Cushion for neck problems and ease of use in the treatment of forward head posture and neck pain in patients
You may have heard of it the KISS method – Keep It Simple Stupid! It is attributed to a US Navy design principle in the 1960s that emphasized that systems work best when they are kept simple rather than complicated. After over 30 years in the practice, I see the importance of this principle in managing the biomechanical problems patients face, including the chiropractic instruments and pillows used for neck problems due to abnormal loading. Perhaps the minor principle for chiropractic care should be FALS – Fix Abnormal Loading Stupid!
Excessive loading of the disc
In a 2006 study by Spine entitled “What is Disc Degeneration and What Causes It” 1, authors Adams and Roughly stated, “Excessive mechanical stress clearly causes a disc to degenerate by destroying its structure and a cascade of irreversible cell-mediated reactions that lead to further disturbances. “
My question to patients with the KISS method is, “If you have a cart and put all of your weight on the right rear side of the cart, what will wear out?” The patient’s KISS response: “The rear right side ! “
As our society continues to penetrate technology through everyday use of computers, laptops, tablets, and cell phones, the effect of everyday use of these devices is reflected in the evolving forward posture of the head. There is a long list of cultural names given to this postural misalignment: Text Neck, Computer Neck, iHunch, and iPosture, to name a few. In technical jargon, the literature speaks of forward head posture, upper cross syndrome and widow’s hump.
The Effects of Front Head Posture
Forward head posture is observed daily in chiropractic practices when patients experience a variety of different symptoms: headache, neck pain, middle back pain, shoulder symptoms, or a combination thereof.
The forward-facing head position can cause problems beyond just pain. It can cause degenerative changes and increase the patient’s risk of falling. It is seen on physical exam with the chin protruding above the sternum, the ear canal in front of the shoulder, and the classic upper cross syndrome with tight upper traps / suboccipital / pecs with elongated neck flexors / lower traps.
In addition to these physical examination results, changes can also be seen in the x-ray of the cervix. In my practice, we see an increasing number of cases with loss of the cervical lordosis and reversal of the curvature of the neck. In the population aged 40 and over, degenerative disc disease is also consistently found, especially in the lower cervical spine. The forward head posture is the excessive mechanical stress mentioned by Adams and Roughly that contributes to degenerative disc disease in the cervical spine.
What worries me even more is that we see this forward-facing head pose in younger years. When we see the forward-facing head posture that is putting abnormal strain on the lower cervical spine in these younger people, does it make no sense that they are heading for the same degenerative disc disease?
All of this boils down to abnormal stress on the cervical spine.
If you don’t change the loading, you will never change the destruction!
As chiropractors, we have a toolbox full of useful resources that can help us change the stress on the patient’s musculoskeletal system. Here is just a partial list of tools chiropractors can use:
- Spinal manipulation
- Adjustment of the soft tissue
- Therapy modalities (IF, US, etc.)
- Low level laser light therapy
- Spinal decompression
- Dry needling
- Kinesiology taping
- Neck pillow for neck problems
Treatment of the forward head posture
In my office I use the “3 R” approach: reduce, restore, rehab.
You must to reduce the subluxations and abnormal strain on the musculoskeletal system with aids such as pillows for neck problems. The most important tool, of course, is manipulative therapy of the spine. This is the key to correcting the abnormal stress (FALS).
Restore is next and involves restoring posture and movement patterns. The use of good neck pillows for neck problems is important here. Many are well received by patients and are very adaptable as they have several different uses depending on the patient. I have very little time with a patient to make spine adjustments, but neck pillows for neck problems come with me 6-8 hours a night. Neck pillows for neck problems support and correct abnormal loads (FALS).
Rehab Addresses the muscle imbalance that exists in the forward head posture. The main exercise I teach is neck retraction. Imagine the head on a rail and the patient should slide his head back on the rail. One trick I use to help them do this is to lean their back against the wall with their feet about a foot away from the wall. Put on sunglasses and lower them down on your nose so that they look out over the glasses. If you are doing this exercise correctly, you should never look through your glasses. When you look through the glasses, you stretch your head out instead of pulling it in. Again, this is another tool to help fix abnormal stress levels (FALS).
Suspenders and retainers
There are many more options that you can safely recommend. But in my opinion you need KISS to improve patient compliance. I explain it to my patients this way: Think of the spine adjustments as the braces that move the teeth. Neck pillows for neck problems and exercise are the brackets that can help maintain the new position.
As I try to find more and better ways to help my patients, I try to evaluate my treatment plans by asking if I am keeping it simple and if I am changing the abnormal stress. When this is the case, patient compliance and postural outcomes are improved.
JEFF MCKINLEY, DC, received his bachelor’s degree in biology from Lipscomb University in Nashville, Tennessee and his PhD from Logan College of Chiropractic. He completed postdoc training in the field of sports injuries and is a Certified Chiropractic Sport Physician (CCSP). He has been part of the Pioneer Sports Medicine team at Warren County High School for over 25 years, working with the sports coach, orthopedic surgeon, physical therapist, and paramedic to mentor high school athletes. He also completed a two-week rotation at the US Olympic Training Center in Colorado Springs, Colorado. He is a member of the Foot Levelers Speaker’s Bureau, where he tours the country teaching seminars on key chiropractic topics. Check out upcoming seminars at footlevelers.com/continuing-education-seminars and visit his website at drmckinley.com.