Neck Pain From Using Cell Phones, Tablets and Laptops

My son, a personal trainer, told me that one of his clients was complaining of neck pain. He asked her how often she used her new Kindle Fire. It turned out that excessive tablet use coupled with poor posture was the source of her pain.

When using a cell phone for text messaging, anchor your upper arms close to your body and bend your elbows to raise the phone closer to your face. Then lower your eyes, instead of tilting the head down, to see the screen. Avoid bending the neck forward and down; if you still must tilt your head, use the top-most “hinge” joint of the neck. But do try to have your arms and eyes do most of the work.

A handheld tablet with keyboard seems like it would be very awkward to type with (needs thumb-typing or one-handed typing). So a tablet is probably placed on a surface for that. My son says the Apple Ipad has dictation capability; maybe typing is not so necessary. Then there’s the stylus, a one handed implement for note-taking. [update: one needs to speak very clearly for Ipad dictation to be accurate (good speech therapy for those who need it!). My son bought a case that tilts the Ipad up so he doesn’t need to tilt his head down as much. He also says a case is available that comes with a separate keyboard and also elevates the Ipad. Essentially the Ipad becomes a desktop.]

Typing on a laptop rather than a tablet should be easier on the neck, as long as it is on a surface like a table top, which it seems most people do. But still the monitor cannot often be raised to comfortable eye level so see people bending their necks down all the time. As with cell phones, it is better to roll the eyes down. Better still would be if the laptop screen could be separated and hung at eye level. (Do any laptops come with separatable screens?). For now I am sticking to my desktop computer. At least the monitor can be adjusted to a comfortable height, which for me is just below eye level, so I can see it in the reading part of my eyeglass lenses without tilting my head up. (First I adjust my chair height so my feet rest firmly on the ground and my lower legs are perpendicular to the ground. If the monitor needs to be higher, I use a large book or two to raise the monitor further.)

For an informative video on improving sitting posture to avoid neck and shoulder pain due to prolonged desk work, computer and mobile device use; see Sitting At Your Computer on Dr. Robert Kelty’s Chiropractic Wellness Center Website

 

Fighting the Fatigue of Chronic Illness

Chronic illness may cause severe fatigue,  leaving little energy for work, exercise, or just getting out of the house to enjoy a pleasant day. And fatigue deteriorates posture, predisposing to neck, shoulder and upper back pain.  How to fight fatigue?   Here are some tips (modified from Ellen Greenlaw’s article, Fighting Lupus Fatigue and Boosting Energy,  at webmd.com.)

1. Treat Underlying Conditions that may be causing the fatigue.  These might include anemia, nutrient deficiency, depression, hypothyroid,  kidney disorders or one of a myriad of possible conditions.  Side effects of medication are a special case.   A change in dose or medication may help.(this is what helped me)  See a doctor for help finding an underlying condition.

2. Exercise Regularly to Boost Energy.  Start slow. Exercise during the time of day you have the most energy. Choose an exercise you like doing. Maybe a 5 minute walk in the park, exercise-cycling to a movie, cleaning the house to your favorite music and adding a few dance steps while your’re at it. Of course don’t overdo it.

3. Get Enough Good Quality Sleep.  Night-time sleep is important for healing.  Go to bed early, even if you have to drag yourself away from TV or the computer (something I have to do all the time). Avoid alcohol (which makes you sleepy but later disturbs sleep) caffeinated drinks, and overeating or eating a late dinner.
Try using a white noise machine at night. I have a Marpac. But there are several brands, many of which feature sounds like rain or waterfalls or heart beats. I found that the rain sound was okay (radio static is okay too) but couldn’t get to sleep with the other sounds. (For me with mast cell activation disorder, I discovered that the white noise machine lessened  my mast cell reactions to bad dreams. This may be so for  people with normal mast cells as well, thus lessening inflammatory mediator release at night and allowing for better sleep.)
If night-time sleep isn’t enough, then rest during the day. An afternoon nap or siesta can be refreshing. More frequent naps may help, but not too close to evening, which may interfere with night-time sleep.

4. Prioritize Activities.  Make an activity schedule for daily basics so you can plan rest periods and still get done what needs doing. Keeping to a schedule also helps avoid the stress of hurrying to get important things done on time.  Try to do the most strenuous things first when you have the most energy.  It may help to  break bigger projects into smaller, more manageable tasks. Then get done what you can, and what’s left, leave for a better time. Don’t stress over what you can’t do. You’ll get to it, as your energy allows.

5. Learn to Say No.  Your first priority is healing. After that are the activities that mean the most to you. If you know an activity will leave you exhausted, find another way, or say NO. Also avoid activities that increase your stress level.  Along with that, avoid people who add more stress to your life.  (Some people are just plain toxic.)

6. Keep a diary (or simply a daily graph) of your symptoms and  how you feel.  This little “research project” can help you figure out what activities or meds or time of day etc. make you feel better, and which make you feel worse. If you want to track your health online (some neat tools)  and want to join a social health network, you might consider www.patientslike me.com. (This site has a research staff (PhDs), who mine the data for research purposes and publish research articles in well regarded medical journals.

Droopy Shoulders Syndrome

An exception to use of part 1 of Fix the Shoulder Blades Exercise is a condition called Droopy Shoulders Syndrome (DSS) that is mainly present in women with low set, steeply sloping shoulders and long, swan necks. Their collar bones (clavicles) slope down at the outer ends rather than the usual slope up. In lateral neck x–rays, all of the 7th cervical vertebra, the 1st thoracic and sometimes part of the 2nd are easily seen when usually the shoulders prevent visualization. Pain in neck, shoulder, arms, hands is aggravated by downward traction on shoulders and relieved by propping up the arms, and may involve Thoracic outlet syndrome. In DSS the shoulder blades are already held too low on the back and don’t need to be lower. Maintaining a slight lift of the shoulders so they are more squared helps. Part 2, Pinch the Shoulder Blades Together is still useful if shoulder blades are wider apart than 4 inches. Consult your physician or physical therapist. See “The Droopy Shoulder Syndrome,” L. Clein, and “The Droopy Shoulder Syndrome” by Swift and Nichols]

My neighbor had neck, shoulder and arm pain (around the biceps muscle). Her shoulders were obviously very sloped down, and her neck seemed very long. I urged her to see a physical therapist, which she did. Luckily the head physical therapist (not the assistant) knew how to help her. The advice was to keep her shoulders raised a bit. I recently talked to her and noticed her shoulders are more squared and she says her pain is gone. It has only been recently that I realized the clavicle (collar bone) in front in most people slopes up toward the outside ends., showing that the shoulder blades, which are attached to the clavicle near the shoulder joint are held a little higher.  But hers are straight horizontal. Wish I’d noticed whether her clavicles were downwardly sloped before she got the therapists advice to lift her shoulders.