Neck problems begin before a person can walk: in the womb. The fact that we grow up to stare at our phones for hours doesn’t make things any better. Part 1 of our series examines the causes of neck pain.
This experiment is taking place at Chiropraktik Wien, the practice which Anna Fiand, Master of Science in Chiropractic and physiotherapist, runs with chiropractor and physiotherapist Wolfgang Placht. «Since Covid, we’ve had a waiting room full cervical spine problems,» she says. «These complaints aren’t new, they’ve just become more frequent with the increase in home working.»
The pain’s in the wrong chair
Neck pain: heavy is the head that stares at a phone
Space problems during pregnancy
Impaired flow of information from the brain to the extremities
But when the cervical vertebrae are displaced, the flow of information from the brain doesn’t work properly, so the child moves their hand and leg on the same side or drags a leg, to give just two examples. The muscle chain that is later needed to stand up and keep the child stable when walking cannot develop properly either. The result: it works, but physiologically not quite correctly.
Nevertheless, the human system works. But it’s possible that the child may have flat feet at the age of three because the arch of the foot wasn’t able to develop. Parents are often reassured that their child will grow out of it. On the contrary, says Anna Fiand: «The curvature serves as a shock absorber. Without it, we can’t roll properly, namely over the big toe, and this promotes the formation of flat feet, splay feet and hallux valgus. It’s a chain reaction.»
Moving the handbrake on
It’s a phenomenon of our time, she says. «Certain muscle chains are responsible for us being able to bend or straighten out.» A crooked posture creates tension, pulling on the handbrake. Upright posture allows for axial loading. In short: it releases the handbrake. If the movement chain for standing up is too weak, you slow yourself down, often for the rest of your life.
The nervous system, the in-body detective
Part 2 of this series will be about what can help you with neck pain and shoulder and cervical vertebrae problems.
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Physically speaking, Anna Fiand isn’t an amazing specimen. Technically, though, she is. When the slender chiropractor leans her forearm on my neck, I don’t groan under the weight. It’s baffling. She does it twice. Sitting upright in a chair doesn’t feel like a strain. The weight feels something like a cat making itself comfortable. Then I arch my back and sink into the typical sloppy desk posture. Suddenly, Anna weighs down my shoulders as if she were a bodybuilder. The difference in load is clear, demonstrating the huge difference between correct and incorrect posture.
Not every company is fully equipped with ergonomically sophisticated office furniture. But home working means people working at their kitchen tables or sitting on the edge of their beds. They then take the consequences to specialists from chiropractic to orthopaedics. Dr Gerd Ivanic, lecturer and head of the Institute for Orthopaedic and Cardiological Rehabilitation at the Graz Ragnitz private clinic, confirms: «Cases are on the increase, mainly due to incorrect posture when using tablets, desktop computers and mobile phones.»
The statistics back this up. The «Frankfurter Allgemeine» quoted calculations by analysis platform «App Annie» demonstrating that people around the world spent 3.7 hours a day on their smartphones in 2020. According to Postbank’s youth digital studies, German under-40s have been online for an average of 86.2 hours a week in 2022. In 2021, it was only slightly less at 85.1 hours. From the age of 40, the desire for digital entertainment decreases: the figure is 55.4 hours for 2022 and 55.6 hours for the previous year. The most popular device for going online – regardless of age – is the smartphone, occupying an 84 per cent share.
While office work and computers force people to sit down, smartphones force us to look down. «The most common issues are cervical spine complaints and the so-called mobile phone neck,» says Dr. Ivanic. «But patients also visit us with tinnitus, chewing pain, dizziness and unsteady gaits.» Tension can radiate inside the body. «A patient from the board of a large company came to us with a headache and nausea. We had to change their entire daily routine, work routine and office setup.»
Dr Kenneth Hansraj investigated how muscle imbalances occur at the New York Spinal Surgery and Rehabilitation Clinic. The study, which was published in the specialist journal «Surgical Technology International», weighs heavy. An adult head usually weighs about six kilograms, and the further it tilts forward, the more weight is placed on the cervical spine. Just a 15-degree tilt increases the load to 13 kilos. Smartphone users lower their heads up to 60 degrees. This hyperextends neck muscles and forces of up to 27 kilos act on the neck and back.
«Patients always want to know where their pain is coming from,» says chiropractor Anna Fiand. Her answer is simple: «Because we’re alive.» And life begins in the womb. If a pregnant woman’s skeleton isn’t properly adjusted, poor posture can easily occur, which can affect the child. This leaves them too little space to lie properly. When the mother’s sacrum tilts forward or the pelvis tilts inward, they can press against the embryo’s head and push it to the side. It’s as if the child has a crooked neck; and, if the pressure comes from behind, it’s the equivalent of the mobile phone effect.
«At birth, the baby usually has to go through an extremely narrow tunnel head first. This also places a heavy strain on the cervical spine, which can be shifted or blocked because the muscles that connect the skull and torso are still weak. If infants’ first and second cervical vertebrae were adjusted after birth, children could often be spared an ordeal,» says Fiand. If midwives were also trained in craniosacral therapy, the cause could be eliminated in two minutes in the delivery room. However, if the atlas (the first cervical vertebra that supports the entire head) and the axis or epistropheus (the second cervical vertebra and the rotational axis of the head) remain misaligned, you might find yourself taking your child from doctor to doctor.
There’s a vast range of potential complaints. Causes for colic or difficulties with coordination and concentration can start with the cervical vertebrae, because the main receptors for movement and posture are located there. Displaced vertebrae put pressure on the nervous system. Displaced vertebrae impede the unrestricted flow of information in the nervous system from the brain to the periphery and back. A child may be crawling, but not quite correctly. They actually have to crawl using opposing limbs, i.e. moving their right hand forward with their left leg or their left hand with their right leg. This requires a connection between the left and right halves of the brain and body.
So, neck problems can begin before humans can even walk. Things are connected, affecting each other. Some children have problems with fine motor skills, which is noticeable when they press too hard while writing at school. They find it difficult to perform a complex movement pattern, such as a jumping jack. These are all micro signs, but not ones which lead teachers and parents to take a look at the cervical spine. Instead, they assume that the child is clumsy. Anna Fiand says: «The child isn’t clumsy; they’re just not properly adjusted neurologically. They move like they still have the handbrake on.»
Anna Fiand describes this vividly. The first shifted vertebrae don’t cause any problems in the body. The brain compensates for them. But that doesn’t last forever. At some point, the structure changes. Sharp edges form on the bones that look like little mice teeth. There’s an incorrect load on the bones. Incorrect posture squeezes the intervertebral discs backwards. That sound many people hear when they turn their heads is wear and tear like this. «It’s like sand tricking onto my neck.»
It’s the nervous system that controls information processing in the brain and constantly compares the target state in the brain with the actual state in the periphery. It’s the supreme controller in the body. If something doesn’t work, an attempt is made to adjust it. Chiropractic, explains Fiand, «aims to ensure that the nervous system and brain regions can work together appropriately, from the first breath to the last.» An ambitious goal. Thirty new brain areas have been discovered since 2018 alone. The required work faces hurdles and blocks from all directions, such as acidosis, stress, trauma, inflammation and hormonal imbalances, to name just the usual suspects.
«The body is doubly burdened,» says Anna Fiand, «both due to the incorrect posture that we notice and through the bad posture that comes later.» Whether that’s through tablet and mobile phone use or trauma, for example after an accident. One thing is often overlooked after classic whiplash. X-rays reveal fractures, but only MRIs show the condition of the soft tissue, and structural changes often take months to appear. The steep position of the cervical spine is particularly underestimated, and it’s this that causes a string of subsequent complaints, from headaches and neck pain to concentration disorders, burnout and loss of libido.
