We had a new patient in the office recently with a complaint of right upper back, shoulder blade, and neck pain. He also noted intermittent right arm ache, numbness, and tingling to the ring and pinky fingers. “I haven’t done anything to cause this, I just woke up with it yesterday and it was bad. Laid on a heating pad all night last night and could barely lift my head off the pillow to get up today.”
A thorough history revealed no trauma or physical activity that might have contributed, but the patient did relate that he sat at a computer all day, and that he was a stomach sleeper – and a devout one at that!.
When told these two activities could contribute to his symptoms, he was incredulous. “How”? Let us count the ways:
1. Sitting with poor posture at a computer all day is a recipe for just this type of condition. Chronic strain on the muscles and joints of the mid-upper back and neck can cause the condition, or make it more likely that you’ll get it from something else, such as…
2. Belly sleeping, with your head turned (rotated) to one side and tilted backwards (extended) on a pillow, is incredibly tough on your spine. Your entire spine, from the low back to (especially) your neck and upper back. Rotation and extension of your neck causes compression of the pain-sensitive joints (facet joints) between your vertebrae. It also causes the narrowing of the canals through which the nerves exit the spine (the IVF or intervertebral foramen). And, it tightens and irritates the muscles in your neck and shoulder area. (Other than that, it’s pretty good for you!)
To add insult to injury, laying on a heating pad only added to the inflammatory reaction, prolonging and worsening his pain.
After examination, a course of treatment was initiated, including proper home care instructions and, once ready, a stretching regimen. The patient responded favorably, and now sleeps comfortably on his side – cursing us less frequently, he assures, as he gets used to it!