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Tension Neck Syndrome |
Neck Pain Relief  Tension Neck Syndrome |
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Tension neck syndrome can be defined as pain and stiffness in the neck with palpation tenderness in the trapezius muscle on physical examination.Tension neck syndrome may cause a feeling of fatigue or stiffness in the neck, neck pain or headache radiating from the neck. Signs consist of at least two tender spots or palpable hardenings. Many of the non joint related (nonarticular) pain syndromes of the neck and shoulder (cervicobrachial) area have been given a host of names, e.g., fibrositis, fibromyositis, myofascial syndrome, muscular rheumatism, tension myalgia, trapezius myalgia, tech neck, posture related neck pain or cervical strain. These vague and poorly defined syndromes account for a substantial number of musculoskeletal disorders and much work absenteeism. Cervicobrachial myalgia has been noticed often among office and factory workers with mental stress and repetitive or static loading of the muscles. Thus the syndrome has been called occupational cramp or myalgia or occupational cervicobrachial disorder. Tension neck syndrome consists of a variety of symptoms such as pain, tenderness and stiffness of muscles, signs of hardened bands or nodularities, and muscle spasm. The complex usually has a point of origin - trigger point - from which the pain and numbness is referred to the reference zone and the common boundaries of nerve distribution are often ignored. Various reflex phenomena mediate via the sympathetic nervous system, such as involvement of the central nervous system. The psychogenic basis of the syndrome has been stressed by many authors, and it has led to terms like "psychogenic rheumatism" or occupational neurosis. Typical symptoms of Tension Neck Syndrome:
As there are no universally accepted criteria for diagnosing tension myalgia of the cervicobrachial area, reports of this syndrome are not comparable. Vague pains of the neck and shoulder girdle are often noted. Occupational cervicobrachial disorder has been widely discussed, and its prevalence stated among, e.g., assembly-line workers, cashiers, packers, and office workers. If myalga due to clear injuries, infections and inflammatory or degenerative musculoskeletal diseases are ruled out, there remains an inconstant, functional entity which can be called "primary tension myalgia". This may cause local chilling, acute strain, overexertion and excess fatigue of the muscles, or immobility and inadequate exercise. Also chronic straining, habitually poor posture and psychogenic factors such as depression or emotional stress and tension have been considered important. Tension neck syndrome may be a functional and organic disorder due to muscular and mental fatigue in static and/or repetitive arm and hand work. The causative dynamic muscle loads can be repetitive, high speed finger, wrist and arm motions hundreds or thousands of times per workday. Unnatural and static positions of the arms with raised elbows and shoulders, as well as the need for excessive force increased the static muscular load. Mental strain such as monotonous work conditions, need for concentration and much responsibility, together with poor illumination and noise, were characteristic of most of the occupations. Working with elevated arms, especially in overhead positions, may cause subjective shoulder-arm fatigue. By means of quantitative electromyography localized muscle fatigue can be identified in the deltoid, trapezius and supraspinous muscles. The cause of tension neck syndrome is still somewhat speculative. Three of the four cardinal features of myalgia (palpable hardening, local tenderness of the muscle, referred pain and reflex phenomena associated with muscle pain) may occur alone or in any combination. The most commonly proposed theory for the pathogenetic mechanism of this disorder focuses on localized muscle fatigue due to static, sustained contraction. The basic process has been proposed to be the accumulation of metabolic end products in the muscles or insufficient oxygen supply resulting in chronic muscle fatigue and myalgia. Many of the investigations concerning tension neck syndrome stress its psychogenic aspects. The subjective feeling of localized fatigue and pain is often guided by motivational or social factors, and the psychological constitution of the patient partially determines the' behavior and prognosis of the disorder. One cannot state whether the recorded psychological disorders,' such as hypochondria or depression, are due a neurotic preoccupation or are a consequence of the vicious long-lasting spasm pain cycle necessitating methods of coping with neck pain. Tension neck syndrome and cervicobrachial myalgia is a functional disorder with fairly common, but somewhat various, clinical symptoms. The objective clinical, electromyographic, histological, and laboratory findings are, however, inconsistent. Both the psychological and, partially, physiological constitution of the worker may contribute to the development of the syndrome, External work factors, such as static loading of the shoulders and arms, and repetitive, high speed motions in connection with mental stress can lead to muscle in-coordination and spasm. The connections between external work load and acute muscle fatigue and ache have been well established, but the occupational basis of chronic myalgia has been only indirectly indicated by epidemiologic investigations. These investigations also promise, however, that by work design and ergonomic improvements of the work environment the morbidity of this syndrome can be decreased. Mouse use is associated with an increased risk of pain in the neck and shoulder, and an association with tension neck syndrome is possible. A study found the prevalence of tension neck syndrome was 1.4% at baseline, but the risk for tension neck syndrome among the participants who used their mouse for >25 hours/week was fourfold in comparison with no-or-minor use. A community-based case-control study found for women a significant association for shoulder-neck diagnosis (58% of affected subjects had tension neck syndrome) with computer work about 4 hours/day. A study found more trigger points and pain provoked by neck sideways flexion in subjects performing data entry work compared with subjects doing data dialogue work. A prospective study of air-traffic controllers changing from varied computer work to a strict mouse-based system, only found significant increase of musculoskeletal disorders in the neck and shoulders among the younger half of the study group. At baseline a majority of the affected controllers had tension neck syndrome, however there was no information on specific diagnoses at follow-up. The work-related load of the neck in computer work is influenced by the computer workstation lay-out (including use of specific devices) and individual working technique. In a study with no observed association to computer work in general, an association to tension neck syndrome was found in subjects with limited rest break opportunities, in subjects who had their keyboard too highly placed relative to elbow level, and in subjects who used bifocal glasses. Some studies show an association between computer work and tension neck syndrome, especially for women. With respect to specific aspects of computer work, one very high quality prospective study documents a clear association between mouse use and tension neck syndrome. In two very high quality intervention trials the introduction of forearm support protected against shoulder-neck diagnoses among female call center operators. Indications are found of the importance of individual working technique and work station lay-out in causality of tension neck syndrome. These include lack of forearm support, non-neutral position of forearm and neck flexion. Common Causes for Neck Tension Syndrome:
Common Solutions for Neck Tension Syndrome:
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