Pillows

When my neck pain was bad, I went through—I can’t remember how many pillows…firm, soft, overstuffed, feathers, brand names, hotel, orthopedic etc.—trying to find one that didn’t leave my neck worse in the morning. Finally I took a medium polyester filled pillow, removed some filling from the center to cradle my head, then used the extra filling to form a “hump” at the lower edge to support my neck, and that was about all that “worked,” but even that wasn’t perfect because the fluff kept compacting. The fancy shaped orthopedic pillows didn’t help. The neck support area always seemed too thick and the new fangled “visco-elastic” material never shaped to my neck (which had lost it’s normal lordotic curve years ago). So I always ended up whittling away at the foam, reshaping it again and again until I had to throw the pillow out. (Some in my neck/back pain group put their memory foam pillows through the dryer several times to soften them. I think I tried it once but it didn’t help.) The one with the little styrofoam beads didn’t help either. I opened it to remove some of them; they got everywhere and stuck to everything, and still my neck didn’t like it. And then there was the water pillow that I ordered online. No matter how much or little I filled that thing, it still wasn’t comfortable. And besides it was heavy with all that water sloshing around and lifting it was tough on my neck.

From all this trying of pillows, it became clear to me, there was no “magic” pillow when one’s neck is inflamed and painful. Some can make it worse, especially the high, over stuffed ones that force your neck to curve into flexion/kephosis (“C” curve). But most won’t help reduce pain that’s already there because of long term poor posture.

Well my neck pain is gone thanks to my new posturally correct self. Currently, I have a nondescript, unmodified, no-name pillow that works fine. I have been thinking of getting a slightly firmer one because I always sleep on my side now. A far cry from when I slept rigidly on my back, towel rolls under the ends of my pillow to prevent my head from rolling to either side.

 

Rear and Side View Car Mirrors

A panoramic rear view mirror* became a necessity when my neck muscles were so spasmed I could barely turn my head.  To this day, I still use a panoramic rear view mirror, because it feels wrong not to.  Why don’t all cars come so equipped?  They have loads of new technology and safety equipment,  front and side airbags, hands-free blue tooth, GPS, T.V. and wired for mobile everything.  A simple panoramic rear view mirror seems a no-brainer. (However, when I couldn’t turn my head at all, I didn’t dare drive even with the panoramic mirror; it was just too dangerous.)

*Auto parts stores have inexpensive, light-weight panoramic rear view mirrors that fit over the existing rear view mirror.

To help with seeing cars  in the blind spot, I use a little stick-on convex mirror in the corner of the driver’s side-view mirror.  This was another necessity when my neck was so stiff and now I still use it.

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

 

Habit Formation, Exercise and Posture

As much as possible, the brain converts repeated actions into automatic routines or habits in a process called chunking. Once chunked, behavioral routines require minimal attention or mental energy to perform. All that’s needed is a cue (or trigger) that switches the brain to autopilot and starts the routine; and then at the end, a reward tells the brain if this particular routine (may be physical, mental, or emotional) is worth doing again. The cue and the reward become associated so that when the cue is present, a craving to perform the sequence emerges. Cues and rewards can be obvious; e.g. doing the grocery shopping every Saturday morning (cue) and afterwards buying a coffee at Starbuck’s (reward). Or not so obvious: washing up before bedtime (cue) triggers toothbrushing, and afterwards the feeling of a clean mouth serves as the reward. Some cues and rewards are so slight that one may hardly be aware of them, but our neural systems certainly are.

Trying to change a habit sequence once it’s triggered is difficult because the conscious brain is not actively involved. One approach in particular seems to help; a study on exercise habits showed that when participants were educated about habit formation and then asked to identify cues and rewards that might increase participation in exercise routines, they exercised twice as much as those who only received lessons on the importance of exercise. Simple cues seemed to be most effective. For example, I put a pedometer (a Fitbit) in my pocket after dressing in the morning (the cue) and take one walk then. Checking how many steps are recorded, gives me a little rush of satisfaction (the reward). (A second walk is cued by my dogs, who won’t leave me alone until we head out the door in the afternoon.)

For an interesting article on habits see the New York Times Article, How Companies Learn Your Secrets (they want to know when a life changing event, such as impending marriage or childbirth will occur, in order to get a headstart sending out advertising. Otherwise one’s spending habits aren’t very open to change and advertising has minimal effect. This article is based on the book by Charles Duhigg, “The Power of Habit: Why We Do What We Do in Life and Business

So how can cues and rewards be applied to improving posture? My experience has been that the feeling of slumped posture can become a cue, and when I become aware of it, I tighten and straighten my mid-back, which lifts my chest and gives me a feeling of release from chest constriction (a reward) and I take a deep breath. Then I do a rep of the Fix the Shoulder Blades Exercise, during which I often remember how much better my profile looks (even when I’m not anywhere near a mirror) and how good my neck feels now versus how miserable it used to be (more rewards). Finding and appreciating those rewards required that I become more aware of how my body looks (especially from different points of view), and also more sensitive to how my body feels, not just pain, but muscle tension, joint position, limitations imposed by poor posture, awareness of shoulder blade anchoring, spine position, posture during movement etc., or everything that comes under the classification of kinesthetic senses. Sometimes I wonder why I didn’t naturally have those sensitivities when I was younger. Perhaps it was my sedentary life. And perhaps also because poor posture develops so slowly there’s never enough difference to notice; and meanwhile the body memory of good posture is slowly lost. As well there’s often little feedback from other sources of information, such as visual (generally only face forward view in a mirror is available and that doesn’t help in seeing the entire body’s alignment), or comments from family and friends (who often don’t want to say anything upsetting, even my mother had stopped criticizing), or advice from medical professionals, fitness professionals and physical education teachers (of all the many I had contact with, none ever said anything about my posture). And perhaps also, poor posture itself, and any pain from poor posture, deadens sensitivity to body state. Is it any wonder that a person’s posture seems to be a relatively unchanging part of his or her physical appearance, except to slowly get worse with age? In order for a person to improve posture, an epiphany of some sort is needed. And once some improvement has been experienced, the body becomes more sensitive to what a healthy postural state feels like, and strives to maintain that state.

However, there is a matter of backsliding into poor posture, and I do find myself slouching, but only when working long hours at the computer, not when standing, walking or other more physical activities. The good thing is though, that I’m more aware of slumped posture, and I put more effort into correcting it. So why is slumping more likely at the computer? Perhaps because computer work takes a great deal of mental energy, and the mind and body tires quickly. And being tired means less energy for the back extensors, which are the critical muscles keeping our backs erect against gravity. Our body structure doesn’t help either. The spine tends to bend forward because the bulk of body weight, is in front of the spine. The thoracic spine, in particular, supports the ribcage and attached muscles and organs, which are a major part of the body’s mass. No wonder the thoracic spine, which naturally has a rounded, kephotic curve, tends to curve even more forward under that weight if the back extensors aren’t kept strong.

Ultimately, maintaining good posture is a continuous challenge, but it is a challenge that can be won, if one becomes aware that it feels so much better (the reward) than slumped posture. The reward is even greater if one has suffered years of pain from it.

Mattresses

When my back was painful and spasmed because I had to sleep motionless on my back all night long (because of my neck), my new Beautyrest mattress was just as hard on my back as the old Sealy Posturepedic. I could feel every little dip of the pattern stitched into the pillowtop…darn uncomfortable. I tried a thick visco-elastic foam topper and after one night—my back spasmed like crazy. The only help would be to sleep on my side, but that had to wait until I’d fixed my neck pain.

The neck/pain support group I belong to has discussed mattresses. The Select Comfort Sleep Number bed seemed to be the mattress of choice. Having separate controls to adjust firmness on either side of the bed for couples was mentioned as a great help. But one member said the massage feature was not helpful and noisy besides. He found the local reps to be very helpful. But of course the sleep number bed is more expensive than most. The Tempurpedic mattress has been mentioned. One woman’s comment was that it felt great in the store but once home, did not give support—it seemed to sag—and by the second night she was “crying in pain.” But she wasn’t helped by an old Select Comfort a friend lent her, either. (This woman was concerned about customer complaints about the pump on the Select Comfort breaking after the 2 year warranty period expired.) Another woman said her Tempurpedic made all the difference in giving her pain relief. And another was sore the next day after trying it in store.

There seems to be back pain patients on both sides—Tempurpedic vs. Sleep number. So which is the best mattress for back pain? Some advice included giving the mattress a try for an hour or two in the store, and then not to consider buying it until after you know how your back feels the next day. As with pillows, a lot depends on the state of one’s back. But how do you improve the state of one’s back if sleeping doesn’t rest it? What will help? Changing sleeping position, improving posture during the day, muscle relaxants, sleeping aids, having surgery if needed? It’s a major puzzle and a “pain” to go through trying to figure out.

Of note: one support group member highly recommends an adjustable “hospital” type bed. Check out if either Tempurpedic or Sleep number comes with adjustable head and foot controls.