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Hey, welcome to the Stay Healthy El Paso Podcast. I'm your host Dr. David Middaugh, specialist physical therapist over at El Paso Manual Physical Therapy. I'll be talking to you today about the three big signs that you have a tension headache.

We see people here at El Paso Manual Physical Therapy for tension headaches, consistently. I wouldn't say it's the most common problem that we see here in the clinic, but we get at least one every month, or two most and they get better.

Let me just differentiate the different types of headaches and let's talk about migraines briefly for a moment, because I'm talking about specifically a tension headache. A lot of people, they have headache or migraine problems. They will start googling information and try to tease out what's a headache? What's a migraine? Do I have this type of headache or that type of headache? Because there are all kinds. But what I want to highlight here today is a tension headache.

A migraine is usually related to some sort of hormonal problem. It could be a nutritional problem or hydration problem. It's usually something that we call physiological rather than mechanical. To put the two against each other, physiological is like the cells that are inside the body, the blood flow, the fluids that are inside the body. The chemicals inside the body and how they all interact and work with each other. Versus mechanical, it’s the joints, muscles and nerves and how all those things move together.

When we are talking about a tension headache, I'm talking about a mechanical headache. The top three signs that you have a tension headache, or aka a mechanical headache:

The number one sign that everybody talks about is pain on the outside of your head.

I'm talking on the top of the head, it could be on the sides of the head, on the forehead. Some people come in saying my scalp is tender on the top of my head. Some people only have one sided head pain, you are only hurting on the right or only on the left. That's very common. Or they will say that it hurts on their forehead or right above their ear on one side. And some people just have pain on the backside of the head, kind of on the back half or back third of the head.

If you are to lie face up on a bed or a pillow, and pain anywhere around there is one of the common signs, as opposed to other headaches can create pain kind of deeper in the head, not necessarily on the on the outer surface of the head. Some headaches can cause pain behind the eye or face pain as well like around your nose and jaw. That's a different type of headache.

I'm talking about a tension headache, and we are discussing pain on the top of the head, the sides of the head above the ears, the back of the head and on the forehead as well. Another reason for this is because when you have a tension headache, there are certain nerves that can get pinched that innervate the top of your head, that on the on the outer most superficial part of your your head along the scalp pretty much. So that's where you are most likely to get all the pain sensations.

The number two most common sign is tightness at the base of your neck.

It's usually pretty strong at the base of the neck, right behind the head, on the bottom part of the head, right where the skull meets the neck, the upper most part of the neck. People usually will reach back there, and they will start digging on the muscles in the upper part of their neck. And they will say it's just tight there all the time. It just feels hard and tight and I can't turn my head all the way because it's so tight back there.

There are some muscles right there called the sub occipital muscles. And those muscles control the base of the skull against the top two vertebrae in the in the spine up there. Those muscles can spasm. They can get shortened, they can overwork or a combination of those three things and begin to not allow the joint where the skull connects to the first bone to move properly. And guess what? There are some nerves that come out right at that level that innervate the scalp, so that's why you can get pain into the scalp, and all the way to the front of the head and along the sides of the head.

But anyways, that tightness that people feel in the back of their head, or the back of the neck, right into the back of the head is the second most common sign.

The third most common sign of a tension headache is burning, achiness, stiffness and pain that can go into the neck and shoulders like lower into the neck

The pain can go into the into the neck, the middle of the neck and into the base of the neck at the bottom, and all the way into the upper part of the shoulders. The upper track region is what we call it, which is between your shoulders and neck area, and then even into the upper back and on the back of the shoulder blades and into the upper back.

The muscles that are in that region often get affected with these tension headaches. And they will feel it. They will let you know commonly that people can't turn all the way, they can turn better to one side versus the other. If they are looking to their right, it may not turn as well when they turn their head that way, but the left side is better.

Sometimes both sides are very limited. People usually just say that they feel pain, tenderness, stiffness, achiness ache Enos and oftentimes burning is a is a symptom that people tell us about whenever they've got these tension headaches.

Let's talk about treatment options for tension headaches. By far the most common treatment option that people will start on their own is over the counter pain medication. They will go to Walgreens, CVS any anywhere where they have medications, at grocery store, and they will buy the over the counter Tylenol. If it's something a little stronger that they want ibuprofen, aleeve etc. those kinds of things.

Pharmaceutical companies are so smart because they know that headaches affect so many people and that it's just so simple to go take medication, they have come out with specific medications for headaches. And usually, people will have some sort of what is it a sleeping aid along with this then they put the two medications together in one so that they can knock themselves out and also feel better. So, you can try that over the counter.

A lot of people try that over the counter and it's effective for a short term, it really is just a short-term solution that masks the pain for a bit, so that you can get through the day, or get through a few days if you need to. But I highly encourage you to use caution and be careful when taking medications because of the side effects.

Those medications, if you read the labels, you are not supposed to use them for more than a few days at a time. You need to eventually talk to your doctor. It's not a good idea to rely on an over the counter pain medication for the long term for this type of problem, for a tension headache. You have to make sure that you are careful about how you are using your medications.

Then some people will go to the doctor, if over the counter pain medications don't work, because they want a stronger prescription strength medication, and doctors of course, that's their bread and butter, they're great at handing out medications. And it's very helpful for a lot of people. But it's the same idea, you are still taking a medication, which is only going to give you short term relief.

In this case, hopefully it lasts a few days, or a week and the doctor of course is considering your overall health in the process. You have to figure that out for yourself if you want to be on prescription strength medications.

Another option that doctors will give you for tension headaches is, a lot of doctors recognize that the source of the problem is usually at the base of the skull, where it connects to that first vertebrae, so sometimes they will do injections into that area. They will do a pain injection directly in that area, and it can be pretty relieving for most people. But again, it's short lived. It only lasts for a month, sometimes a few months at most, but there's usually some underlying problem that sets up that joint to become stiff, and the muscles to become overactive and the nerves to get pinched in the area.

Injections or medications just don't fix that, they don't address stiffness and strength. They alleviate pain, they turn off the pain signals coming from that part of the body so that you can continue through your day. So it's short lived relief.

Another common treatment is chiropractic. And it's pretty effective. If you have ever visited a chiropractor, of course you know that they like to pop and snap joints so that's their bread and butter. That's what they've gone to school for it. They're usually extremely good at it. And if you have stiff joints up in your neck, they are probably going to be excellent to free it up. And they can definitely relieve the problem for the short term again.

What has to be factored in is the strength of the muscles around the neck joints, the upper neck joints so that that joint can remain free for the long term. Because it is possible to on your own, have good mobility in your neck joints, and have excellent strength in your neck bone, in your neck muscles and be able to live free of having tension headaches over and over again. It's not necessary to rely on somebody to help you out.

But chiropractic is a great place to start. Of course, it's natural, it doesn't involve any sort of medications or injections. I definitely think that it's a good place to go. But what chiropractors just usually aren't good at doing is prescribing the right kind of exercise, because that's not what they usually do. So, consider that if you've gone to a chiropractor and you've experienced the relief that they can provide for this kind of a headache problem, but if it keeps coming back then maybe you need a little bit something more.

That's when I go into this final recommendation that I make for tension headaches, and it would be physical therapy. Specifically, manual physical therapy, which is what we specialize in here at El Paso Manual Physical Therapy, of course. The reason why I highly recommend this and I'm biased of course, I'm a manual therapist myself, but seeing the results in people and seeing the long term relief that people get where they really are coming back for tension headaches over and over again, because they're taught how to self-manage.

We free up the joints here by hand. Ww do some chiropractic like maneuvers. Sometimes there's joint popping involved. It just depends on what the patient needs. In some cases, we find that the joints are actually moving okay. And it's not going to ever pop because, I don't know if you've been to the chiropractor and you've ever had the experience where they try to pop your neck and it didn't pop. Well that's usually because the joint isn't really stuck.

But you can still have that perception of stiffness in the area. And that's usually because there are muscles that are just grabbing in that area and they're not freeing up and popping the joint, or going through the technique to pop a joint can kind of free up the muscles, but it just doesn't do the same as going through some manual therapy treatment where we do specific massage techniques to free up.

But even then I tell my patients this whenever they come in for a tension headache, all the stuff that I've done by hand to you is only going to be short lived unless you do your exercises. There has to be accompanying exercises with a hands-on treatment plans so that the results can the long-term results. And you can know what to do on your own. When this comes back, if it starts to come back, there's usually some sort of maintenance program that needs to be kept up which, which most clients find easy to do. Because especially if they have an exercise routine already, it's easy to say, hey, well, you are in the gym three times a week, just let's just make sure that you are doing these exercises when you go, and you are fine, you are going to be managing your headache problems so that it's not coming back over and over again.

It's not always got to be like a physical therapy, one of those goofy looking exercises with the rubber band. We hardly ever do that here in the clinic because it needs to be something that you take home with you, that you can do at the gym, that you can do at the desk, if you have a desk job or at home, if you are at home. It needs to be something that's easily transferable and that fits into your normal routine in life.

That is how we fix tension headache problems here in the clinic naturally. Most of the time, people don't need surgery for this. I can't think of a time honestly that anybody's ever had a surgery for a tension headache specifically, if a tension headache problem continues over time, people will usually end up in pain management, or they will have an associated neck arthritis condition and they may end up having surgery for the neck arthritis.

It's usually a bunch of problems that are all stacked on each other that and then there's one that is surgical that the surgeon might operate on, but there are still problems that need to be addressed. I highly recommend clients get problems addressed right when they happen, so that they're not seeing extra healthcare professionals, and possibly having unnecessary treatments that they could have avoided.

But we help people with that all the time and they get better. They get tremendously better their clarity comes back, they can think clearly. They're not having to worry about taking pain medications every day, especially as the day goes on. It tends to get worse. They can sleep well at night. A lot of people have pain when they go to bed, they can't get comfortable. And then they get woken up at night from their a tension headache problem. And then they're just grumpy.

That's one of the, I think hidden symptoms that people don't talk about a lot. But I asked all our clients, I tell them, because I'm a big proponent of no medications, no injections and avoid surgery if you can, but there are times when it's necessary and appropriate. And whenever I get a tension headache client coming in here, the one of the things I have to ask them is, do you have any family at home that you live with? And most of the time people say yes. And then ask them when your headache symptoms are really bad. Do you think you could be nicer to them at times, and most the time people sheepishly say, yeah, I'm grumpy at times. I tell them, it's okay. That's normal, you are in pain. It happens to everybody.

They are here in the clinic usually. So I tell him, you are likely going to start working with us and this is going to get cleared up. So it's not going to be a thing here in a few months at most. But in the meantime, if you are at home with all the families and you are in pain, maybe take some medication so that you are nice to them, and your relationships can be great.

Those are times that you might consider getting some medication or talking to your doctor about an injection or medication. You have to look at the life that way because it's about quality of life. Not just avoiding surgery and injections and medication, but you need to make sure that that the people around you are happy and that you are happy around them too.

Anyways, I hope that this podcast was helpful for you. I hope that you learned about tension headaches. And if you have these signs or symptoms and you are in the El Paso region and you want to get in touch with us, the quickest way is to call us at 915-503-1314. Tell my staff that you heard this podcast and ask for a complimentary discovery visit. They will make sure to discount your discovery visit, which is a 20-minute visit to get assessed, to get checked out and learn about what's going on and get a diagnosis for the problem. You get a chance to ask questions and figure out all the details about what's involved in treating your tension headache problem with manual physical therapy.

Another option is to go on our website and look for the discovery visit option, and you can apply for a discovery visit and just mentioned that you heard about this on the podcast so that we can discount it always for you. Anyways, if you have any other questions, please reach out to us. We are happy to help, and I hope you have the best day.

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Hello El Paso! This is Dr. David over at El Paso Manual Physical Therapy. I'm the host for the Stay Healthy El Paso Podcast.

What we are going to be talking about today we've had tons of patients in the clinic coming in with neck and shoulder problems and over half of them have been asking this question of “Why do I have this neck hump on my back, my upper back, lower neck where the two places meet?”. They'll reach over behind their neck and point exactly to where it's at. And it's that lower neck area.

In some of these people, it's painful and others it's not. But all of them are concerned about it, they all know that something's not right. It's not normal. It wasn't there before when they were kids or when they were younger.  It's something that's kind of weird. It's unsightly, for some ladies, especially.

I see all the ladies that have this problem, they wear their hair down most of the time because they don't want that part of their back exposed, they are afraid to cut their hair shorter than, upper back length, because they want that part of their upper back, lower neck area covered up by their beautiful hair.

I'm going to go over four contributing factors to this. And then we are going to talk about the top four ways to reverse the neck hump. Because in just about everybody there is a small population that this isn't the case, but in just about everybody, the neck hump can be reversed. It may not be 100%, but it can definitely be reduced and managed properly. And most importantly, this neck hump can cause some bad stuff.

If we can reduce it, or control it, so that it doesn't get any worse, then you are in the best position to continue to be active, healthy and mobile, while avoiding any sort of unnecessary surgery, medications, or having to get injections for this problem. We see people get injections for this all the time, unfortunately.

But let me go into those four contributing factors.

Number one, contributing factor to the neck hump is posture.

When I talk about this, I'm giving this the number one, but that does not mean that it's a priority. With posture, of course, if you slouch forward, the classic computer posture, where your faces is closer to the computer, and your hands are on the keyboard, when your head juts out forward on your body, it will make that hump just a bit more.

Which is why I put posture here, just because it's the most common one that people think of. And it's definitely an easy fix relatively to the other ones. But it's not the most important thing to consider. I just want to highlight that part because just about all these ladies that are coming in right now with their poor neck humps and they are concerned about it. They all tell me, I've been working on my posture, and I just can't seem to get rid of it. And I believe them, I think that they really are at the desk, trying to sit up straighter and be taller and all that.

It's just not working out for them because it's not the biggest priority. There are other things that we'll get into here in a second, that are way more important, and that are going to affect the neck hump way more than if you just try to sit up straighter. But posture is definitely a contributing factor. If you are out there with a neck hump issue, whether it hurts or not, and you are just concerned about it, you want to definitely work on sitting up taller.

The reason that most people will lean in and put their face closer to the computer screen is because they might have trouble seeing the screen. Think about this, if you have trouble seeing the screens, it may be time to get some new glasses, get some reading glasses if you are having trouble reading small text. Or maybe you need to play with the fonts on your computer and see if you can zoom in on things. Computers these days, they are all very manipulatable that you can change the fonts and screens and zoom in and everything. Work with that if that's an option for you.

Of course, mobile devices are the other screens that we look at, our phones, our tablets, and what I always tell people if posture is a big concern for you while you are using your mobile device. You need to get in the habit of bringing that screen a little bit closer to your face, using your hand, not by leaning your head in towards the screen. So literally you have to pick up your hands and figure out a way to rest your elbows on something and get a better setup.

If you are doing this in bed or on the couch or wherever you tend to use your mobile device, you need to make sure that you are not slouching over with your head to look at your screen as best as possible. You want to bring the screen up to your head; our shoulder joints and elbow joints are best designed to move like that. It just might be that your muscles aren't as strong to keep it up there for a long time.

You have to just accommodate your posture, you are sitting posture to hold up that tablet or that phone up against your face. Also get your eyesight checked and check your sitting posture.

The second factor here, and I would go to say that this one is probably the most important which is strength.

The strength of the muscles that support the upper back, and the lower neck area is critical in making sure that the alignment, and the stability of all the joints and bones in the area are properly aligned, properly strengthen, and spaced out. It's a big, big, big deal. And that's the number one thing that I'll start fixing with somebody that's coming in for a neck hump related problem. We'll start addressing the strength.

There are many muscles in the area. For me, as a specialist, physical therapist, I'm having to dissect the case and look at every single muscle that can be contributing, all the relative strength of each muscle. We look at muscle imbalances. We look at their past activity levels. Many of the ladies coming in right now have been exercising regularly. When I talk to them about strength, they are saying, well, I've been working out I'm sore every week from going to the gym, I have a trainer even.

But they are not addressing the right muscles in the right way. That's going to maximize the impact on straightening out that neck hump. That's the problem that I'm finding. Most of the time, there is an upper trap problem. If you look at the names of muscles, the trapezius for short, in the medical field, we call it the trap. The upper trap because there are three parts to it, there's an upper, middle and lower, but it's usually upper trap strength, that's an issue and there are special ways that we have to exercise it and strengthen it over time to get the effect that we are looking for.

It's a complicated process actually. It's not as straightforward as just saying, Oh, well, he said, I need to strengthen my upper trap I have the neck hump. So I'm going to go do that. Let me look up a YouTube video and let's get this going. That is just half of the of the piece, there's much more than we need to look at. But I can tell you that if you have an neck hump problem, chances are nine times out of ten, you likely have a serious weakness somewhere. And the trap might be the first place to look.

Other muscles that contribute to this is the deep neck flexors or scalings. This might be a little too technical, but if you wanted to go look it up, you can find out the names of all these muscles and where exactly they are.

Those are probably the top three contributing weaknesses. But anyways, the let me just get into the mechanics of this, so if you are not very science minded, follow me as best as he can. I'm going to do my best to keep it as simple as possible.

Visualize the neck hump. What's going on is it's your spine that's right there. It's the upper part of your spine. It's bending over forward, because the muscles that are supposed to hold it up straight are too weak, and it tends to bend over forward because of gravity. Gravity just pulls it over. You can straighten up like we talked about with posture and that does help. But it's a short-lived effect. Versus if you are strengthening, if you are exercising in such a way that is generating the strength for your muscles to hold you up better, to hold up that part of your spine better, without you consciously thinking about it. That is where the goal is. That is where you reverse this problem for the long term so that you are not ending up with some side effect of this neck hump issue. That is going to lead into a surgery or having to rely on pain medications and injections.

I hope that is simple enough for you to understand. By the way, if you ever have questions or anything, you can reach out to us. You can go on our website, and there is a little place where you can type in questions. You can also call our clinic if you are concerned about something you want to talk to us. We have people do that all the time. So just a little side note in case you are confused about something or want to learn more.

Anyways, let me keep going here. So, posture was the number one factor that I talked about that contributes to the neck hump, strength is the number two factor that contributes to the net comp.

The third one is activity level.

If you are just sedentary, whether it's by choice or not, because that happens sometimes. An example of that would be, you have a desk job and you just have to sit in front of a computer to do your work. That to a large degree is of out of your control, you just have to do it. If you just had a child, and we see a lot of ladies get the begin to get the neck hump when they become new mothers because they are now stuck carrying a baby for months and months and months. At least until they are close to a year old maybe longer. And if you have multiple kids and you go through that multiple times.

That weakness in posture just accumulates over the years. On top of that when nursing a baby, you are hunched over, you are looking down at the baby most of the time. It's going to affect that neck part. And many women do tie this back into the old ladies that we get that their kids are all grown up, maybe they even have grandkids at this point. Sometimes they'll tie back the formation of their neck hump to when they were in their 20s and 30s, when they were having kids. And that's when it all started, and it's just gotten worse and worse over the years. Now they are in their 50s and 60s, and it's causing a problem.

That's kind of the typical story that we hear. But we do get young ladies in here as well and then they get the problem. It just affects them sooner in some different way. I'll talk more about why that is here in a second. But let's hang on activity for a bit. If you are not moving very much what happens to your muscles, those ones that are weak up in the neck, is they shut down. Muscles are very cool organs, they are super smart in that if you don't use them, they start to atrophy or they get smaller in an effort to be efficient within your body.

Of course, it's not desirable to have smaller muscles but in the grand scheme of the body, it's that's a pretty cool effect that it has. The other thing that muscles do is they almost shut off, they turn off, when you are not using it for a long time. In order to reserve energy and nutrition and all that they literally will not work. So, if you are sitting for a long time and you don't really need that muscle, because you are going to be sitting for another few hours, those muscles just turn off.

That's a bad thing when you need to become active again. And that muscle has to warm up and wake up over time. But if you are chronically sedentary, because say you have a new baby, and you are going to be holding that baby, again within minutes or hours at most, that muscle just never gets the activity that it needs. The more activity that the muscles get, the better they can operate in effect the joints that they are supposed to in the way that they are supposed to.

I want you to separate this out from strength, strength and activity are two separate things in my mind. Because when you get stronger, that strength is carried into your sedentary position, and it helps you to maintain your posture. But you can have good strength, you can be able to pick up significant weight. But if you go be sedentary for a while, even if you have that strength, those muscles can still shut down and cause problems. And you can have both come together.

Obviously, you lack the strength because you haven't exercised at all in a long time. And then you can also be sedentary on top of that. Now you are stuck between a rock and a hard place. You are weak and you are not active, and your muscles are shut down. Both need to be a component of each other.

So if you are out there and you have a desk job, or you are a new mother or have had kids in the past, and life has just never been the same for your neck and shoulders, and you got the hump developing over the years, over the decades, I strongly encourage you to go start getting stronger and definitely get more regular activity.

Just to put some specifics on regular activity, because it's very individual. I mean, if you have a desk job, you have to move every 30 minutes or so. Even if it's small, even if you just stretch, even if you just do some simple exercises that take 30 seconds or a minute. That makes a big difference over the course of a day of working at a desk all day.

Or right now we are in the COVID time so if you are stuck at home, you are working from home and then you might not be very active outdoors because they are not letting you go out, you might end up watching Netflix at home or something similar. And you are more sedentary, you just have to build in some sort of physical activity. Go do some chores around the house, or go do some yard work outside if you can get some movement so that your muscles have to work.

That would work enough to the point where you feel like you are going to sweat, like you are going to perspire. That is usually enough to warm up your muscles and use them enough to move the joints. I hope that makes sense.

Let's talk about the final contributing factor. And this is the one that's least in your control. That's why I put it here,

Your genetics.

Your genetics, who are your mom and dad and who are their mom and dads, and what kinds of genetics did you get? What kind of body type did you get? Just like we know that if you have a history of heart problems in the family or diabetes or cancer, certain cancers, you are going to be more likely to get those same problems if you don't manage your health.

Well, obviously almost all heart problems and diabetes are definitely preventable. And just because your mom and dad might have it or other relatives might have it, it doesn't mean that you are absolutely going to get it. It just means that you are more likely to get diabetes, for instance, if you don't take care of your health. But chances are that if you eat well and get enough exercise and manage your health, you are likely never going to get diabetes, but you are still genetically predisposed. And you are going to pass on that genetic that genetic predisposition to your kids and grandkids.

That's just the way life is and every race out there has its own genetic predispositions for certain problems and illnesses. It's the same thing in joints and muscles and bones. What I find is that people that tend to have longer necks, or more slender build necks will usually get this neck hump problem quicker than others. Now, it's not a hard and fast rule. So if you are out there and you are thinking, Oh my gosh, I'm have a long and slender neck, and I've always been thinner. That doesn't mean that you are going to get it.

There are other factors that contribute to this. That's just what I tend to see. I've seen short, people get it. I've seen stocky people get this issue, the neck hump problem. So, it's not a hard and fast rule, but it's just one predisposition to getting it for sure. Now, if you know that mom and dad had this problem, or grandma or grandpa had this problem, then I would be just extra concerned about it. Especially if you are becoming a new mom, or if you've had a desk job for a while, or if you are getting some sort of neck pain.

Even if you don't have the hump developing yet that's a sign that you might be getting it soon. And the hump doesn't come on suddenly, by the way, it's not something that you wake up with the next day and it wasn't there the day before. It gradually comes on over time as you get weaker and as you spend more time sedentary and your posture is not as good.

All those factors contribute to this problem and it just goes by quicker if your genetics are predisposed to it. Think about that factor as well. Now if you end up having an neck hump problem, and you are not really dealing with any pain yet, or maybe you are just starting to deal with some pain, people usually get a burning sensations, a tightness in the muscles around it. It's sensitive. When they poke back there if they touch the bones or just touch certain areas of the of the upper back, lower neck area. It's just very tender.

They tend to have problems leaning up against certain chairs. Certain couches that put pressure on that area they don't like. And they didn't have other related issues over time. So people with this problem are more likely to get neck arthritis, osteoarthritis in the joints of their spine, they are more likely to have pinched nerves and all the nerves that come out of the neck. They start getting affected over time.

On the neck hump part, what's going on inside the spine, without getting into too many technical details, the joints are being compressed on each other. The cartilage is getting squashed between the joints. When cartilage gets squashed, it gets dehydrated, which means that it's not going to move as good, because cartilage is supposed to be very hydrated so that it's slick and there's less friction between those bones.

That movement can happen. But if you have lost that lubrication from the cartilage, then the joints get stuck and if it stays like that for years and years, even decades, even then the joint surfaces begin to change. That's how arthritis develops within the joints. When we see people that are in their 70s, 80s, or 90s, and they have this neck hump problem, many times at that point when it's been going on for decades, it's not reversible much. And we are just talking about what can be done to not hurt so much. But we are conceding on that it's going to hurt. We are telling these people, you are just going to have to live with this problem. If you know there's no other options for it. You are just going to have to live with it and manage it. Here's what you can do to not make it so bad.

But if you are in your 40s, 50s, or evn 60s in that age range, you are younger, you have a great chance at actually reversing it. You haven't had it long enough to get the joint surfaces to change and become arthritic Now you can get, like I said, those pinched nerves that can turn into other stuff like carpal tunnel syndrome, it can create pain in the shoulder because of the nerves that go out into the shoulder.

When those nerves get pinched, they reduce the effectiveness of the muscles they connect to. Which can cause shoulders not work normally. And that can set up shoulder problems like rotator cuff tears, and shoulder labrum tears. There are all kinds of other shoulder problems that are affected.

Of course, arthritis and shoulders is one thing. If the muscles aren't working right, the ball and socket joint of the shoulder just doesn't move normally. And if that's going on for years and decades, then you get arthritis in the shoulder. This is definitely a root problem. This neck hump issue is a root problem to many other neck and shoulder related conditions that people end up getting surgery for, injections, or live off of pain medication. It's just, it's a bad thing.

You just don't want it and if you feel like you are getting it already. Do something about it right now! Because you can prevent a whole bunch of problems later on in life. What I always like to tell my younger patients is, if you have this thing going on, and you are in your 30s, you need to teach your kids about this, because they are probably going to have it when they get to their 20s and 30s. It’s best to educate them about how to manage their own body, if it's a genetic predisposition that you have.

Alright, let's shift gears here. And let's go into the top four ways to reverse this problem. I've alluded into a few already, but I'm going to get into some nitty gritty about this.

Number one, get regular exercise.

I talked about that when we are talking about the activity part earlier on this podcast. But let me write this down. It's critical for you to regularly, and what I mean by regularly is, at least two to three times a week. Go do something that gets your heart rate up, that gets you sweating, at least a little bit. Of course, not everybody sweats the same. But if you start to generate a bit of a sweat or you feel like you are going to sweat. If you are just the type of person that doesn't sweat much, that's usually enough to warm up your whole body and move virtually every joint in your body to some degrees, so that you are not getting them stuck and you are activating muscles. That way you are keeping them from shutting down all the way.

Especially if you are a desk worker, I would up that, I would venture to say that every day that you have to work on a computer and be stuck at a desk, build in time about 20 to 30 minutes where the activity is vigorous enough to get your heart rate up pretty good. Where you feel your heart pounding inside your chest. And of course, if you have any sort of other conditions that might be floated by exercise, talk with your doctor about that.

But if you are free of that, then go start exercising right away. For some people it's as simple as going on a jog, that tends to move all your muscles in your body. Doing some sort of workout video on TV or streaming, everybody's streams these days. Those are fantastic, and if they are shorter, if they are just 10-15 minutes long, do two of them. Do two back to back or take a short break between.

If you have a home gym, getting your workout, if you can go to the gym, if you choose to go to the gym, go to the gym and get your pump on. You need to do exercise that moves your entire body. It is critical for your overall health and it's just what I tell people. It's like flossing and brushing your teeth. If you go to the dentist, if you are not flossing and brushing regularly, they are going to tell you something about it. And even if you are flossing and brushing regularly, you are going to get tips from the dentist.

For example, when I go to the dentist as a kid, I had lots of cavities. I didn't brush very good, I never flossed, and it was always dreadful going to the dentist because I knew they were going to find a cavity or find something that needed to be work on. Pull the drill, and it was going to be miserable. Then I flipped it and I said, alright, I'm flossing every day. And I'm brushing two, three times a day. And that's sort of made the dentist is happy. But then he started to still pick on me and say, hey, that spot back there on that molar, you need to just brush it a little bit longer than you have been. Or this spot over here between these teeth, you need to get the floss all the way in there, maybe even go in there two or three times to get all the stuff out. And it was great. I began to love it at that point, because I knew I'm on the right track. I just need to do more of it, in the way that he's telling me.

Same thing with exercise. If you are already exercising you need to find which type of exercise is going to be best for your neck hump problem? For your neck issue, you shoulder issue, which one isn't going to hurt, but it's going to help. Be thinking about that.

Let's talk about strength training.

I'm talking about weightlifting or anything where you have to give it a good effort for a few seconds. This is the opposite on the spectrum of exercise. This is the opposite of cardiovascular training. On one end of the spectrum, you have cardio, where you are moving consistently, like going on a run or elliptical, or bike, those are common cardio exercises. You might be there for 10, 20, 30 minutes or more. Strength training on the other end is where you are doing something intense for just a few seconds, and you might do just so many reps of it.

Strength training is very important for this neck hump problem for strengthening the muscles. Now how you do it? Getting down to the nitty gritty specifics of it is important. What I tell people a lot of times to fixer upper trap strength, is to do overhead weightlifting exercises, doesn't need to be super heavy to start out but eventually it should increase enough to work. It's an effort and it's significant weights for that individual. When I say significant weight for that individual, me I'm over 200 pounds, I'm six two, I'm a decently big guy. I need to pick up some decently big weights.

But if you are a five, nothing, small female, barely 100 pounds soaking wet, you need to pick up some significant weight for you. And that might be starting at five pounds, or ten pounds, or not even that if you have a neck and shoulder problem. Right now you need to go even easier, maybe no weight. But you need to work up to a significant weight once you get stronger. So it's relative to the individual and their current ability. But it needs to be in such a way where the exertion that you have to put on the weights to push them up overhead, or to perform the exercise is pretty high.

On zero to ten scale of exertion. You need to be like a 6, 7, 8 or nine, a 10 would mean it's your most weight, you can lift in one or two single reps. It needs to be about that much. And you might work up to it. That doesn't mean you need to do it right away. If you have never lifted weights overhead in your life, or you haven't done in a long time, I'm not saying, go start doing it today and get to a 9 or 10. Because that's what I said in this podcast. Use some common sense and work your way up to it.

It's probably going to be months before you get to the point where you are like, Alright, I'm going to pick up the most I've ever picked up overhead because that's what I have to do. You may never even do that, you might always stick to an eight or nine. But strength training is critical.

The reason why it is so critical is because when you exert yourself like that, and it always makes you sweat, it always gets your heart rate up, and you have to mentally focus on it. You cause your muscles, you cause a cascade of hormones and other effects inside your muscles. That turns on the muscle growth, that kicks in the factors that make the most Say, Hey, we need to develop more, we need to get thicker and stronger for the long term, so that we can continue to lift these weights again. And we can hold up joints and hold up the spine better. And that's how you get that long-term effect.

The posture, the technique, the form is important because when you strain yourself that much, when say you are going to do just 30 reps and you are going as hard as you can, as heavy as you can. Form tends to fall apart, and one of the first things I do when people are pushing the weights up overhead, one of the first things I do is tell them you need to tuck the chin in, don't let you change it out. Don't get into that computer head posture, and you need to make sure your shoulders go up all the way. You need to shove your shoulders up into your ears.

That's always missed. People don't go up high enough. You need to think about bringing your shoulder blades up 110%. Most people are just going at 70. And they are not really aware of that part. I'll get behind them and I'll shove their shoulders up from the sides of their body, to give them the effect that they need. And it needs to happen like that. Every single rep. And if you are not able to do that right now, then you need to lower the weight and just practice the technique.

You might need to hang out there for a month or two or three, until you can effectively get the technique down right without hurting your neck or hurting your shoulders in some other way. Don't add weight, just stay where you are and get the technique down. It's like training wheels. We have three kids, and my older two took off the training wheels already. They are riding their bikes normally. My oldest had his training wheels on for probably the better part of a year, and we had some relatives telling us take the training wheels off. Just take them off, he's ready! And I said no, just wait he's not bothered by them. Really. He's not concerned about them, nobody's telling him anything and he's enjoying riding his bike. I don't want him to have a broken bone or fall that we could have prevented.

I would rather wear those training wheels down to a nub, until there's no more plastic left on them before letting them loose. And it was it was a great decision. Once the training wheels finally came off. He was an expert at riding the bike. That kid is all over the place now. So I was very comfortable letting him out of the training wheels. Just like that, I would want you to be comfortable saying I'm not picking up heavyweight yet until my technique is very good. Then once I'm comfortable with my technique, I don't have to think about it so much. It just happens. Now I can add the weights, and I can go on. I hope that helps.

Okay, number three is posture.

Let's talk about that. This is related to the last thing I was talking about which was strength. There's no such thing as being in the best position ever, for long periods of time because your body needs to move. Let me say that differently, you can get in the best posture ever. But you can't stay there, you just cannot stay there for more than about 15 or 20 minutes effectively. Our bodies are meant to move, remember those muscles shut down if they don't get some activity.

So, even when you are in good posture, it's the same rule that the muscles follow. You need movement. I wouldn't worry too much about posture. What I do with patients, when they come in is, we'll have a talk and I'll tell them what good posture is. But I don't make it a big deal. And I don't really visit it much after that because it's not something that I need them to be thinking about all the time. If you have gone down the rabbit hole of trying to figure out what good posture is for you, and you have researched it and you have talked to people and you have bought a device about it.

I've seen people that have that. They have little sensors that they can put on their clothes or on their body, and when they start slouching, they get a notification on their phone. And there's some that even give you a very small shock, they electrocute you just a tiny bit, to try to train you to keep your posture better. That's cool at all. And for the most part, most people, I'd say eight out of 10 don't really have terrible posture, they just have slightly bad posture. and improving it a bit, it's only going to create a minor effect on their neck hump problem. It really isn't going to make a big difference, like strengthening will and keeping up regular exercise will.

Posture is a small factor. But some of the big things that just most people aren't aware about is get your eyes checked, if you are leaning into the computer screen, because you can't see it might be a way better effect to go get your eyes checked and get an updated prescription if you wear glasses already. Or start getting glasses if you haven't. Or if you are getting a little older in age and your eyes are being affected by that. I suggest, go get some reading glasses.

I've had some people that I've told, especially the ones that were like bifocals. Of course, you have the two lenses, or there's even trifocals out there, you have multiple lenses on the same glasses. And in order to look through one lens, you have to tip your head up a bit in order to access the reading lens, the ones that lets you see close up. And then you tip your head back down to look at the upper lens, which allows you to see farther away.

Think about this. If you are keeping your head up all the time to read your computer screen. It's making you jump your chin out and possibly stick your head forward. That's going to create that neck hump situation more frequently. Maybe your glasses work just fine. But you need to go to the optometrist, the eye doctor and get yourself a set of glasses that are full size. And the entire lens is just for reading. And you keep those glasses around you whenever you are working, whenever you are at the computer. So you need to have a pair of glasses that are for reading and then your normal glasses for everyday use.

That way you are not having to tilt your head and mess with your spine, your neck position and get your back in your upper back your neck hump area into that posture. That way you can keep it up straighter. So that might be an easier thing to do then having to constantly think about, oh, I have to sit up straight. I got to make sure that my chest is out, and my head is tall, and all the things that people say.

I would go fix that first though before you start thinking all day, throughout the day about your posture. So then, that was number three, top way to reverse the neck hump. Let's talk about number four.

Get specialist help.

Undoubtedly, I think this is the most important thing. It speeds up the process. It eliminates confusion. It just gets you on the right track as fast as possible. And it's the express highway to fixing this problem. Because what I see is, people come in in their 50s and 60s and beyond, sometimes with a carpal tunnel problem, or a shoulder problem that's related to this neck hump problem. And they've been doing something about it over the years, but it hasn't been that effective for them.

They looked up some videos here and there, they've tried a couple different things. And it just didn't get them the effect they needed. And now they are faced with this neck arthritis problem. This herniated disc in their neck, this pinched nerve, this rotator cuff issue, this numbness and pain in their hand that's related to carpal tunnel, or some other nerve problem.

And it's a mess, we have to help them. I'm going to help them and that's what I do here anyway, but I have to tell them we got to free up this nerve. We got to loosen up this joint, we got to strengthen these muscles. And we have to make sure we address the hump in your neck. Because if that doesn't go away, all these problems are going to return right away, because that's the root of the issue.

By getting specialist help, it allows you to fix this problem way faster and more effectively. And most importantly, you can learn what you need to keep doing for the long term that's most effective. You can whittle down the 10 things you were doing to one or two, and what that's going to help you the most for the long term.

When I talk about a specialist, you need to find somebody in your area. Ideally, if you are in the El Paso, Texas area, of course here in the clinic, we deal with this problem all the time. We are specialists at it for sure. And hopefully you are looking for some non-surgical way to deal with this. I can tell you most surgeons out there, if you don't have some herniated disk that's pinching on a nerve, or some massive instability like were the joints are overly loose. They are not going to operate on you and the neck. They don't do anything, they'll just give you injections, if that for pain, but they don't really know what to do to fix it for the long term. And even if they find a tear or something that they can operate on, it's not correcting the strength problem, it's not correcting the posture problem or the activity problem that's still for you correct.

I've seen people go get surgeries for a herniated disc or something in the neck, they get the rods and screws put in to straighten out a segment of the spine. But if they never get the strength back, it's just a matter of time before a level that wasn't operated on becomes affected like the one that ended up getting operated on. And then that person goes back for another surgery and it's the same cycle that they get stuck in.

So, it's super important to make sure that you fix the root problem. And it's going to have to be under your control. In other words, do you have to be able to know what do I need to do when I get a little bit of pain, or when I see the hump starting to get worse. I need to know what to do on my own so that when I get to 50, 60, 70, 80 and beyond, I'm not dealing with this neck hump problem and I can have excellent quality of life and enjoy everything that life has to offer at that point in time.

So guys, that wraps up the podcast, we answered in depth the question of why do I have a neck hump, and then went into the top four ways to reverse it. I hope this was helpful for you. If you like this, please share this with somebody that you think probably needs to hear this, and subscribe to our podcast, to hear more information related to neck and shoulder problems and other body parts as well. And give us a review. If you found that this was helpful. Give us a quick five-star review. If you tried some of this stuff and found it made your neck and shoulder problem and your neck problem, better. Tell us about it on the review, just explain everything about it. I'm sure that people will benefit from seeing these reviews. So I hope you have the best day and we'll talk soon. Bye.

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