Pain has been the biggest enemy of humanity from time immemorial. Coincidentally, it is also the best marker indicating something abnormal. It helps one to be cautious and take up appropriate measures to prevent further deterioration or damage. Neck pain though not as common and chronic as the back pain or the knee pain often suffered by individuals, but causes substantial distress and disability. It is reported that at any given time, 10% to 20% of the population reports neck problems, with 54% of individuals having experienced neck pain within the last 6 months. Though not all neck pain arise due the same cause but we find several preventive and curative measures for neck pain mentioned in Ayurveda as per the cause.
In common mans words any condition presenting with ache, pain or discomfort in the neck is considered to be neck pain. In simple medical terms neck pain is defined as pain located in the anatomical region of the neck with or without radiation to the head, trunk, and upper limbs. However many a patients present with ill defined discomforts in the neck which are to be considered as some form of neck pain. Based on this neck pain is classified as
Postural neck pain – Very common and generally arises due to improper posture. Common causes are postural defects related to sleep, wrong postures while watching gadgets, adopting a posture for too long a duration.
Whiplash-associated neck pain – Neck pain arising due to sudden jerky movement of the neck while driving.Whiplash injuries follow sudden acceleration–deceleration of the neck, such as in road traffic or sporting accidents.
Traumatic – Due to direct injuries such as road traffic accident or worksite injury.
Occupational neck pain – Developed as a result of the occupation. Those working in software and allied activities where they have to stare at the screen for long periods of time or hold the neck in a specific position for long periods of time.
Sports-related neck pain – developed while in the act of sport
Nonspecific neck pain – cannot be attributed to one specific cause. Non-specific neck pain has a postural or mechanical basis and affects about two-thirds of people at some stage, especially in middle age. Acute neck pain resolves within days or weeks but may become chronic in about 10% of people.
Neck pains are graded depending upon the involvement of structures and severity of pain.
Causes
- Bad postures while at home or at work place
- Excess strain – lifting heavy loads, heavy head gear or ornaments.
- External Injury like road traffic accident.
- Congenital (developed at the time of birth) and genetic (transferred from parents).
- Disc degeneration due to age or rarely in the young.
- Infective conditions of the neck like tuberculosis.
- Poor muscle tone of the neck muscles.
- Excessive sleep deprivation.
- Smoking seems to contribute to neck pain.
- Tumours and growths in the neck may sometimes cause neck pain.
- Alcohol can create a stiff neck due to dehydration of the disc.
- Mental stress
- Consuming only high fiber foods avoiding oil or ghee completely deprives the joint of nourishment.
- Consuming vata increasing foods like excess of cereals and millets.
- Regular Day sleep in excess.
What are the symptoms?
- Pain or discomfort in the neck.
- Difficulty in moving the neck.
- Tightness in the neck.
- Spasms in the neck.
- Difficulty in doing routine activities.
- Neck stiffness or pain with radiation to the hands.
- Neck associated with Loss of strength in the hand
When should you consult your Doctor?
- When neck pain is accompanied by severe stiffness
- When neck pain is accompanied by fever
- When accompanied by vomiting
- When accompanied by severe radiation of pain to both the arms
- When accompanied by numbness or pinprick sensation in the hands
- In case you notice a swelling or redness in the neck
- Progressive and continues for longer periods of time beyond 15days.
What are the complications of untreated neck pain?
- May end up in an infective condition like meningitis rarely
- May cause chronic pain and Stiffness
- Neurological deficit like numbness in the hands
- Thinning of the hand (sudden decrease in muscle bulk)
Ayurveda in prevention
There are some preventive advises which are generalized and some exclusive to Ayurveda. Let me list out the general advice first which has been mentioned in different contexts in Ayurveda and then the specific remedies.
- Bad postures at the workplace – many of the professionals are compelled to work for hours in front of the computer. This can be managed by taking a break and walking around at least once in 30-45 min. do not become too tensed while working and if you feel so take 8-10 deep breaths with complete awareness of the breath, thereby relaxing. Your desk chair and level at which the computer is placed does matter. The monitor should be at the level of the eye with a chair such that the knee slightly below the hips. The chair should have a comfortable armrest.
- While sleeping align yourself in a straight line as far as possible. Avoid using a hefty pillow and avoid irregular or too soft a surface.
- Sleep sufficiently lack of sleep can be one of the major reasons for your neck pain.
- Day sleep – If you are too tired only then sleep for a short duration (45min) during the day. If not avoid day sleep completely except for a short duration during hot summers.
- Smoking and Alcohol can contribute to neck pain significantly, therefore, quit smoking and alcohol.
- Do not overstrain yourself – do not stretch yourself beyond a limit. No gain is satisfying at the cost of health.
- Diet changes -include some form of dairy and good fat in your diet. It is not dangerous instead it protects your joints and bones.
- No Hurry – Avoid doing activities hurriedly and that decreases your risk of developing an injury considerably.
- No worry – be calm and relaxed; do not ponder upon negative thoughts continuously.
- Yoga and meditation tones up the body, mind and spirit.
- Exercise regularly to keep all your muscles in good shape.
- Kavala or oil pulling is also helpful in the inner part of the mouth and the adjacent tissues also become stronger. The act of performing this activity exercises even the neck muscles.
- Nasal medication (Nasya – instilling two drops of oil into the nostrils and sucking it up) mentioned in Ayurveda is to be practiced regularly in order to strengthen the neck muscles.
- Application of oil to head and neck and massage (abhyanga mentioned in Ayurveda) is helpful for a healthy neck.
Food and Drinks – these are best customized according to the cause of the condition. Below are some general advice which helps manage neck pain.
- Avoid all artificial and processed foods to the extent possible.
- Avoid too cold and refrigerated items
- Carbonated drinks are best avoided
- Include healthy dairy like ghee and milk in a regular diet.
- Consume only freshly prepared food on time in moderate quantity.
- Consume seasonal and local foods of the region you belong to.
- Reduce the amount of intake of dicotyledons like pea, groundnut, green pea, etc.
- Tubers like potato and sweet potato are not favorable for neck pain.
- Fruits containing calcium like oranges, guavas, papaya, dates, prunes, anjeer are beneficial especially in the elderly.
- Fish and meat freshly procured from healthy animals can be consumed in moderate amounts.
- Remember good digestion is key to absorption and assimilation of all food and medication consumed so maintain it optimally.
Domestic external remedies recommended in Ayurveda for neck pain
- Abhyanga (oil massage) – apply some sesame oil impregnated with salt and heated for a while and applied with a mild massage.
- Swedana (steam therapy) with a thick towel there are two methods of domestic implementation –
- Method 1 – Take a thick cotton towel; dip it in sufficiently hot water remove it squeeze and wrap it around your neck allow it to remain in place as long as it cools. Repeat the same for a period of at least 15 min.
- Method 2 – take a thin cotton cloth and wrap it around the neck and spray tolerably hot water for a period of 10 min. If the shower is unavailable use a mug to pour water.
Treatments done in a hospital set up
- Lepa chikitsas – for those suffering mild pain we recommend application of some medicated paste to the affected area and then wash it off after a certain period of time.
- Pain-relieving treatment – Patra panda sweda – this is very effective in relieving the spasm and stiffness. Here we make use of medicinal leaves powders and other drugs made into a bag dipped in medicated oil and then applied to the affected area.
- Nourishing treatment – Shastika shali panda Sweda – here the bag is prepared with a special variety of rice and then applied to the region after dipping it in medicated milk. It is effective in degenerative conditions and provides good nourishment to the joints and improves muscle strength,
- Valuka Sweda – in this method of heat treatment the bag is filled with sand
- Seka – a stream of medicated oil is poured with a gentle massage. Effective in relieving muscle spasm and improves muscle strength and tone.
- Greeva Basti – a small circular wall is constructed in the posterior part of the neck with the patient lying in the prone position. This forms a small well in which medicated oil is stored for a certain period of time.
- Nasya – as mentioned earlier this is administered through the nose and strengthens the muscles of the neck.
- Treatments like Shiro Basti (similar to Janu Basti performed on the head) and Shirodhara(a stream of medication applied on the forehead)are also helpful in certain cases of neck pain.
- Marma chikitsa is also beneficial in both acute and chronic cases.
- Leech treatment is helpful in selected cases.
Internal medication
There are several internal medications which are helpful in the following ways
1) Improves the strength of neck muscles
2) Improves the tone of neck muscles
3) Alleviates pain without adverse effects
4) Stabilizes the neck muscles therefore less prone for injuries.
5) Relieves the spasm in the neck
6) Nourishes the joints and repairs the damaged cartilages
Remember that Ayurveda has its own method of diagnosis and treatment which is holistic unlike the western medicine. Therefore if you suffer from it think about the several options that Ayurveda can offer both external and internal. Earlier the approach, lesser the suffering better the prognosis.
By Dr Sandeep Bekal R , MD (ayu)
Consultant, Dept of Pnchakarma, Sharada Ayurveda Hospital, Mangalore.