I'll Never Know Why She Hit Me

By Dr. W. Gifford Jones

February 25, 2001

The time? 35 years ago at the Imperial Hotel in Tokyo. I was totally relaxed in the hotel spa as a Japanese girl massaged my back. But while working on my neck she suddenly struck the side of my head. I'll never know why. I had not been indiscreet. But her sudden caused pain in the cervical spine. And years later I still suffer from intermittent neck pain. Sir William Osler, one of North America's most famous physicians, was right. He said a doctor never truly knows a disease well until he experiences it. So let me pass along some tips on when neck pain is serious and when it isn't. And the best treatment for it.

Our maker intended that our heads should sit well©balanced on the neck. But this is rarely the case. Some people are born with long necks. Others with heads that lean to far forward. And today we often hold our heads forward for hours looking at computer screens or leaning over a steering wheel.

This anatomical displacement causes constant neck strain. And over many years may result in chronic neck pain. But what about neck pain that strikes suddenly? And you've never seen a Japanese masseuse? Nevertheless, on wakening there's no position that decreases the pain.

The most likely cause of this discomfort is muscle spasm. In this case the pain usually, mysteriously, disappears in a few days for no apparent reason.

But on other occasions neck pain means more than just a sore neck. Aging is dangerous for the neck as for other parts of the body. And as we age the spinal disks, shock©absorbers between the bony vertebra, develop wear and tear.

Like an automobile tire that suddenly blows, the disk ruptures. But it's not air that leaks out. In this case it's the inner gelatinous material that protrudes through the disk's tough covering.

This causes pressure on a cervical nerve and often severe pain. Unless you're very lucky it won't resolve in a few days.

How much pain occurs depends on the extent of the "blowout". If it's a major one the pain is accompanied by tingling of the shoulder, arm, hand or fingers. There may be numbness of these areas. Or a weakness, or an inability to move the arm or leg. Less frequently, neck pain is due to more serious problems. Heart disease may result in referred pain to the neck. If the pain occurs while eating this may be due to disease in the esophagus (food pipe). And if it is accompanied by weight loss and fever a malignancy may be present.

Usually there's no need to run to the doctor for neck pain that lasts just a few days or a week or two. But if the pain increases, or if there's weakness of the arm or leg see the doctor immediately.

For the first few days the application of heat and cold provides some relief of pain. The best way to apply cold is to buy a package of frozen peas. This wraps easily around the neck as the package thaws.

Non©steroidal anti©inflammatory drugs such as Aspirin, ibuprofen or naproxen sodium help to reduce inflammation and decrease pain.

A physiotherapist can help the discomfort by using ultrasound which acts as a localized anti©inflammatory agent at low doses. In addition, an interferrential current, a type of current that acts as a pain killer and muscle relaxant. This treatment for several days allowed me to continue working.

To ease the current pain and to prevent future pain neck exercises are helpful. And what most people need to correct is the "protruded head posture". The best way to accomplish this is by "chin©tucking".

Standing straight and tucking in the chin helps to correct the extended head. This relieves strain on the muscles, tendons and the shock absorbers between the vertebra. The chin tuck should be done several times a day. Short©term immobilization using a cervical collar may be helpful. But prolonged use may decrease muscle strength and limit the range of motion.

There are some "don't". Try not to sleep on your stomach which forces the head sideways. Lying in bed reading with two pillows also causes strain on the neck muscles. And sleep with only one pillow.

Lastly, if you ever have the good fortune to visit a spa in Japan, be very friendly to your masseuse.

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones

Canada Free Press, CFP Editor Judi McLeod