Neck Injuries, Neck Pain

Article by Paul Ingraham | Featured on Pain Science

We fear spine pain more than we fear other kinds of pain. Backs and necks seem vulnerable. And yet most spinal pain does not have a serious cause. The bark of neck pain is usually worse than its bite. This article explains how to tell the difference.

Please do seek care immediately if you’ve been in an accident or you have very severe or weird pain or other symptoms — obviously. This article is for non-emergency situations. But if you have neck pain that’s been starting to worry you, this is a good place to get some reassurance and decide whether or not to talk to a doctor.

Although it’s rare, once in a while neck pain may be a warning sign of cancer, infection, autoimmune disease, or some kind of structural problem like spinal cord injury or a threat to an important blood vessel. Some of these ominous situations cause hard-to-miss signs and symptoms other than pain and are likely to be diagnosed correctly and promptly — so, if it feels serious, go get checked out. Otherwise, if you are aware of the “red flags,” you can get checked out when the time is right — and avoid excessive worry until then.

A personal worry example One day I became convinced that the terrible stubborn pain in my neck had to be a cancer. It was one of the lowest moments of my life. The pain had been escalating slowly for months, and eventually it got so severe and unrelenting that I lost my cool. But then, after an emergency massage appointment, I felt almost completely better … and that particular pain never bothered me again.

This is often how it goes with chronic pain: just when we think we can’t stand it anymore, it finally goes away. It’s always darkest before the dawn.

The rule of thumb is that you should start a more thorough medical investigation only when all three of these conditions are met, three general red flags for neck pain:

  1. it’s been bothering you for more than about 6 weeks
  2. it’s severe and/or not improving, or actually getting worse
  3. there is at least one other “red flag” (see below)

And there is one (hopefully obvious) situation where there’s no need to wait several weeks before deciding the situation is serious: if you’ve had an accident with forces that may have been sufficient to fracture your spine or tear nerves. I didn’t really have to tell you that, did I? Well, I did for legal reasons!

Several more specific red flags for neck pain: a checklist

Check all that apply. Most people will not be able to check many of these! But the more you can check, the more worthwhile it is to ask your doctor if it’s possible that there’s something more serious going on than just neck pain. Most people who check off an item or two will turn out not to have an ominous health issue. But red flags are reasons to check… not reasons to worry.

  • Light tapping on the spine is painful.
  • Weight loss without dieting is a potential sign of cancer.
  • Mystery fevers and/or chills (especially in diabetic patients).
  • A fierce headache, and/or an inability to bend the head forward (nuchal rigidity), and/or fever, and/or altered mental state are all symptoms of meningitis (inflammation of the membranes covering the brain and spinal cord, caused by infection or drug side effects).
  • A severe headache that comes on suddenly is colourfully called a “thunderclap headache”! Most are harmless, but they should always be investigated.1
  • Severe, novel pain (throbbing or constrictive) may be caused by an artery tear234 with a high risk of a stroke. Pain is the only symptom of some tears. Most but not all cases5 are sudden, on one side, and cause both neck and head pain (in the temple or back the skull), but the pain is usually strange.6 Any hint of other symptoms?7 Go to the ER.
  • There are many possible signs of spinal cord trouble in the neck,8 with or without neck pain, mostly affecting the limbs in surprisingly vague ways that can have other causes: poor hand coordination; weakness, “heavy” feelings, and atrophy; diffuse numbness; shooting pains in the limbs (especially when bending the head forward); an awkward gait. Sometimes people have both neck pain and more remote symptoms without realizing they are related.
  • Unexplained episodes of dizziness and/or nausea and vomiting may indicate a problem with stability of the upper cervical spine. (Such symptoms should never be dismissed by alternative health professionals as “detoxification” or “healing crisis.” For context, see What Happened To My Barber?)
  • Steroid use, other drug abuse, and HIV are all risk factors for a serious cause of neck pain.
  • If you are feeling quite unwell in any other way, that could be an indication that neck pain isn’t the only thing going on.9
  • The main signs that neck pain might caused by autoimmune disease specifically include: a family history of autoimmune disease, gradual but progressive increase in symptoms before the age of 40, marked morning stiffness, pain in other joints as well as the low back, rashes, difficult digestion, irritated eyes, and discharge from the urethra.

Signs of arthritis are not red flags

One of the most common concerns about the neck that is not especially worrisome: signs of “wear and tear” on the cervical spine, arthritis, and degenerative disc disease, as revealed by x-ray, CT scans, and MRI. Many people who have clear signs of arthritic degeneration in their spines will never have any symptoms, or only minor, and/or not for a long time.10 For instance, about 50% of fortysomethings have clinically silent disk bulges, and even at age 20 there’s a surprising amount of spinal arthritis. The seriousness of these signs is routinely overestimated by patients and healthcare professionals alike.11

Signs of arthritis are almost never diagnostic on their own.12 Do yourself a favour: don’t assume that you have a serious problem based only on pain plus signs of arthritis. Pain is common; serious degeneration is not.

Percentages of people with various kinds of spinal degeneration but no pain. Source: Brinjikji et al
Imaging findingAge
20304050607080
Disc degeneration37%52%68%80%88%93%96%
Disk height loss24%34%45%56%67%76%84%
Disk bulge30%40%50%60%69%77%84%
Disk protrusion29%31%33%36%38%40%43%
Annular fissure19%20%22%23%25%27%29%
Facet degeneration4%9%18%32%50%69%83%

Sharp, stabbing, and shooting neck pains are usually false alarms

Sharp neck pain is not in itself a red flag. Believe it or not there is no common worrisome cause of neck pain that is indicated by a sharp quality. In fact, oddly, sharp pains are actually a bit reassuring, despite how they feel. In isolation — with no other obvious problem — they usually indicate that you just have a temporary, minor source of irritation in the cervical spine. Serious causes of neck pain like infections, tumours, and spinal cord problems tend grind you down with throbbing pains, not “stab” you.

Sharp, shooting pains are mostly neurological false alarms about relatively trivial musculoskeletal troubles: your brain reacting over-protectively to real-but-trivial irritations in and around the spine. The brain takes these much more seriously than it really needs to, but evolution has honed us to be oversensitive in this way. That’s not to say that the brain is always over-reacting, but it usually is. Most of the time, a sharp pain is a warning you can ignore.

The cervical spine is also surrounded by a thick, tangled web of nerves. In general, those nerves are amazingly difficult to irritate, much harder than people think, but it’s not impossible. Many sharp and shooting neck pains are probably caused by minor neuropathy (pain from nerve irritation) that will ease gradually over several days or a few weeks at the worst, like a bruise healing. It’s unpleasant, but not actually scary, like banging your funny bone (ulnar nerve): that thing can really take a licking and keep on ticking. So can the nerves in your neck.

Is a stiff neck serious?

Rarely. Nearly all neck stiffness is minor, diffuse musculoskeletal pain: several mildly irritated structures adding up to uncomfortable, reluctant movement as opposed to physically limited movement. The most common scary neck stiffness is the “nuchal rigidity” of meningitis — which makes it very difficult and uncomfortable to tilt the head forward — but that will be accompanied by other serious warning signs, of course. Like feeling gross otherwise (flu-like malaise).

If you have severe neck stiffness for a long time, plus any other warning signs, there could be a worrisome cause — but still probably not, and probably not urgent. Investigate if you have enough red flags, and even then it’s likely to amount to nothing.

Miscellaneous medical causes of neck pain that might mean you can stop worrying about something worse

This section presents a comprehensive list of somewhat common medical problems that can cause neck pain (and might, conceivably, be confused with an “ordinary” case of neck pain). I’ll give you a quick idea of what they are and what distinguishes them. If you find anything on this list that seems awfully similar to your case, please bring the idea to your doctor like a dog with an interesting bone; and get a referral to a specialist if necessary.

Important! None of these are dangerous! Although some are quite unpleasant. Reading about medical problems on the Internet can easily freak us out,13 so the goal here is to identify possible causes of neck pain that are not so scary. If you can get a positive ID on one of these conditions, then you get to stop worrying about the threat of something worse.

Some skin problems on the neck can cause neck pain, but are usually obvious — most people will identify them as “skin problems on the neck” and not “a neck problem affecting the skin.” Herpes zoster (shingles) [CDC] causes a painful rash, cellulitis [Mayo] is extremely painful but superficial, and a carbuncle[Wikipedia] … well, it’s just a super zit, basically. If you can’t diagnose that one on your own, I can’t help you!

Bornholm disease [NHS] is a crazy viral disease with several other intimidating names.14 It feels like a vice-grip on the chest and lungs, is intensely painful, and sometimes also causes neck pain. If you feel like you can’t breathe, you should look into this. The infection is temporary. It’s an extremely unlikely diagnosis.

Trichinosis [Wikipedia] (or trichinellosis, or trichiniasis) is a parasitic disease caused by eating raw or undercooked pork and wild game. It can be mild or severe or fatal, and digestive disturbance is likely. It can also cause spasming and widespread muscle pain, including the neck. There’s a laundry list of other symptoms.

 Photo of a person’s temple, with an obvious swollen and tortuous artery.

Temporal arteritis can cause neck pain as well as fierce headaches.

Temporal arteritis [healthline] is an inflammation of arteries in the temple, with a lot of symptoms: severe headache, fever, scalp tenderness, jaw pain, vision trouble, and ringing in the ears are all possible symptoms, along with neck pain. It’s almost unheard of in people younger than 50, and it usually occurs in people with other diseases or infections.

Lymphadenopathy. [Merck] The lymph nodes of the neck may bulge and swell in response to disease or infection. Once in a blue moon, someone might mistake these bulgings for muscle knots. More likely, it will be obvious that something else is going on: a variety of other symptoms.

Parsonage-Turner syndrome, [RareDiseases.org] inflammation of the brachial plexus. For no known reason, sometimes the web of nerves that exit the cervical spine, the brachial plexus, becomes rapidly inflamed. This condition may sometimes occur along with neck pain. Strong pain in the shoulder and arm develops quickly, weakens the limb, and even atrophies the muscles over several months. There is no cure, but most people make a complete recovery.

Thyroiditis, [Wikipedia] inflammation of the thyroid gland in the throat, can be difficult to diagnose, causing a bewildering array of vague symptoms. If your neck pain is accompanied by symptoms like fatigue, weight gain, feeling “fuzzy headed,” depression and constipation, consider checking with your doctor.

Eagle’s syndrome [Medscape] is a rare abnormal elongation of a bizarre little bit of bone at the back of the throat called the styloid process. Even a normal styloid process looks jarring when you first see one: it is so skinny and sharp that it makes one wonder how it can possibly not be stabbing something. Well, it turns out that in some cases it does “stab” you in the neck. This will cause a feeling of a lump in the throat and/or moderate intensity pains throughout the region, possibly including the side of the neck, although pain is more likely to dominate the jaw and throat.15

And one more important one …

Necks just hurt sometimes

The neck is one of a few areas of the body — along with the low back, jaw, and bowels — that is vulnerable to bouts of unexplained pain, sometimes quite stubborn. In most cases, the pain goes away. Pain is weird and unpredictable, and is often the result of the brain being overprotective and paranoid.

Worrying about the pain may be literally the worst thing you can do — not just a poor coping mechanism, but a genuine risk factor. Like noise pollution, the more you focus on it, the worse it gets. That’s why this article is focused on rational reassurance.

If you want more, carry on with my huge neck crick tutorial, for people with a frustrating sensation of mechanical stuckness. Or read about the weirdness of pain and learn more about how to tame your brain’s false alarm: Pain is Weird.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

https://nmortho.com/wp-content/uploads/2019/12/When-to-Worry-About-Neck-Pain-and-when-not-to.jpg 300 833 nmortho https://nmortho.com/wp-content/uploads/2015/03/new-mexico-orthopaedics-web-logo-vs7.png nmortho2019-12-28 18:04:022019-12-28 18:04:02When to Worry About Neck Pain … and when not to!

What Is Cervicogenic Headache?

in Neck Pain

Article Featured on Spine Health

Cervicogenic headache (CGH) occurs when pain is referred from a specific source in the neck up to the head. This pain is commonly a steady ache or dull feeling, but sometimes the pain intensity can worsen. CGH symptoms are usually side-locked, which means they occur on one side of the neck, head, and/or face.

CGH is a secondary headache that occurs because of a physical or neurologic condition that started first. CGH may be caused by trauma, such as fracture, dislocation, or whiplash injury, or an underlying medical condition such as rheumatoid arthritis, cancer, or infection. While the pain source is located in the cervical spine, CGH can be difficult to diagnose because pain is not always felt in the neck. CGH symptoms can also mimic primary headaches, such as migraine and tension-type headache.

Cervicogenic Headache Pain

CGH usually starts as an intermittent pain and may progress to become a continuous pain. The common features of CGH include:

  • Pain originating at the back of the neck and radiating along the forehead, area around the eye, temple, and ear
  • Pain along the shoulder and arm on the same side
  • Reduced flexibility of the neck
  • Eye swelling and blurriness of vision may occur on the affected side in some cases
  • Pain almost always affects the same side of the neck and head, but in uncommon cases both sides may be affected

CGH pain is mainly triggered by abnormal movements or postures of the neck, pressing the back of the neck, or sudden movements from coughing or sneezing.

The long-term outlook for CGH depends on the underlying cause of the headache. CGH is generally chronic and may continue for months or years. However, once diagnosed the condition can be well managed with treatment.

How a Neck Problem Can Cause Cervicogenic Headache

In the upper cervical spine region, the trigeminocervical nucleus is an area of convergence of sensory nerve fibers originating from both the trigeminal nerve and the upper spinal nerves. The trigeminal nerve is responsible for pain sensation in the face including the top of the head, forehead, eye, and temple area. When a pain sensation from a cause of CGH is sensed by the upper spinal nerves, it gets transferred to the trigeminal nerve fibers in the trigeminocervical nucleus. This results in pain being felt in different regions of the head.

Several factors can transmit pain from the neck to the head, such as:

  • An injury to the atlanto-occipital joint (joint between the base of the skull and the first cervical vertebra)
  • Injury to a component of the cervical spine, such as a vertebra, facet joint, or disc
  • Cervical radiculopathy resulting from pinched nerve in the upper spinal region
  • Injury to neck muscles
  • Tumors in the cervical region

A common cause for CGH is whiplash injury resulting in pain shortly after the injury. CGH originating from whiplash may resolve in a few days, or may last for years.

When Is Cervicogenic Headache Serious?

In some cases, CGH may be caused by dangerous underlying conditions such as tumor, hemorrhage, fracture, or arteriovenous malformation (abnormal connection between arteries and veins) in the head or neck region. In such cases, one or more of the following symptoms may also be present:

  • A change in the type of headache pain, such as severe headache that is intolerable
  • Nausea and vomiting
  • Confusion and disorientation
  • Headaches triggered by coughing or Valsalva maneuver (an attempt to expel air with the mouth shut and nostrils pinched tight)
  • Neck stiffness and swelling
  • Numbness in the arms

It is important to seek medical attention immediately if any of these symptoms are experienced.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

https://nmortho.com/wp-content/uploads/2019/12/What-Is-Cervicogenic-Headache.jpg 300 833 nmortho https://nmortho.com/wp-content/uploads/2015/03/new-mexico-orthopaedics-web-logo-vs7.png nmortho2019-12-13 21:18:492019-12-13 21:18:49What Is Cervicogenic Headache?
Neck Injuries Among Athletes Are Serious. Here's Why.

Neck Injuries Among Athletes Are Serious. Here’s Why.

in Neck Pain, Sports Injuries

By Neel Anand, M.D., Contributor | Article Featured on US News

WHEN IT COMES TO football-related head injuries, the headline-grabbers are usually about concussion. However, it’s not infrequent that a hard-enough hit to the head can result in both a concussion and a significant injury to the cervical spine, or neck. What’s more, it isn’t the professional players who are sustaining the majority of neck injuries related to football play. It’s mostly collegiate and youth athletes. When a hard enough hit or fall can result in a fracture or paralysis, it’s essential to look at why and how these injuries occur. Then, we must figure out ways to prevent them – or at least reduce the risk.

It might seem delicate on the outside, but your neck is one biological powerhouse on the inside. It must be flexible enough for you to turn your head from side to side, but strong enough to support the head, which weighs about 10 pounds. Neck stability occurs through the intricate arrangement of vertebrae in the cervical spine – the seven vertebrae in the neck. Between each vertebra is shock-absorbing cushions called disks, and surrounding the neck are muscles that provide strength and allow for flexibility.

Though designed for strength, the neck can be gravely injured. Hard football tackles and falls can result in severe neck injury – in much the same way and by the same force that happens with whiplash during a car accident. When the neck is hyperextended (flung too far backward) or hyper-flexed (thrown too far forward), ligament tears, sprains and strains can be the result. On the other hand, a tackle or fall that pushes the head too far to one side can result in a burner or stinger type of injury. Burners and stingers get their name from the electricity-like jolt of pain they can cause, which may also send the sensation down the arm. These injuries are the result of damage to the brachial plexus, a group of nerves that provides feeling to the arms. The incidence of burner or stinger injuries is quite high among collegiate football players, with up to 70% having sustained one.

The risk of neck injuries in football isn’t only high for collegiate or professional players. Sports-related emergency room visits for neck-related fractures number into the thousands each year, with football among the top five sports contributing to these numbers. And the age of incidence is highest in kids who are 15 years old or younger.

Any neck injury as the result of a hard tackle or fall should be evaluated a qualified medical professional, though most will resolve with minimal intervention. However, there are some signs of serious neck injury that warrant an emergency room visit. These include severe, uncontrollable pain; pain that shoots or radiates into the arms or legs; any tingling or numbness sensations; and trouble with bowel or bladder control.

Like any other injured body part, the neck needs time and care to heal properly. Even if a player is seemingly “fine” after the incident, neck injuries should be given at least a few days to recover. Of course, the best neck injury is the one that never happens. So taking proper safety precautions is always a must. If it’s tackle football, ensure that the equipment is functioning correctly. Shoulder pads and helmets should always be worn (in practice and during games) and must fit appropriately based on both the age and size of the player. Proper technique is also crucial. Remember: You should always see what you hit. Just because you wear a helmet does not mean it should be used as a weapon.

Serving as the director of spine trauma at a major metropolitan hospital for several years, I’m heartbroken to see kids come in with catastrophic but preventable neck injuries. For as much time and attention as coaches and team staff put into concussion detection and prevention, I firmly believe there should also be a significant amount dedicated to protection against serious neck injuries.

 


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

https://nmortho.com/wp-content/uploads/2019/12/Neck-Injuries-Among-Athletes-Are-Serious-Heres-Why.jpg 300 833 nmortho https://nmortho.com/wp-content/uploads/2015/03/new-mexico-orthopaedics-web-logo-vs7.png nmortho2019-12-04 20:00:332019-12-04 20:00:33Neck Injuries Among Athletes Are Serious. Here’s Why.
The 7 Faces of Neck Pain

The 7 Faces of Neck Pain

in Neck Injuries, Neck Pain

Article Featured on Harvard Health

If you’re bothered by neck pain, you have plenty of company. Doctors estimate that seven out of 10 people will be troubled by such pain at some point in their lives. But if you were to ask each of these people to describe their neck pain, you would probably get seven different stories.

Read more

https://nmortho.com/wp-content/uploads/2019/04/The-7-Faces-of-Neck-Pain.jpg 300 833 nmortho https://nmortho.com/wp-content/uploads/2015/03/new-mexico-orthopaedics-web-logo-vs7.png nmortho2019-04-06 04:27:392019-04-06 04:27:39The 7 Faces of Neck Pain
Could Neck-Strengthening Prevent Some Concussions?

Could Neck-Strengthening Prevent Some Concussions?

in Neck Injuries, Neck Pain

BY ROBERT PREIDT | Article Featured on US News

Boosting athletes’ neck strength in the off season might reduce their concussion risk in sports such as football and soccer, researchers say.

This is among several recommendations from researchers at Rutgers University in New Brunswick, N.J., who are looking to prevent these serious head injuries in athletes.

“Our ability to detect sports-related concussions has greatly improved, but our ability to prevent concussions and decrease post-injury outcomes remains limited,” said study lead author Allison Brown. She is an assistant professor in the School of Health Professions.

“We have identified neck strength, size and posture as potential factors that reduce risk by lessening the magnitude of force upon impact. Thus, increasing neck strength and possibly size could substantially reduce risk or severity of injury or outcomes,” Brown said in a university news release.

For the study, her team reviewed previous research on the relationship between sports-related concussion risk and neck strength, size and posture.

A neck that is stronger, thicker or in a forward posture — ears ahead of rather than aligned with the shoulders — may reduce the amount of energy transferred to the brain during an impact, reducing the risk and severity of concussion, said study senior author Carrie Esopenko, also an assistant professor in the health professions school.

Esopenko noted that compared with men, women typically have less neck strength and a higher risk of concussion, more severe symptoms, and a longer recovery.

Their other recommendations for physical therapists and athletic trainers include doing a thorough cervical spine assessment as part of the pre-athletic participation exam, and screening for pain. Pre-existing neck pain has been associated with increased concussion risk in young athletes, the study authors said.

A concussion occurs when an impact to the head makes the brain move within the skull. It can cause nausea, dizziness, problems with thinking, concentration and mood, and other neurological changes.

The study was published online Jan. 15 in the Journal of Orthopaedic and Sports Physical Therapy.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

https://nmortho.com/wp-content/uploads/2019/02/Could-Neck-Strengthening-Prevent-Some-Concussions.jpg 300 833 nmortho https://nmortho.com/wp-content/uploads/2015/03/new-mexico-orthopaedics-web-logo-vs7.png nmortho2019-02-13 15:25:462019-02-13 15:25:46Could Neck-Strengthening Prevent Some Concussions?
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