This article is a transcribed edited summary of a video Bob and Brad recorded in March of 2021 . For the original video go to https://www.youtube.com/watch?v=ntWElqA4LFU&t=276s
Bob: Today we're going to talk about common "pain makers" causing pain in your neck and arm and how to get rid of them. So our goal is you want to, of course, decrease the amount of neck and arm pain you're having. So to do that, we're going to show you exercises and all sorts of other things, positioning but it's also important for you to decrease the things that are causing the pain in your life.
Brad: And you might say, well, it hurts all the time everything irritates it, but we're going to talk about how you can find a few things out. Because we've heard those comments many times from patients, and after a little discussion, we find out, “Oh well, they say it really hurts when I do this.” And then we go into that area and it becomes very much clearer than.
Bob: It becomes clear as you stop doing some of these things, you start finding out that things are causing my pain. Like, let's say you, you sit in a chair with your head bent down, you know? And after a while, you fall asleep in a chair, and your neck falls down and your head falls down and that causes increased pain. And that pain goes on for a couple of hours because of that.
Brad: Sure.
Bob: And, you stop doing that all of a sudden, you maybe have two, three hours of pain free moving. So, you know, it could be pain in your neck or even referred pain down your arm. If you perform a task and it increases your pain, it's a pain maker in our book. If you move a certain way and it increases pain, it's a pain maker. If you're lying in bed and that causes pain, it's a pain maker.
Brad: It may be something as simple as just posture you're not aware of. And it's, you have poor posture you have no idea, until someone takes a picture of you, and you look at it from a certain angle.
Bob: Or like the bed example, you think, well, I'm lying in bed. Why am I having pain? And then, maybe you're lying with too many pillows
Brad: Sure
Bob: You know so, the other problem with the pain is that the more pain you have often the more sensitive your nerves get. So now rather than taking a large event to cause your pain, it only takes a small trigger. You know what I mean?
Brad: Right.
Bob: The nerves become so much more sensitive that the what used to cause a lot of pain hardly takes anything now to set it off.
Brad: And you can think of that. You know it's going to be painful when you move this direction or when you're going to do this activity, so even before you get to it because you're starting to feel anxiety and that can all trigger into the whole pain cycle.
Bob: Right. So the cycle is hitting the wrong way. It's getting worse and worse. Now you can also hit it the right way by taking the pain makers out of your life you can see that you can control the pain.
Brad: That's a big deal. When you find out you can control it. You know, that's, that's huge.
Bob: Yeah. It doesn't have to control you. So, what Brad and I thought was that we’d go over some things that you probably should do right now. And Brad, and I 'll go back and forth. And now, number one I would not look down continuously, right now when you're having neck pain while reading, knitting or performing desk duties. You want to try to get things. That's how we often talk about setting up your office or home computer, making sure the screen's high enough so that you don't have to look down.
Brad: In our society, these are challenges that Yeah, they are challenges.
Bob: Yep, they are challenges.
Brad: And number two, we're looking at continuously looking at a phone or a laptop. You know phones are, you know pretty much phones are the new TV.
Bob: Yes, it is.
Brad: You know? So we're down looking at the phone, putting stress on the neck. And it's one of those things. When you do it immediately, it doesn't cause pain, but over 20 minutes, it gets it that fired up mode, and then you don't really realize that, that was the problem.
Bob: You don't even realize it that it's sneaking up on you. So bring that phone up by your face. This is what you need to do. So I just a generalize one is putting the neck in what we call putting the head in the forward head posture. So you know, that neck is geeking forward. This is such a common position that we see with sitting and working and, and even lying down sometimes.
Brad: Yeah, the pillow issue again.
Bob: All right, Brad, what else we got?
Brad: Ooh sleeping on your stomach or your head is turned to one direction as far as it can go. And that's fine. But if you lie there for any period of time, that's end-range on the joints, which is a common therapist term that we use. We know we don't like to put our joints at end range for prolonged periods, that irritates them. So, no more sleeping on the stomach.
Bob: Yeah. If you do it, do it for a very brief time.
Brad: Hopefully if you do, when people that do sleep on their stomach that don't have any pain, they've probably got pretty normal motion. They probably turn their head right to left frequently, without even knowing that.
Bob: Sure. All right. Like we alluded to a number of times as sleeping on your back with the wrong number of pillows. Generally, when you sleep on your back, and we'll go into this in another video, you want to have a thinner pillow so it doesn't move your head and neck forward.
Brad: And the same thing with sleeping on your side you've got a different posture you need to accommodate so that your neck is not stressed. And we'll cover that probably in the same video.
Bob: The other one, number seven don't sit in a slumped rounded position. What does this have to do with neck? Well, if you're like mid back is rounded out, there's no way you can have the neck in good posture. It just, it just follows suit. So you got to have the entire spine in good posture or your necks going to be in a bad position.
Brad: And this is one of those things where it comes into play with our next thing, watching TV, you know it's all that slumped posture, sitting in your car or sitting anywhere. And you know, Bob, we both know that particularly with younger kids, you ask them to sit up tall and straight with good posture and a lot of times they'll say “it just feels so weird and it’s not even comfortable.”
Bob: I know they say, “who sits like this.” They don't realize how bad they look the other way and how good they actually look sitting up straight. But the other thing with that, Brad from that same point is that you don't want to have your computer screen off to the one side either or TV off to one side. If you're constantly looking, let's say to the right, you're going to develop pain on that right side of the neck possibly. So you want to have the things right in front of you, even if it's slightly off, it's not a good thing.
Brad: This is one of those things that, the older you get the more you realize it.
Bob: Yeah, it becomes very evident with you as you get older because these things crop up and you’ll know.
Brad: Particularly over the age of 50. I just had a physical and the doctor said “Once you get over 50 things kind of start changing.” It's like, wow, that, that was my experience.
Bob: Well, Brad jokes, something new crops up pretty much every day,
Brad: Nothing major, but you know things that you used to be able to do.
Bob: Next, cycling with your head down posture, Brad you're a big biker. I do some biking.
Rad: Yeah. And it depends on the type of bike you have. If you've got a bike that is more normal it keeps you upright. you're going to have less stress on your neck.
Bob: You’re just not going to go very fast.
Brad: I have the bike that you lean forward and go in the arrow bars, and it's not that comfortable. I've got to sit up every now and then stretch my neck because it's a little uncomfortable.
Bob: Yeah. And you know what I do? My bike is upright but I often like take my arms behind my back and stretch it.
Brad: You can let go of the handlebars?
Bob: I can let go of the handlebars. But I started thinking maybe I shouldn't do that anymore because if I go down, I'll go down. So, all right. Number 10, Brad, you’ve got number 10, right?
Bob: Oh yeah. Driving with incorrect posture, same concepts that we aren't talking about. The thing in a car is you can adjust your lumbar support, hopefully. If your lumbar support is good it makes it much easier to have good posture in your neck. So make sure you're got that adjusted properly.
Bob: This next recommendation is with a caveat because if you can run without pain, I absolutely recommend that you run. But if it's increasing your pain one might be that you have bad posture while you're running and then it's actually the shock absorption is making it worse. But generally, running is good for you as far as increasing the oxygen to the area, and the healing power but you have to have good posture while you're doing it. We have a neighbor lady, I want to put my knee between her and back, pull her shoulders back
Brad: Go out there and do it and see what happens. She’ll probably thank you for it. There are a small percentage of people that actually run, I think overall, but yeah. It's something good to point out. Oh, here we go. Next one sporting activities.
Bob: Don't do them if they increase your pain.
Brad: Or change how you're doing them. Maybe it is a postural thing or something of that nature.
Bob: We’re not saying that you can't go back to it, but we want to calm things down. We want to calm the pain down. So let's say you're having pain while you're playing tennis. Cause you're turning your head a lot, wait until we get the pain knocked down again. Then you can gradually go back into town
Brad: Boy, that sport just with the abrupt changes in directions, that can cause pain.
Bob: I think the big one now is pickle ball.
Brad: Oh yeah. That is becoming very popular. Do they eat pickles?
Bob: I don't know. I haven't got into it. So, lifting weights am I'm going to tell you it’s fine to lift weights, as long as it doesn't increase your pain but if it increases your pain, you can't do it. It’s that simple.
Brad: Well, body mechanics is so critical at lifting weights and there's a lot of people that lift that aren't aware of their poor biomechanics. So make sure you get some proper instructions.
Bob: Yeah. You want to bring up pretty much you, one of your spine nice and upright and completely erect when you’re lifting.
Brad: And that's why a lot of gyms have mirrors. So you can actually see what's going on with your posture.
Bob: Not just to look at yourself and see how big you're getting or toned you're getting. So number 14, Brad that's you.
Brad: Oh, working in a cramped or awkward space. That's very typical with a lot of computer work stations. You put everything into one area so you can work. Especially now with COVID people are trying to convert things into their house.
Bob: What about a car mechanic or a painter? You know, they're really in confined spaces a lot.
Brad: Yeah. It depends. I mean, when I was working on equipment for service calls where I'd be almost upside down and trying to reach under something. You need three elbows just to get your arm around. If you're a mechanic, you know exactly what I'm talking about.
Bob: Unfortunately, with that, if it’s your livelihood, there's nothing you can do right now. We'll try to show you some things to do in between.
Brad: The elevating work bench can be a really handy tool for something of that nature.
Bob: If you tilt your head out of habit in the same directions, a lot of you don't know you even do this. I do this when I'm doing notes, I'm always tilting my head to the left. So as an exercise, actually I have to tilt my head to the right, the opposite direction. We'll go into that later. But you want to try to avoid those, you know especially if it's a daily habit you're doing hour upon hour, day upon day, years upon years.
Brad: Yeah.
Bob: All of a sudden it will start giving you pain.
Brad: So shoppers tilt?
Bob: Well, is that referring to the same as the shopping cart and a shopper's tilt is when you just carry something on just one side.
Brad: Oh. So if you've got a big purse or something of that nature or backpack.
Bob: Or if you bought something and you're carrying it all in one hand you're supposed to have spread out the load.
Brad: So you should buy two of them?
Bob: That's right. Lol
Brad: Carry one in each arm.
Bob: That’s what you can tell your spouse. I was supposed to buy two of these Bob and Brad said. So, keep the weight evenly distributed. Number 17, it's kind of a repeat there but what they're talking about is if you're carrying a heavy suitcase at the airport. You, want to get a rolling one.
Brad: I don’t even think they make them the other way anymore
Bob: I know my, my niece just was having trouble with this. She, she flies a lot, was flying a lot. And she was getting like thoracic outlet syndrome. I don't know why she didn't have a roller. What I think it was, you know there's times you have to lift it up to go upstairs or something. You know what I mean? And she was always using one arm and she has a purse over her neck.
Brad: Did you straighten her out?
Bob: I straighten her out.
Brad: Oh good.
Bob: So anyway, again, decrease the pain. So you decrease the sensitivity of the nerves. We're going to show you some exercises to help you also along with this but the pain does not have to be permanent. You know, we're going to help you get rid of it. By the way this is a part of a series of videos on neck pain. So you go to https://www.bobandbrad.com/ go to the program section and look for neck pain. And you'll see a whole series of videos.
Brad: Go to the one that fits you. Don't worry. They're not all just talking like this. We're actually going to show you some exercises that we've had great success with patients and you can work with them yourself. And there's a PDF printout to show you the exercises. Once you turn the video off so that you can refer to it, a little review of the video, it's a great thing. There's no email or anything. It's all free and rate ready for you.
Bob: Like this one week, for example we got a list of the 17 things you should do right now.
Brad: Oh so they can read it all. Yeah. They'll probably print it and not watch the video.
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