About That Pain in Your Neck

by Sharon on April 13, 2016

Most people hold at least a little tension in their necks and shoulders. But sometimes even ordinary, every day tension suddenly descends into pain. Maybe you can’t turn your head because of pain and stiffness. Maybe you have pain shooting to your shoulder and arm. Is your sleep affected?

Maybe you’ve decided it’s time to get help and want to know more about it, including who can help. In New York City and New York State you can see a Physical Therapist directly without going to a doctor for a referral. Or you might prefer to see your doctor first to get his advice and impression. Common diagnoses for neck pain are cervical pain, cervical spondylosis, cervical arthritis and cervical radiculopathy.

I’ve made some notes below which I hope will help you on your journey of healing.

The Physical

  • You are getting older and your disks and joints may be injured from misuse, overuse or just stiffness which can come with age. (NB this can be helped.)
  • You have a family history of neck or back problems. Does anyone in your family have degenerative disk disease (DDD) also called Degenerative Joint Disease (DJD)? (Don’t worry, these are awful and unfortunate medical names which basically just mean that your body is aging.) Likewise with a family history of cervical radiculopathy, cervical spondylosis and cervical osteoarthritis, you might be at a greater risk of developing neck pain. Genetics.
  • It’s possible you sleep in a way that irritates your neck muscles and joints. Is your pillow too hard, too soft, too high or too low?  Did you sleep on your belly?
  • Overwork or strain from sitting hours at the computer.
  • Slouching.
  • From exercising – too much or too little.
  • You pulled a muscle in your shoulder or neck – not likely.
  • You were in a car accident or you fell and injured your neck. Do you have whiplash?
  • Your have a habit of holding tension in your neck and shoulders – not just a little but a lot. (Do you have a super stressful job or life or both?) Are your shoulders up around your ears?

 The Psychological

  • You hold psychological tension and stress in your neck. See above.
  • You are stressed / angry / sad / mad / anxious / depressed.  John Sarno, MD writes extensively about the  psychological influences, even causes, of our unacknowledged, unconscious, emotions and thoughts on our bodies.
  • You are sticking your neck out, engaging in some new and uncomfortable activities which may be causing you stress.
  • You’re a parent
  • A student
  • You work at a stressful job
  • You don’t have a job
  • You have financial stresses
  • You get the picture.

What to do About It?

 

Please feel free to contact Sharon Gary for more information or to set up an appointment.

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Sciatica, Herniated Disc and Back Pain

by Sharon on April 12, 2016

Sciatica

Sciatica

If you arrived at this page, I imagine that you or a loved one are looking for help and the right treatment for sciatica, back pain or a pinched nerve. (Your nerve isn’t really pinched though it may be compressed from a herniated disc.) Sciatica can be an irritating,  painful, sometimes scary, condition. I want to reassure you that it is possible to find effective treatment to manage and heal your sciatica – at least I’ve found this to be true in my 20 plus years working as a NY physical therapist, specializing in neck pain, spine pain and sciatica.

Do you have the hallmark signs of sciatica: pain, numbness, burning or tingling anywhere from your low back to your hip or further down your leg, even all the way to your toes on one side of your body? Do you have trouble walking, sitting, or exercising because of it?

Since sciatic nerve pain is most often associated with back pain, and since the causes of low back pain are not crystal clear, neither is the cause of sciatica. If you have a history of back pain plus radiating leg pain, has your doctor performed an MRI and found you have a bulging disc or herniated disc? Were you diagnosed with lumbar radiculopathy?

Physical therapists and other medical professionals describe sciatica as a set of symptoms, not a clearly defined disorder. When a patient comes in for treatment of her sciatica, a number of questions run through my mind. Is her low back pain or sciatica caused by a bulging disc or herniated disc? Does the pain arise because of an irritated or stuck facet joint (other joints on each vertebrae)? Or is her sciatica caused by inflammation or irritation anywhere in the low back or along the sciatic nerve in that one leg? Does she have arthritis in the spine or osteophytes? Does the pain arise from a biochemical reaction to injury? Or did she develop sciatica and/or back pain after taking a fall or some other compression injury to the buttocks? Even a tense muscle can pull the spine in such a way that you experience nerve impingement. Did you know that stress and how you work with it can be a huge contributing cause to pain? Then might you want to choose a physical therapist who, in addition to giving you the best treatment possible in nyc, also gives you the time and gentle care you need so you can work through all of the factors contributing to your pain and stress?

Now sciatic pain can be simply due to a tight or injured piriformis. This is called piriformis syndrome. What this means is that the piriformis muscle, a muscle deep in the buttocks, may be pressing on the sciatic nerve because of your structural anatomy or because you slipped and fell on your buttocks, or because the piriformis is overworked and tight, as can happen with dancers. Most of the time though, both in my experience and in the medical literature, that sciatic pain in your leg originates in your low back. The piriformis muscle is likely to be tight or implicated at the same time and needs to be treated as well.

Maybe you and/or your health care providers have thought that the pain in your buttocks was a hamstring pull, or the pain in the back of your ankle was achilles tendonitis. The missing link in treating plantar fasciitis may be related to the lower branches of the sciatic nerve. Is it possible you have a hip, leg, ankle or foot issue AND the nerve somewhere in the leg is out of whack? Oh yes. I have encountered this so many times in my physical therapy practice.

Now if you are treated for any of these seemingly unrelated injuries – a pulled hamstring, calf, achilles tendon, or plantar fasciitis – and the problem still lingers, you might want to consider seeing a physical therapist who is knowledgeable and skilled at treatment of peripheral or, in this case specifically, sciatic nerve pain.

Again, stress can be a huge contributing factor in chronic pain. Huge. Most of us intuit this, but we don’t know what to do about it. We also know that stress affects us physically, emotionally, mentally, or spiritually. Did you know that even your beliefs about pain can affect its intensity and duration? The question is how do you work with the stress which may be exacerbating your low back pain, lumbar radiculopathy or sciatica?

This is where Yoga Physical Therapy in NYC comes in. In these one-hour private  sessions, you learn to become aware of the stress in your body and then how to work with it. Your insights into your stress are gold. Here, you will be instructed in different strategies for relaxation and mindful breathing. A mashup of gentle, targeted exercises – from yoga, Feldenkrais, dance, and physical therapy – are given for their healing effects. By learning to breathe with and into the pain during these gentle exercises, you are doubly empowered to decrease and manage your own stress and pain.

What are other best treatments for sciatica and back pain? Look for a physical therapist who knows neurodynamics, also known as nerve flossing or neural glides, who knows about nerve massage, which together can be super effective in easing the sciatic pain. Gentle hip stretches are among the first exercises to do to soothe and open the body and mind. Maitland’s spinal mobilizations are hugely effective. So is myofascial release to the trunk, hips and leg. Often yoga poses, like sphinx and cobra, are effective in the treatment of bulging and herniated discs. They don’t work for everybody. If they are the right treatment for you, they can help decrease back pain and stiffness as well as relieve pressure on the sciatic nerve.

Each patient is unique and requires different treatment strategies. Therapeutic exercises need to be carefully chosen and monitored to see how they work for you at each stage of healing. I think of each exercise, carefully taught using a mindful breath, as a discreet dose of medicine. These exercises, knitted together with your ongoing feedback, are designed to ease and heal what hurts. Your feedback, questions and preferences are consulted at all stages of treatment. You set the tone and pace of your physical therapy, not the therapist. Not the insurance company.

As most cases of sciatica, or lumbar radiculopathy, arise from the low back, the spine needs to be evaluated and treated. I find a gentle, thoughtful approach is best. Effective physical therapy treatment will work first to decrease the pain. There are stages of stretching and strengthening which come next. But first I’m concerned, as I imagine you are, too, with finding the fastest and best ways to decrease your pain.

Sharon Gary, a NY physical therapist offering the best treatment practices in midtown Manhattan, will work with you one-on-one in private one hour sessions. Using these effective healing treatments, strategies and techniques, her approach with Yoga Physical Therapy has helped many people with herniated discs, back pain, lumbar radiculopathy and sciatica.

 

Please feel free to contact Sharon Gary for more information or to set up an appointment.

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Did you just wake up one morning with neck stiffness, neck pain? Or did you have a stabbing sensation around your shoulder blade and you can’t turn your head? Do you feel pain radiating to your shoulder, deltoid, wrist or hand? Chances are that these symptoms start in your neck.

Here are strategies to get through it and back to feeling great.

First, try to identify the cause of your neck pain. Did you sleep in an awkward position? Did you overexert yourself the day before? Spend too many hours at the computer leaning into the screen slumping in your chair?

Next, reach out to someone in your network to help you — a good massage therapist, acupuncturist, physical therapist, doctor or physiatrist.

Rest lying down on your back with head on a low pillow. Apply a moist heating pad for 20-30 minutes. Longer if you have the time. Constructive Rest, breathing and meditation can be extremely helpful. It is amazing how much mindful  breathing in a supported position can melt away overall body soreness and tension.

Feldenkrais arm movements. Make the arms into a shelf by holding onto the forearm/wrists perpendicular to the torso. Keep a loose hold on both wrists and let the arms fall to the side. Breathe. Breathe deeply. Alternate sides 3x. These are my favorite neck exercises, which really help with neck pain.

Exercise Balls. I have nubby balls, and balls made with spikes to dig into the trigger points. Get some small balls to place under your shoulders, neck or back to dig into the painful or tight spots, wherever they help with the pain. You will want to use balls smaller than tennis balls. Golf balls are the perfect size but much too hard. You can probably find a rubber sports ball that’s the perfect size in your the gym section of big box stores or in a local sports store. Rubz for instance should be perfect.

Heat or Ice for at least 15-20 minutes. Different people respond differently to ice and heat. If you have an electric heating pad with a sponge for moist heat, or a microwavable heating pad, lie on it for 15-20 minutes, longer if you have the time. If you prefer ice and have gel packs, great. If not, many use a large bag of frozen peas or corn as an ice pack. You can also make your own by throwing 8-12 cubes of ice into a drip free plastic bag. If using ice, be sure protect your skin with a moistened towel.

Finally, don’t forget to take an anti-inflammatory medication, depending on your beliefs about medication. Your doctor may recommend something – use what works best for you. Many people swear by ibuprofen (Advil, Motrin and store brands). Or you might prefer Naproxen, aspirin or Tylenol. There are any number of topical creams or patches from the drugstore that may help. A homeopathic cream with arnica used by many people is Traumeel. If you live near Chinatown, you can find some great remedies there. Take something that works for you that will take the edge off the pain so you can begin to work your way through it. Tumeric is known to be good for pain. Lavender and chamomile teas before bed are relaxing.

Another tip. Paradoxically, I have found hip stretches to be great relievers of neck pain — secretary stretch, hip stirs, knee-to-chest stretch and the wonderfully relieving figure-4 stretch (sometimes called thread-the-needle).

Please feel free to contact Sharon Gary for more information or to set up an appointment.

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How Your Breath Moves Your Body

January 13, 2016

Inhaling Watch in the gif to the left how the rib cage expands and rises with each in-breath as the organs below the diaphragm* are pushed down to make room for air to fill the lungs. The diaphragm, the primary breathing muscle, is a mushroom-shaped structure. It lies under your ribs and above the liver, […]

Please feel free to contact Sharon Gary for more information or to set up an appointment.

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Are you getting the best Physical Therapy in NYC?

July 17, 2015

How to get rock star Physical Therapy when all you’ve been getting is factory made. How do you know if you are getting great Physical Therapy? Wouldn’t you like your physical therapy to help you heal, feel better AND help you understand your body better at work, home and play? Sharon Gary at Yoga Physical Therapy will give you […]

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The Best Way to Relax

October 14, 2011

When you are suffering from neck, back, hip or shoulder pain, even if you’re just plain tired, Constructive Rest, practiced just 10 minutes a day, is the way to go. Constructive Rest, pictured below, is a resting position of the body, in which the arms and legs are supported rather than held by the muscles […]

Please feel free to contact Sharon Gary for more information or to set up an appointment.

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Variations on Constructive Rest

October 14, 2011

In a previous blog post, The Best Way to Relax, I described the many benefits of Constructive Rest. Here, I wish to offer a few variations on the basic position, pictured at left. At different times, or because of your body type, you might find one of these variations more comfortable. And comfort is what […]

Please feel free to contact Sharon Gary for more information or to set up an appointment.

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Is Your Posture Causing Shoulder Pain?

September 7, 2011

Have you been taught by your Physical Therapist, Yoga teacher, Pilates teacher or trainer to press your shoulders back and down for good posture? What if, instead, you were to ease your shoulders up; rotate them slightly back to open the chest; and then allow them to gently drop into place. Then forget about them […]

Please feel free to contact Sharon Gary for more information or to set up an appointment.

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Degenerative Disc Disease – Neck and Back Pain

March 8, 2011

Is Degenerative Disc Disease Causing My Neck & Back Pain? At the age of 42, after an MRI, I was diagnosed with Degenerative Disc Disease. I also had two bulging and one herniated disk. I went home, crawled into bed and cried, convinced that my body was aging beyond repair, and it would be all […]

Please feel free to contact Sharon Gary for more information or to set up an appointment.

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Free Your Body – Part II

March 7, 2011

Holding On vs. Letting Go Just for a moment, think about what you are doing right now. Feel your body. How are you sitting? What muscles are you using? Are you sitting still? Are you relaxed or are you holding tension in your body? Next, let’s move to thinking about the concept “holding the body.” […]

Please feel free to contact Sharon Gary for more information or to set up an appointment.

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