Patients may present with atypical abdominal and chest pain that may be related to spinal problems. The key features on history that point to spinal referred pain are pain on movement, tenderness and tightness of musculoskeletal structures at a spinal level supplying the painful area, and an absence or paucity of symptoms suggestive of a nonmusculoskeletal cause. Harding G. Yelland M. Back, chest and abdominal pain - is it spinal referred pain?. Australian Family Physician. 36(6):422-3, 425, 427-9, 2007 Jun.  

In those who have chest/abdominal pain due to musculoskeletal causes, the prevalence of thoracic intervertebral dysfunction could be as high as 65.5%. Intervertebral dysfunction prevalence could be even as high as 72.0% in those with back pain and 79.0% in those with back pain with chest/abdominal pain. Chest pain was more commonly associated thoracic intervertebral dysfunction compared to abdominal pain. 

For those with cervical problems having pain in the back, chest and/or abdomen, there was an association with pain on active movements and overpressure at end range and with loss of range of motion.  Range of motion restriction was not noted in patients with thoracic intervertebral dysfunction.

The minimum examination for the detection of intervertebral dysfunction is testing for pain with spinal movements and palpation for tenderness. The interpretation of positive signs requires knowledge of their prevalence in pain free controls and in patients with visceral disease. The prevalence of thoracic intervertebral dysfunction was 25.0% in controls. Yelland MJ. Back, chest and abdominal pain. How good are spinal signs at identifying musculoskeletal causes of back, chest or abdominal pain?. Australian Family Physician. 30(9):908-12, 2001 Sep.  

eToims treatments  for atypical chest and abdominal pain involve not only treating paraspinal muscles supplied by cervical and thoracic nerve roots but also the chest and abdominal wall musculature.  Treatments must also involve the paraspinal muscles of the lower spine and even the muscles of the upper and lower limbs. 

© 2008 copyright all rights reserved www.stopmusclepain.com Neck Pain and Thoracic Pain| Atypical Chest and Abdominal Pain 

The temporomandibular joint (TMJ) is in front of the ear and the joint movements can be felt if you place your finger at that level.  To examine the movements of this joint, the rhythm of the closing and opening of the jaw must be noted.  The jaw should open and close easy and the teeth come together and separate easily. 

If there is jaw pain, that will be a break in the arc of motion on the painful side with obvious movement of the jaw to one side or the other. When the mouth is closed, the line drawn between the tip of the nose and midpoint of the chin will be in the same vertical line and the jaw is centered well.   The teeth can also close symmetrically in the midline.  When the patient has pain in the jaw, the line drawn from the tip of the nose will not be able to go through the midpoint of the chin since the jaw will not be centered well. 

With problems of the temporomandibular joint, jaw movements may create a clicking sound, due to problems with that joint cartilage.  Problems with the inner lining of the joint known as the synovium may also be the cause that causes the joint to click.  In such situations with trauma to the joint cartilage, the joint may dislocate when the mouth is opened as wide as possible. 

This joint is prone to trauma especially in auto accidents where the head is thrown backward and the mouth opens wide in a sudden and forceful motion.  The joint may dislocate in these positions.  The cartilage as well as the joint capsule can be torn. Joint overload may occur when the head is placed in traction, or when a person has poor dentition or when a person grinds his teeth during sleep. 

Testing of range of motion of this joint involves examining the movements of the mouth and jaw.  Normally, the mouth can be opened wide enough to insert three fingers between the to and bottom teeth.  Horizontal movements should be free enough so that a person when sliding the lower jaw forward, the bottom teeth can be placed in front of the upper teeth.  Limitations in range of motion can be due to pain from arthritis of the joint or from muscle spasm. 

Muscles involved in opening the mouth are:

1. External pterygoid muscle supplied by the mandibular portion of the fifth cranial nerve.
2. Hyoid muscles.

Muscles involved in closing the mouth are:

Primarily masseter and temporalis muscles aided by the internal pterygoid muscle.  All these muscles are supplied by the trigeminal nerve.

In all cases of TMJ problems, it is essential to examine the movements of neck and shoulders and spine.  Patients with neck pain who keep the head forward and downward can cause abnormalities in the line of action of the muscles which open and close the mouth and eventually put wear and tear on the jaw joint. 

Therefore, treatments directed only to the TMJ will not alleviate the jaw pain problems unless head and neck posture is also corrected.  Examine the muscles of the jaw and the masseter muscle, is easiest to examine. You can feel this muscle just above the angle of the jaw as you clench your teeth. 

If there are myofascial pain problems, tight and tender myofascial bands can be felt in the masseter muscle.  There can be tenderness in the temporalis muscle also which can be felt at the side of the head above the ear.  It is essential to treat the myofascial pain problems not only for the muscles responsible for jaw movements but the treatments must include muscles of the neck in order to alleviate jaw pain problems. 

© 2008 copyright all rights reserved www.stopmusclepain.com Neck Pain| Temporomandibular Joint (TMJ) Pain

Neck pain has been steadily increasing over the past two decades and is now second to back pain, the most common musculoskeletal disorder.   

One of the newest randomized controlled studies on 94 Danish women suffering from trapezius muscle pain due to work-related repetitive injuries, such as typing and assembly line work, had shown that specific strength training exercises can lead to significant prolonged neck pain relief whereas general fitness training resulted in only mild neck pain reduction.  

Both exercise groups worked out for 20 minutes three times a week for 10 weeks. Those who did supervised specific strength training (SST) exercises for the neck and shoulder muscles showed a marked decrease in pain over a prolonged training period and with a lasting effect after the training ended (1). 

What is unclear with this study is the amount of resistance used for the supervised specific strength training (SST) group and which muscles were exercised.   Usually strength training in those with pain can cause increase in pain.  This is because muscle pain due to tightness and spasm is from intramuscular lack of blood to nerves and blood vessels entrapped within the spasm as well as the traction effect on periosteum of bones and synovial tissue within joints. 

On the other hand, if strength training occurred to the powerful lifting muscles of the shoulder such as lattisimus dorsi, deltoid and triceps, this could reduce the load on the trapezius muscle.  Trapezius is not a muscle suitable in weight lifting activities and in the weakness of the above mentioned 3 muscles, trapezius is called into play for lifting activities by performing the shoulder shrug.   This is the main reason for trapezius myalgia for those with repetitive motion activities.  

(1) Lars L. Andersen, Michael Kjær, Karen Søgaard, Lone Hansen, Ann I. Kryger, Gisela Sjøgaard: "Effect of Two Contrasting Types of Physical Exercise on Chronic Neck Muscle Pain,", Arthritis Care & Research, January 2008; 59:1; pp. 84-91.  

© 2008 copyright all rights reserved www.stopmusclepain.com Neck pain|Strength Training

According to a study in the February 13 issue of JAMA, expenses related to back and neck problems have increased substantially in the last decade.  However, outcomes such as functional disability and work limitations are not improving, 

In a 2002 survey of U.S. adults, 26 percent reported low back pain and 14 percent reported neck pain in the previous three months. Rates of imaging and therapy for back and neck problems have increased substantially in the last decade, but it is not clear how this has effected expenditures or health outcomes for individuals with these problems.

The study sampled a total of 23,045 adult respondents in 1997 (3,139 who reported spine problems) and again in 2005, sampled 22,258 respondents (3,187 who reported spine problems). It was found that expenditures were higher in each year for those with spine problems than for those without. In 1997,the average age- and sex-adjusted medical costs for respondents with spine problems was $4,695, compared with $2,731 among those without spine problems (inflation adjusted to 2005 dollars). In 2005, the average age- and sex-adjusted medical expenditures among respondents with spine problems was $6,096, compared with $3,516 among those without spine problems.

From 1997 to 2005, these trends resulted in an estimated 65 percent inflation-adjusted increase in the total national expenditure of adults with spine problems, a more rapid increase than overall health expenditures to an estimated $85.9 billion nationally One of the biggest drivers of spending was increased use of expensive painkillers. Spending on narcotic drugs for back pain soared an astonishing 423% during the period.

The estimated proportion of persons with back or neck problems who self-reported physical functioning limitations increased from 20.7 percent to 24.7 percent from 1997 to 2005. Adjusted self-reported measures of mental health, physical functioning, work or school limitations, and social limitations among adults with spine problems were worse in 2005 than in 1997. "These data suggest that spine problems are expensive, due both to large numbers of affected persons and to high costs per person. We did not observe improvements in health outcomes commensurate with the increasing costs over time. Spine problems may offer opportunities to reduce expenditures without associated worsening of clinical outcomes," the authors conclude. (JAMA. 2008;299[6]:656-664).

Pharmacotherapy plays an important role in LBP treatment, although drug cost data in LBP is limited. Newer, more costly agents such cyclooxengenase-2 selective nonsterioidal anti-inflammatory agents will increase drug costs as a portion of total costs, particularly if not used in accordance with treatment guidelines. (Asche CV. Kirkness CS. McAdam-Marx C. Fritz JM. The societal costs of low back pain: data published between 2001 and 2007. Journal of Pain & Palliative Care Pharmacotherapy. 21(4):25-33, 2007).   

eToims® Twitch Relief Method provides nerve related muscle pain relief with state-of-the-art noninvasive, surface electrical stimulation to excite deep neuromuscular junctions.  The twitches elicited provide internal stretch to the deep muscle layers so that there will be removal/reduction of traction/compression/distortion of pain sensitive structures such as nerves and blood vessels within tight shortened muscles, annulus fibrosus of intervertebral discs, periosteum and synovial tissue within joints.  The twitch induced intramuscular exercise also help in bringing fresh circulation and help heal irritated nerves and muscles and also help in the out flow of pain causing chemicals within blood stagnated at the injured site due to inability of tight and short muscles to contract. 

Depending on the duration of pain and extent of nerve damage, there is potential for cure with eToims® Twitch Relief Method.  With more long-standing severe pain continuation of treatments on a regular basis provide ongoing pain relief and pain reduction with improvement in quality-of-life.  We have a long-term retention of  85% of the self pay patients who return for more than three treatments.   

The press release of the launch of our much-anticipated web site as the only web site dedicated to reversing back pain was featured in Forbes, Business Journals including Philadelphia Business Journal, AOL Money News, Fox Business News, etc.  Please do visit the main site  www.stopmusclepain.com by clicking on the left homepage button above.

© 2008 copyright all rights reserved www.stopmusclepain.com Back Pain| Neck Pain| Expenses

In a study on cervical spine specimens (59-92 years) including C2-C7 levels, it was found that the prevalence of cervical facet joint degeneration was very high in individuals aged 50 years and more, with a tendency to increase in severity with age. All levels of the middle and lower cervical spine were affected to almost the same degree, whereas in the lumbar spine an increase in degeneration towards the lower levels was reported. Also, in the cervical spine in most cases the facet joint cartilage was evenly degenerated all over the joint surface while in the lumbar spine certain regions were reported to be affected predominantly. Least osteophytes were found on the medial border of the facet joints (1).  

A study on 1,064 unselected women (181 monozygotic and 351 dizygotic twin pairs) was performed to assess genetic and environmental influences on low back and neck pain to examine the extent to which these are explained by structural changes seen on magnetic resonance imaging (MRI) and psychological and lifestyle variables.  

For all definitions of pain, there was a consistent excess concordance in monozygotic twins when compared with dizygotic twins, equating to a heritability for low back pain in the range of 52-68% and for neck pain in the range of 35-58%.  The strongest associations were between low back pain and MRI change and between neck pain and psychological distress and these associations were mediated genetically.  

It was concluded that genetic factors have an important influence on back and neck pain reporting in women. These factors include the genetic determinants of structural disc degeneration and an individual's inherited tendency toward psychological distress. MRI changes are the strongest predictor of low back pain (2).

(1) Kettler A. Werner K. Wilke HJ. Morphological changes of cervical facet joints in elderly individuals. European Spine Journal. 16(7):987-92, 2007 Jul.

(2) MacGregor AJ. Andrew T. Sambrook PN. Spector TD. Structural, psychological, and genetic influences on low back and neck pain: a study of adult female twins. Arthritis & Rheumatism. 51(2):160-7, 2004 Apr 15. 

www.stopmusclepain.com Neck Pain| Low Back Pain| Spinal Degeneration 

Various hypotheses account for the manifestations of fibromyalgia syndrome, including immunogenic, endocrine, and neurological mechanisms. Treatments for fibromyalgia are directed toward symptomatic relief without the benefit of targeting known, underlying pathology. It was observed that the common factor among partially effective therapies is a vasodilatory effect. This is true both of conventional treatments, unconventional treatments such as intravenous micronutrient therapy, and lifestyle treatments, specifically graduated exercise. The pain of fibromyalgia is described in terms suggestive of the pain in muscles following extreme exertion and anaerobic metabolism. These characteristics suggest that the pain could be induced by vasomotor dysregulation, and vasoconstriction in muscle, leading to low-level ischemia and its metabolic sequelae.

Vasodilatory influences, including physical activity, relieve the pain of fibromyalgia by increasing muscle perfusion. There are some preliminary data consistent with this hypothesis, and nothing known about fibromyalgia that refutes it. The hypothesis that the downstream cause of fibromyalgia symptoms is muscle hypoperfusion due to regional vasomotor dysregulation has clear implications for treatment; is testable with current technology; and should be investigated¹. 

In neuromuscular pain such as fibromyalgia the mediate cause of pain is muscle shortening and/or spasm under the control of neuromuscular junctions or trigger points.  This muscle shortening and/or spasm results in focal ischemia (lack of blood supply) to intramuscular nerves and blood vessels and also produce a traction effect on pain sensitive structures such as tendons, bones and joints. Electrical Twitch Obtaining Intramuscular Stimulation (eToims® Twitch Relief Method), is a new anatomical and physiological approach to treat neuromuscular pain such as myofascial pain and fibromyalgia.  It is a markedly innovative discovery in medicine as common pain therapies do not attempt to stimulate the neuromuscular junctions of muscles which mediate the pain processes.

Very brief electrical stimulation applied to neuromuscular junctions to elicit characteristic twitches which are brisk focal muscle contractions, produces active local muscle exercise and stretching which, in turn:

 (1) ends traction on selective pain producing structures, (2) ends pain producing local muscle anoxia, by increasing intramuscular influx of blood carrying oxygen, and

(3) ends pain producing accumulation of local muscle tissue wastes, by increasing efflux of fluids carrying these wastes.

(3) ends pain producing accumulation of local muscle tissue wastes, by increasing efflux of fluids carrying these wastes. eToims® Twitch Relief Method mobilizes tissues from inside the muscle by electrically stimulating neuromuscular junctions, essentially providing a form of scientific massage from within the muscle.  Simply put, eToims® attempts to restore to "normal", changes found in involved pathologic muscles associated with neuromuscular pain with pain relief through twitch elicitation. 

1. Katz DL. Greene L. Ali A. Faridi Z. The pain of fibromyalgia syndrome is due to muscle hypoperfusion induced by regional vasomotor dysregulation. [Journal Article. Research Support, N.I.H., Extramural. Research Support, U.S. Gov't, P.H.S.] Medical Hypotheses. 69(3):517-25, 2007. 

© 2007 copyright all rights reserved www.stopmusclepain.com Fibromyalgia|Neuromuscular Pain Twitch Relief

Fibromyalgia is a debilitating disorder characterized by chronic pain and tenderness in muscles throughout the entire body, headache, fatigue, sleep disturbance, depression, interstitial cystitis, irritable bowel syndrome and skin sensitivity. The majority of the patients are women. 

Diagnosis includes the presence of 11/18 tender points in well-defined areas, but many patients with early symptoms might not fit this definition.

Pathogenesis is still unknown, but there has been evidence of increased corticotropin-releasing hormone (CRH) and substance P (SP) in the cerebrospinal fluid and serum of patients with fibromyalgia.  There is also increased IL-6 and IL-8 in their serum¹. 

Increased numbers of activated mast cells were also noted in skin biopsies. The hypothesis is put forward that fibromyalgia is a neuro-immunoendocrine disorder where increased release of CRH and SP from neurons in specific muscle sites triggers local mast cells to release proinflammatory and neurosensitizing molecules. 

There is evidence for mechanical, thermal, and electrical hyperalgesia. Peripheral and central abnormalities of nociception have been described and these changes may be relevant for the increased pain experienced by these patients. 

These changes may result from the release of pain producing substances after muscle or other soft tissue injury. These pain mediators can sensitize important nociceptor systems. Tissue mediators of inflammation and nerve growth factors can excite these receptors and cause substantial changes in pain sensitivity². 

Fibromyalgia pain is widespread and does not seem to be restricted to tender points (TP). It frequently comprises multiple areas of deep tissue pain (trigger points) with adjacent much larger areas of referred pain. Analgesia of areas of extensive nociceptive input has been found to provide often long lasting local as well as general pain relief.  

Thus interventions aimed at reducing local fibromyalgia pain seem to be effective but need to focus less on tender points but more on trigger points and other body areas of heightened pain and inflammation. 

There is no curative treatment although medication such as low doses of tricyclic antidepressants, serotonin reuptake inhibitors, dual reuptake inhibitors, antiseizure medications namely Pre-gabalin in high doses can help.

Although exercises have been suggested, fibromyalgia patients are unable to tolerate exercise due to their high levels of pain and fatigue. 

Fibromyalgia patients may have structural or mechanical causes like scoliosis, localised joint hypomobility, or generalised or local joint laxity; and metabolic factors like depleted tissue iron stores, hypothyroidism or Vitamin D deficiency. Sometimes, correction of an underlying cause of for the muscle pain is needed to resolve the condition³. 

1.  Lucas HJ. Brauch CM. Settas L. Theoharides TC. Fibromyalgia–new concepts of pathogenesis and treatment.  International Journal of Immunopathology & Pharmacology. 19(1):5-10, 2006 Jan-Mar.

2.  Staud R. Are tender point injections beneficial: the role of tonic nociception in fibromyalgia.  Current Pharmaceutical Design. 12(1):23-7, 2006.3. 

Gerwin RD. A review of myofascial pain and fibromyalgia–factors that promote their persistence. Acupuncture in Medicine. 23(3):121-34, 2005 Sep.

 © 2007 copyright all rights reserved www.stopmusclepain.com Neck Pain| Back pain |Fibromyalgia

Neck pain and low back are critical public health problems. The 3-month US prevalence of back and/or neck pain was 31% (low back pain: 34 million, neck pain: 9 million, both back and neck pain: 19 million). Generally, adults with low back and/or neck pain reported more comorbid conditions, exhibited more psychological distress (including serious mental illness), and engaged in more risky health behaviors than adults without either condition¹. 

The age-standardized one-month period prevalence of neck and upper limb pain was 44%. There were significant independent associations between neck and upper limb pain and repeated lifting of heavy objects; prolonged bending of neck; working with arms at/above shoulder height; little job control; and little supervisor support².  

In a study on older adults ages between 70-79, it was found that the correlates of both neck and shoulder pain were female gender, no education beyond high school, poorer self-rated health, depressive symptomatology and a medical history of arthritis, heart attack and angina. Increasing severity of both neck and shoulder pain was associated with an increased prevalence of joint pain at other body sites and with poor functional capacity. Measures of physical performance involving the upper extremity were also decreased³.  

Independent of traumatic or non-traumatic origin of the symptoms, the prevalence of chronic low back pain is 3 times higher in individuals with chronic neck pain than in the general population. Causes other than a history of neck trauma, such as chronic musculoskeletal pain syndromes, may be important in evaluation of these cases. 

The restriction of total neck movement serves as a marker of severity of neck disorders. Women are more likely than men to develop neck pain; more likely to suffer from persistent neck problems and less likely to experience resolution. Neck pain is a disabling condition with a course marked by periods of remission and exacerbation and most individuals with neck pain do not experience complete resolution of their symptoms and disability⁴.  

1. Strine TW. Hootman JM. US national prevalence and correlates of low back and neck pain among adults. Arthritis & Rheumatism. 57(4):656-65, 2007.

2. Sim J. Lacey RJ. Lewis M. The impact of workplace risk factors on the occurrence of neck and upper limb pain: a general population study. BMC Public Health. 6:234, 2006.

3. Newman AB. Health, Aging and Body Composition Study. Neck and shoulder pain in 70- to 79-year-old men and women: findings from the Health, Aging and Body Composition Study. Spine 3(6):435-41, 2003.

4. Cote P. Cassidy JD. Carroll LJ. Kristman V. The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain. 112(3):267-73, 2004 Dec.

 © 2007 copyright all rights reserved www.stopmusclepain.com Neck Pain| Prevalence

Anatomical dissection showing superfical neck muscles (below)

Patients with neck pain and/or neck stiffness without pain may not associate that their hand and finger pain is related to neck problems.  Usually they attribute the hand and finger pain and/or stiffness to arthritis.  Initially, self treatments are usually applied to the fingers in terms of using balms, ointments and lotions.  Patients may also take analgesic medications and anti-inflammatory medications to help ease the pain. When the pain is severe, they may receive injections into the fingers or wrists and sometimes even surgery to release trapped tendons and nerves in the wrist and hand. 

Sometimes patients may exercise the hand against resistance such as squeezing a rubber ball or some gadget hoping to strengthen the hand muscles. If the pain is chronic, these resistive activities will make the pain symptoms worse and can accelerate the progression into bony deformities in the fingers. 

One might notice early arthritic deformities such as swelling and formation of soft nodes especially at the tip of the fingers called Heberden's nodes which begin with sub chondral bone formation as a reaction against inflammation.  Eventually, these will become more calcified forming bony deformities. A recent survey has shown that one in 12 United States adults have symptomatic hand arthritis and incidence increases with age (Dillon CF. Hirsch R. Rasch EK. Gu Q. Symptomatic hand osteoarthritis in the United States: prevalence and functional impairment estimates from the third U.S. National Health and Nutrition Examination Survey, 1991-1994. [Journal Article] American Journal of Physical Medicine & Rehabilitation. 86(1):12-21, 2007 Jan). 

In the early stages before hand deformities occur, pain in the hands can be helped by helping to relax the muscles on the dorsal aspect of the forearm. Neck pain due to spondylotic radiculopathy (arthritis) usually involves the C6 and C7 nerve roots.  These roots supply the muscles on the dorsal aspect of the forearm among other large muscles in the shoulder and arm such as the latissimus dorsi and triceps muscles.   

When these dorsal forearm muscles which move the wrist and fingers into extension become shortened due to nerve root irritation at C6 and C7 levels, they will pull and tug on the joints of the wrist, knuckles and fingers causing pain in these joints. Additionally, shortening of the dorsal muscles of the forearm places an overwork syndrome to the flexor muscles of the forearm and hand since now the long flexor muscle must work harder to counter-act the resistance provided by the tight and short dorsal forearm muscles that not only cross the wrist but extend to the fingers (extensor digitorum communis, extensor pollicis longus and brevis extensor indicis,  extensor digiti minimi and others).   

These flexor forearm muscles also eventually become tight and stiff making it difficult for the fingers to bend.  Initially, finger bending may be slow due to stiffness but eventually it can progress to the stage of significant pain when there is development of a trigger finger.  Triggering of the finger means that there is a tenosynovitis of the flexor tendon (inflammation of the synovial covering of the tendon) such that the tendon becomes thickened.  There is a size mismatch between the tendon and the tunnels through which it must pass through at the level of the palmar aspect of the knuckle or the finger joints.  A nodule on the flexor tendon may prevent the thickened tendon from passing through the tunnel.  The finger may stay locked in flexion at the knuckle joint and there will be significant pain on trying to release it out of its locked position using the other hand.  A click may sometimes be heard as the tendon is able to pass through the tunnel. 

Significant tightness of the long finger flexors can also lead to tenosynovitis of the long flexors causing compression of the median nerve.  This develops into carpal tunnel causing not only pain but tingling and numbness and eventually weakness in the fingers especially in the median nerve distribution (the thumb, index and middle fingers and the thumb ½ of the ring finger) interfering significantly with activities of daily living. 

In the early stages, relaxation of the muscles of the forearm especially those on the dorsal aspect can be obtained by constant massaging of these muscles.  Relaxation of the muscles can also be helped by using heat over the dorsal aspect of the forearm. Massage should also extend to relax all the muscles of the neck, shoulders and arms.  This approach will help to treat the root cause of the finger pain rather than focus the treatments only to the fingers and hand. Activity modification must accompany all treatments in order that progressive healing can take place. 

© 2007 copyright all rights reserved www.stopmusclepain.com Neck Pain | Hand Pain| Finger Stiffness

Those suffering from chronic neck pain and low back pain will have a poor posture and poor posture will aggravate neck and lower back pain. 

Beginning at about age 40, there is loss of height by about half an inch each decade, and this loss of height becomes rapid after age 70. About two inches of height loss can occur between ages 30 and 80 in males, and about three inches in females.

A hunched back can occur because of vertebral fractures due to osteoporosis (bone-loss).  However most of the hunched backs or kyphosis is related to poor posture.  

Most of the activities of daily living are performed in the front of the body leading to strengthening of the muscles in the front from constant and frequent shortening contractions.  This together with a poor posture of keeping the shoulders rounded or hunched with a head forward position during work and activities of daily living, places a tremendous stress on the muscles which extend the spine. 

The spinal extensors must perform lengthening contractions to stabilize the spine in a certain posture and this type of contraction is very injurious to the extensor muscles. As aging progresses, the concomitant presence of multiple spinal nerve root irritation that causes neck and lower back pain also gets worse.  

The nerve root irritation may not be associated with pain symptoms if the sensory dorsal spinal nerve roots are not irritated.  However, due to ongoing irritation of motor ventral nerve roots that supply the muscles, the muscles of the spine and the limbs become weak and tight.  

The spinal nerve roots that get commonly irritated with aging includes the C6 and C7 nerve roots in the cervical spine and the L5 and S1 nerve roots in the lower spine.  The most important muscles that help extend the spine are the latissimus dorsi (supplied by the C6 and C7 nerve roots) and gluteus maximus supplied by the L5 and S1 nerve roots. 

The head forward position also stresses and weakens the trapezius muscles which aid as a spinal extensor muscle.  As the spinal extensors become weaker, the tendency to prevent a poor posture gets more diminished.  

All of us must be aware and be conscious of our postures.  We must correct  bad postures  by keeping the head erect over the shoulders so that a straight line from the bottom of the ears fall straight down to the angle between the neck and the shoulder slope.    The shoulders must be held back as if to the brace the shoulders.  Clasping the hands behind the back and lifting them off the back is a great way to actively exercise the latissimus dorsi muscles through out the day.

Lying on your stomach and then lifting your head and shoulders and keeping your arms stretched out in front will exercise the spinal extensors.  Bridging will strengthen the gluteus maximus muscles and pelvic tilt exercises will strengthen the gluteus maximus, spine and abdominal muscles. Pelvic tilt exercises are very useful since they can be performed while lying down, sitting, standing or walking. 

© 2007 copyright all rights reserved www.stopmusclepain.com Neck pain| Low back pain| Posture