3 Steps To Stronger You

Everyone likes being active and strong, however most of the people think that they do not have enough time to do anything about it. And I just wish if it is easy to be fit forever without making efforts for it.

When you are growing up the fitness comes from active/athletic childhood,your nutrition and even from your genes (Active parents produce active babies). By the time you reach 30 yrs of age, the body's natural ability to remain fit and strong becomes weak. From thereafter only nutrition and active lifestyle matters.

Strength is the force which you can produce while doing a certain task. You need muscles to produce that force. Muscles are made of protein and if your nutrition lacks it then even the exercise cannot help. The road to fitness comes from high protein diet and exercises. When you workout on muscles, the protein from the food gets synthesized and used up by muscles for their growth.

 Regarding Muscles it says :

 " If you Don't use it, You Loose It"

  BUT

When it comes to getting fit, Can the least be done to gain MAX?

Do you know it takes only few set of only 3 exercises to start your fitness journey?

These exercises can help you save time, grow muscles and burn calories.

I suggest choosing exercises which includes whole body where the resistance is your own body weight. The benefit is time efficient, equipment free and travel friendly workout anywhere anytime. Especially this is for the people who are always short of time and feels they need time friendly workout plan.

Assuming readers to be from different fitness levels, I will start exercises from very basic level

So, lets discuss these exercises, their basic preparation and variations to make it challenging at each level...

PLANKS - Builds your core muscles and learn to gain structural stability of the body.

Planks are good as they target abdominal muscles also as an alternative to the crunches. Compared to crunches they target larger group of muscles involving the whole body. They are safer for the SPINE whereas crunches may damage spinal discs. In fact, I came across few patients who got injured because they overdid crunches with poor techniques. From injury point of view and for gross health benefit I always recommend PLANKS over CRUNCHES.

PUSH-UPS - Helps upper body strength along with core stability

Push-ups is all time favorite and a very popular exercise. But technically they are like moving planks. A basic good planking capacity is required before you start push-ups otherwise it can cause you back pain. So improving on your plank becomes must before you attempt any push-ups on ground.

Most people have rounded shoulder while sitting causing chest muscles to become tight and upper back muscles to become weak. This result in weak scapular control and if push ups are done at this time it can create neck or shoulder pain. The strong scapular control can be trained and must be practiced before attempting to start Push-Ups.

Go for my PRE Push-Up regimen to make your muscles work rightly. Pre Pushup exercise is a memory building exercise for the muscles to be used during push-ups. Once you adapt to these movements it will be easy and safe to do pushups.

SQUATS - This is your entire lower body workout starting from calves, thighs, glutes and lower back. This can simply make you stronger with your legs and can make your daily activities like stair climbing, getting down and up from the floor easier. Before starting to perform free squats on the floor, people who are new to squats must do some basics to improve their form.

NO !! Your leg pain is not just SLIP DISC...

It won't be wrong if I quote that BACK PAIN is second most common condition after common cold which makes people suffer affecting their daily life. Every third person has faced atleast one episode of back pain in their life. Our SPINE encloses and protects spinal cord which carry information from brain to the body via nerves. Without such information the body cannot control, move or feel anything effectively making you senseless and motionless.

"Are you suffering from back pain? 

Or

Do you get a pain travelling down your one or both legs? 

Or

Is it difficult to walk few minutes or few steps without a back or leg pain? 

Or 

Do you know someone who is facing such a complaint?"

Read the article carefully to understand what is going wrong inside your body. Read it as you will get to know things beyond your doctor might have missed to share with you.

You may have a leg pain travelling down along with back pain or sometimes without any back pain. The reason for leg pain can be nerves compressed from the spine or even at your hip. Sometimes muscular pain mimics like a nerve pain in the leg which makes you and your doctor confused. The difference between leg pain due to nerve or muscles is that former causes sharp shooting or electric current like leg radiation whereas the latter creates a continuous dull achiness in the affected leg along with pain in the muscle involved.

If you have seen a human spine, it looks like a curvy snake formed by multiple bones called vertebrae arranged in a manner to give it "S SHAPE " when looked from side view. But from front or back view it looks like a straight vertical spine. Any deviation in these curves can put the spine structures under stress causing lot of muscle imbalances or vice a versa.

When your muscles doesn't support the spine symmetrically it can cause excessive stress between couple of vertebrae causing reduced space for the nerves exiting from the spine. Hence, leading to compressed nerves causing painful radiation in the leg. These imbalances can even create severe muscular spasm putting heavy pressure on your affected nerve and the result is your painful suffering again.

Interestingly, the above mentioned reasons can put the disc under pressure and making it appear like a bulge or on MRI Scan. This should be called as false or pseudo disc prolapse causing nerve irritation and leg pain. This type of bulging can disappear or improve once the pressure between vertebrae goes away.

   

I have come across patients who comes with a dull pain in the hip which also radiates down the leg but does not behave like sharp shooting pain. And the reason is not your spinal disc or nerve but a muscle around the hip known as GLUTES MEDIUS (the HIP Abductor) which may have a TRIGGER POINT - muscle knot causing nerve like pain which people often confuse with sciatica due to nerve compression. 

 A deep muscle of the hip known as PIRIFORMIS (the HIP Rotator) is placed right on top of your sciatic nerve and in some cases this nerve pierces from within the piriformis muscle. If this muscle becomes tight it can cause a similar nerve pain but thankfully then the reason is not your spine. This is more common in people who keep purse in their back pocket and also when people sit with scissored legs (Cross Leg Sitting).

A disc is a doughnut like structure with hard outer shell filled with jelly like material inside. Disc is found between the vertebrae of the spine adding shock absorbing effect. In case there is a sudden trauma or repetitive wrong movement pattern in daily life, the disc wall gets weakened and starts bulging mostly backwards and outwards. If the nerve gets compressed by this bulging disc as it is lying very close to it, you can get a sharp shooting pain radiating down the leg. This condition is popularly known as SLIP DISC OR SCIATICA. The people describe this feeling as painful electric spark travelling down the leg. Your bulging disc or slip disc cannot cause leg pain if it is not pressing on to a nerve.

Bulging discs are very common and not everyone who has a bulging disc go through pain. Infact, after 30 yrs of age, every 10 years increases the chance of finding one or more bulging discs with or without leg pain. So when disc bulge is so common then what is causing your leg pain. Careful examination can reveal whether your nerves are compressed due to muscular imbalance, a mis-alignment in the spine or a disc compression on your nerve.

This information is totally in contrast with MRI reports showing disc prolapse as the possible cause of your pain. Trusting the MRI reports without careful examination can misguide you towards unnecessary treatments not required for your stage of the disease.  If you are better informed then you can reduce your suffering by heading towards the effective treatment for your condition.

The information on this blog is helpful in creating awareness related to different problems which produces similar symptoms and often confuse against reaching better treatment approach. 

Please do not consider this blog as a medical advice and do visit your doctor or physiotherapist whenever you experience such symptoms.

Feel free to explore more information by commenting here anytime.

Regards,

Dr. Kunal Vashist,PT

MPT(Ortho), Manual Therapy

DryNeedling Practitioner

Email ID - kvashist.physio@gmail.com

Contact No. 9968302757

More Than Physio... Clinics                       

Shoulder Pain Is Beyond Arthritis, Tendonitis or Muscle Tear

(Do not blame the name, Understand the game)

Br J Sports Med bjsports-2016-096772 Published Online First: 2 November 2016 doi:10.1136/bjsports-2016-096772

Shoulder is a complex joint as it moves along with other structures. Shoulder can produce a powerful movement almost in every direction making it susceptible to numerous injuries. A lot has been said about diagnosing shoulder pain where the focus is too much on identifying the structural damage. Whereas when it comes to managing pain, it has been seen that the symptoms are produced by multiple factors including posture, mobility and muscular strength in and around shoulder joint.

A shoulder joint (Gleno-Humeral joint) is a ball and socket joint between humerus (arm bone) and scapula (triangular flat bone behind shoulder). The collar Bone (Clavicle) connects to scapula  through Acromio-Clavicular joint and chest bone (Sternum) via Sterno-Clavicular joint. A full shoulder Range of motion is a collective effort of all three joints along with good mobility from thoracic spine and ribs.

The muscles responsible for shoulder functions, like Pectorals, Trapezius,  Deltoid Rotator cuff, lattisimus dorsii etc. are not just limited to the above mentioned joints in shoulder complex but also to ribs and thoracic spine via different muscles. It even includes your core and pelvic stabilizers to form the basis of effective and dynamic movements of shoulder. Lower body strength and balance are equally contributing to generate proper force transmission through ground reaction force during a powerful movement from the shoulder.

If you look at the anatomy and function of shoulder region, the arm is almost hanging to the torso via scapula and various muscles enabling it to do large movements but keeping it also at risk of injuries. No matter if you are a high performance athlete or a sedentary person, a poor posture (static or dynamic) leads to loss of mobility in concerned areas and creates muscular imbalances around spine and shoulder joint.

The scapula (triangular flat bone) behind the upper back plays a crucial role in dynamic motion of the shoulder. During a shoulder movement, scapula stabilizes itself on ribs with some degree of movement to produce a strong dynamic movement of humerus (arm bone). The poor muscle control around scapula changes the movement pattern of humerus which leads to impingement of musculature passing from under the shoulder region.

Some various common diagnosis in shoulder pain are supraspinatus tendonitis, bursitis, labral tears, muscle tears, Painful Arc syndrome, shoulder impingement etc. Why we are so keen on naming these diagnosis? Now we already know that there must be multiple events which has gone biomechanically wrong to create the basis for an injury. The investigations such as MRI or CT scan always direct us towards the local structure which is injured but is not usually the source of pain. The injured structure is only one of the source which is creating trouble during the painful movement.

When there are so many events involved in a painful shoulder, it is not feasible to label it with one diagnosis. Rather we should physically assess for muscular imbalances and biomechanical changes which are the root cause of current injury. We should make a physical diagnosis rather than a diagnosis based on mere investigations. The physical diagnosis helps in planning and implicating conservative management mainly corrective exercises to restore the muscular imbalances. 

There is a very limited role of surgeries in managing shoulder pain considering the cost required and risk involved in shoulder repair. Saltychev M et al said there was moderate evidence that surgical treatment is not more effective than active exercises on reducing pain intensity caused by shoulder impingement.

Neck Pain - Three Things To Think Beyond MEDICINE

In the world of technology, the machines are becoming advanced and addictive up to a level that nearly 70% of your active daily time goes into it. Neck pain is as common as Low back Pain since both of them mainly originates from poor lifestyle and reduced physical activities. I see number of patients suffering from Bad Neck Pain and still keen on wanting an X-RAY or MRI scan because they really wants to see what has gone wrong with them. And the kind of reports which comes out after scans keeps them scared for life.

"So many studies have shown that Xray or MRI changes are normal after a certain stage of life even in people with NO PAIN"

Most people consider X-RAY or MRI Scan reports as their diagnosis further complicated by their doctors because they almost stamp the reports to be true. And you start believing in the terms like Cervical Spondylosis, Degeneration, Reduced disc space, loss of cervical curve etc.

What else can be done in 5 min checkup time with your doctor?

You can only prove me wrong if your doctor has examined you thoroughly and tried looking for reasons beyond what investigations are pointing towards. Remember, your reports always quote in the end " This is not a diagnosis, Please correlate clinically". A thorough checkup easily needs 30 min duration to carefully examine all possible reasons which may cause you pain. Identifying the source of pain is as important as your treatment so that you are not misguided towards ineffective solutions to your neck pain.

If you are wondering what else can cause you pain other than what your investigations had so far revealed, then read further down as this can be an eye-opener article for you.

My First question to you, if you have a NECK PAIN :

HOW bad you are with your sleep?

 

DO you feel stiff and painful with your neck in the morning?

 

DO you find your pain worse on the days when you do not sleep enough?

Your sleep quality is directly linked to pain and stiffness in the neck. Good sleep is almost like a restart to your body system ( including hardware- joints and muscles / software- mind and nervous system). Sleep helps recovering from all day stress which your body and mind has gone through. Minimum 7 hours sleep is the baseline for healthy sleeping time including minimum 2 hours of deep sleep.

My second question to you to observe carefully:

Does your pain aggravates from long hours of prolonged sitting at home or work? 

Do you think your bad posture is responsible for your pain?

Is your pain better on the days when you are active with less sitting?

From years doctors have blamed your poor posture for your neck pain. Blaming your bad posture is overrated as no one can sit in good posture for long as it requires enormous strength from the muscles to keep you upright nonstop.

If you do not move enough then even an upright sitting can trouble you equally.

"Your muscles need more blood to survive better"

Keeping yourself inactive for so long makes your muscles stressful and then it doesn't matter even if you try attaining a good posture. So it is not your posture which makes you suffer with strained NECK. Blame your long hours of sitting which reduces blood flow to the muscles and makes your joints feeling stiff.

My third and the last question you need to think about: 

Do you feel your mind gets stuck with thoughts making you worry constantly about random things?

Do you find increased neck pain on the days when your mind is overworked?

Does your neck pain has started giving you emotional response like crying, tensed, irritated etc?

Stress has started bugging our daily life and it has become almost epidemic. We all try to hide our disturbing thoughts and keep them alive in our mind. Generally we all are forgetting / hiding to share as we are scared of letting people know what we think. This huge collection of disturbing thoughts gives emotional response but also a physical response which we don't believe it can. Your neck pain can be an expression of stressful thoughts running in your mind (oh! sorry stuck in mind because running is still better).

If you have a bad disturbing neck pain even more so if it is chronic; you should consider the following factors which alone or in association of your diagnosis and treatment can help you recover better:

SLEEP, PHYSICAL ACTIVITIES AND STRESS

If you want to find more about your neck pain or looking for a solution to resolve your condition effectively, feel free to comment below or contact me on below mentioned details:

Regards,

Dr. Kunal Vashist, PT

MPT (ORTHO), Manual Therapy

Dry Needling Practitioner

Movement Specialist (USA)

Conservative Pain Management Specialist

Email id : kvashist.physio@gmail.com

Contact Number: 9968302757

More than physio... Clinics

Common Low Back Pain - Are You At RISK ?

"IGNORANCE MAKES YOU SUFFER"

While starting to write this topic on risk assessment for low back pain, today I simply searched on google the statistics related to low back pain. It was really shocking to read nearly 80% of population suffer from low back pain at least once in lifetime. You know what it means that leaving just one or two in our family, we all suffer from low back pain. 

Isn't it very disturbing that pain has become such a closest partner for us to live with? Something is seriously going wrong with our bodies. How can it be so fragile that all of us are not so comfortable and pain free to live with. Moreover it makes us less productive and creative as we can't think or move without pain. 

I have categorized different expressions given by your back under pain. If you know the level of severity then you can easily take decision on what action your back pain needs at that moment. Remember it is the ignorance which makes you suffer.

Self Limiting Back Pain

For most people low back pain starts with a dull ache or a tiring sensation around the lower back which comes with physical exertion and goes away with rest. Normally this is a hint by the body that you have done something beyond your body can handle. This kind of pain is usually self limiting and goes away in couple of days or when your exertion days are over.

Acute Back Pain

The issue comes when you keep ignoring this discomfort and the pain becomes stronger or acute which also last longer even with rest. But again just being conscious of basic do's and don'ts things can be managed by adding self management like rest,  ice or hot compress and activity modification. This is an alert by the body to kind of look into your daily routine and work on changing the lifestyle. Mainly look into your daily activities somewhere you might be abusing your body by over exertion or just being too sedentary. Get your nutrition sorted because you become what you eat. Have you been  sleeping enough? Or is it difficult get a good deep sleep?

If at all your discomfort or pain is not getting over in 2 weeks, there is a need to see your physician or physiotherapist who can do a basic examination and rule out anything major. 

Acute Back and Leg Pain (Yellow Alert)

Sometimes the back pain is very disabling and doesn't allow you to work or do any activity. It can also radiate a sharp pain in your leg usually in one leg upto the ankle. This is the time when you should definitely seek a specialist help like an orthopaedic doctor or a specialized physiotherapist. They can diagnose the problem and start your treatment soon. Usually, the leg pain is coming due to compression of a nerve root from the spine primarily on the right or the left side. The nerve can get pinched because of a Bulging Disc, a small bony growth (osteophytes), a stiff or locked vertebral movement or a bad muscular spasm etc. Here I would say follow your doctor's advice rather thinking to self manage as things can get worse if you ignore.

Back Pain Emergency (RED ALERT)

There are certain emergency situations in back pain. In case you feel a sudden numbness or weakness in your leg or gives you a feeling of "dead Leg" or you can't control passing of urine or stool; this is the time where you should rush to the hospital and get emergency checkup done. Our spinal cord and spinal nerves is the only connection between Brain and the Body which helps us regulating sensation and movement control. Without such connection the body can go in paralytic mode where you may loose any conscious control over your body movements.


Year Long (Chronic) Back Pain



I see many patients coming with year long back pain along with an MRI or X-RAY in their hands. They want me to see what their report says about them. And like always my answer is I want to see what your muscles and joints want to tell me regarding you. As with chronic back pain investigations can be MIS-LEADING where we might treat what is even not bothering in the first place. Most chronic back pain is coming from poor body functioning along with contribution from mental health, nutrition, level of physical activities and Tolerance.

Having a Low Back Pain is not always about a pathology, a spinal disease or an injury to the content of Low Back. It can just be a predictor of your general health, your physical activity status or your fitness. Low back pain is very vast when it comes to diagnosing a problem there ranging from Muscular Spasm, Disc Prolapse, Sciatica, Lumbar stenosis, Spondylosis, Spondylo-listhesis, Vertebrae Fractures, Infections and Tumors. Without making you too much scared the biggest relief is most of these issues are rare. But yes majority of back pains are just a poor physical or mental health.

Just keep in mind that if your back pain is associated with:

• fever and chills

• constant back pain not linked to your movements

• continuous pain especially at nights 

• sudden abnormal weight loss along with back pain

Please contact your general practitioner as not all back pains are just physical.

Carefully assessing the low back problems and their timely management can give full recovery. Let me just put certain evidence based facts which we know today about back pain:

• Recovery rate for a back pain case is as high as 99%.
• Investigations have a low value as most back pains are due to poor function where early X-RAY or MRI doesn't give much information to help the treatment.
• Your pain has no relation to how bad or good is your disease. Each one of us has different pain threshold. To some people needle feels like a sword while others can take lot of pain easily.
• 80 - 90 % of low back pain sufferers can get better with lifestyle modification, optimal physical activities and rehabilitation (Exercises).
• Your mental stress is a major contributor to your back pain especially in chronic back pain.
• Conservative treatment with Active Physiotherapy has to be the number one choice of treatment. 
• People who do not recover in due course of time may need Injections or Surgery as per their doctor's advice but there is no other choice but to EXERCISE.

This article is an effort to create awareness regarding back pain in general public. Always talk to your physiotherapist and seek specific advice as every condition is as unique as you.

Feel free to comment or contact in case you need more information on this topic. 

Regards,

Dr. Kunal vashist,PT

Mpt (Ortho), Manual Therapy 

Dryneedling practitioner

Email ID : kvashist.physio@gmail.com 

Contact no. 9968302757

Benefits of exercise- Beyond weight loss

Exercise and weight loss has always been weighed together where the real aim for us is using exercise as a tool for weight loss.

Since ages dieting has been followed to create calorie deficit which is thought to be creating some reduction in body weight. Calorie deficit if combined with calorie burning has a tremendous effect on faster weight reduction. Numerous studies have shown  the role of combining exercises and good diet for effective weight loss.

There are studies to show that an intermittent fasting plan in a diet is way more effective than a long term strict diet routine alone. Whenever the body is challenged consistently it soon adapts to the routine and becomes less effective. Variation is the key to success as your body gives results when you challenge your metabolism (the rate of burning fuel by the body) and not allowing it to adapt with your routine. 

Similarly, when exercise is done uniformly your body soon adjust to the activities you do. And soon the weight loss becomes less effective. When you keep the body under challenge by variating your exercise routine from high to low and high again, the large metabolic changes occur. This variation makes the weight loss more effective and faster. This also makes your cardiovascular system work harder giving you benefits beyond just the weight loss. The most effective variation plan in exercise is HIIT (High intensity interval training) where your body performs high level of activity followed by short rest period and it goes on in a circuit create good strength and effective calorie burning.

Although I do not support HIIT until you do not improve your basic body strength. Human body is very intelligent as it can make you work without realizing the faults and it is too late by the time you experience something is wrong. It is good to identify your weakness and work on it to get a better balanced strength everywhere before you switch to HIIT. You need to get FIT before start HIIT.

Exercise should not just be a tool for weight loss as it has got numerous benefits. The aim behind losing the extra weight should be more than cosmetic appearance. Your extra weight is anyways a sign of bad lifestyle and poor health. Do you know why the weight which you lost with so much effort has a tendency to come back after some time? The reason is you never made permanent change in your lifestyle and eating habits. 

"The change which you want by doing something temporarily will work only temporarily".

In order to achieve good health, the change has to come in whole of you. You should be aware of the benefits coming from exercise and healthy life style. The real benefits of exercises are to control, cure and prevent lifestyle diseases and we have ample of evidence in researches for them.

Benefits Of Exercises Beyond Weight Loss

1. It can control, prevent and treat Hypertension or high blood pressure.
2. It can cure or control type 2 Diabetes.
3. Various cancer types can be prevented and even arrested from progression
4. It can make you live longer, stronger and independent.
5. It can keep you away from aches and pains.
6. It can delay or prevent surgeries.
7. It can counter chronic pain disorders.
8. It can simply make you HAPPIER and bring back the SMILE.

In case you want to know more about how you can make exercise as your RECOVERY TOOL kindly feel free to contact me through details mentioned below:

Dr. Kunal Vashist,PT

MPT (Ortho), Manual Therapy

Dry Needling Practitioner

Exercise and Rehab Specialist

MORE THAN PHYSIO

EMAIL ID : kvashist.physio@gmail.com

Contact No. 9968302757

WORLD BREASTFEEDING WEEK

Celebrating the World breastfeeding week (1st Aug-7th Aug)

Theme of the year: Empower Parents, enable breastfeeding- Now and for the future.

We all know that breastfeeding is a very natural process, but the pity is that at today’s date there is a need to promote breastfeeding. When we all know that nature has given the wonderful power of nurturing the baby through breastfeed then why we are trying to interfere with it and leading toward artificial feeds. Why the introduction of honey, ghutti etc is there to such small babies when it’s world-wide known fact that it can be dangerous for them. Do you really think that providing that ghutti through one of your family member will transfer that person’s qualities to the baby?



Are we really living in 21st century?

My idea is not to offend anyone here but I am trying to find the reasoning. We should think before we do anything instead of just blindly following the unnecessary rituals or beliefs which can put our little one’s health on risk.
Now the question that might come to your mind is what to do in case if someone can’t breastfeed. So the answer is have you seen any animal’s baby having artificial feed; similarly our baby also has a right on mother’s milk only and

"THERE IS NO SUCH MOTHER WHO CAN’T BREASTFEED HER BABY"

It’s the Biggest MYTH and the challenge in INDIA is to break that myth.

Yes it’s true that breastfeeding can come across various challenges like delayed milk supply, sore nipples, heaviness etc. but believe me all this is temporary and the only thing which is required to overcome all the challenges is RIGHT INFORMATION AND RIGHT ADVICE at the RIGHT TIME. So here comes the role of family who should be patient and supportive enough to encourage breastfeeding rather than giving substitutes like formula feed or bottle feed; role of partner who can support the mother with various things like burping the baby, swaddling, swaying or cleaning the baby at times to give the adequate rest to mother.

Government is also spending lot of money to create awareness about early initiation and exclusive breastfeeding till 6 months, creating breastfeeding rooms, provision of maternity leaves till 6 months –Why?






So that we have enough resources and time to give a healthy and happy life to our munchkins

.

To establish a successful breastfeeding work on 3T’s:

Timing: Early initiation of breastfeeding is very important; do not delay it. As soon as you get the baby start feeding.

Techniques: Right positioning and latch as half of the problems come because of the wrong holding.

Trials: Breastfeeding works on demand and supply so give enough time and multiple trials; as practice makes you perfect.

Last but not the least; do not hesitate to seek for help of a lactation consultant as this is her domain to give you the correct guidance and clear myths from realities.


So once again MARK my words:

Every woman can feed her child naturally; you just have to find a way and when there is a will; there is Always a way.

Thank you

Dr Kavita Mehta (PT)
Lactation consultant and a proud mother of 3 year old Son.

For any queries reach out at kavita.mehta@fortishealthcare.com/kavita.physio@gmail.com

Know About Your MYSTERIOUS Neck Pain

Muscular aches and pains are becoming common day by day. Almost all of us face some issues with our muscles and joints as we cross our student life and enter professional life especially if work involves lot of screen time and sitting. 

During school days, kids are forced to sit long hours for studying in the classes as well as at home or tuition but they can still get away from pain as the body can take and forget muscular stress easily. Muscular health is also better at that time because your body is mobile, agile and undergo short periods of high activities like running, indoor or outdoor games etc. As a child your carefree attitude does help in keeping physical and mental stress under control. In addition the body weight is well under control which helps you moving faster. 

With time you enter professional life and then you are bound to do a sitting job in front of laptop or computer for long hours. Gradually work and family do add up some stress to life as you want to perform better in both. That carefree attitude is gone by the time you enter professional and personal maturity. When you move less, you hamper your mobility and your strength declines due to long hours of physical inactivity. Decrease in muscular strength and mobility is just the adaptation of your body towards reduced physical activities. 

Long hours of inactivity, stress and poor diet altogether increases your body weight disallowing you to remain agile the way you were during your early childhood. The collective response from your body is aches and pains gradually becoming unresolved and chronic. 

Neck pain is usually very common in these conditions and can interrupt with your healthy living. It doesn't seem like an emergency but it doesn't allow you work peacefully also. By the time you realize neck pain is a problem it is too late as your body gets well adapted to your current way of living. It is so natural for all of us to find an instant cure but I wish we had such an approach to deal with it. A prolonged neck pain is a consequence of multiple changes mentioned in initial paragraphs of the article which your body has acquired in so many years. A permanent solution is reversal of at least some of those changes which definitely doesn't happen instantly. 

You do not have neck pain because a particular spinal vertebrae or spinal joint has reduced space or degenerated or damaged. You have pain because you do not move functionally well as a whole. Medicines have a very limited role in treatment of neck pain. In fact anything which does not improve how you move or sit through out the day, might not help in long term when it comes to joint and muscles health.

The current evidence based information about neck pain management is as follows:

• X-Rays are not so informative in describing the source of neck pain.

• MRI is an investigation of choice but should be used very carefully as it can pick up issues which are irrelevant for your pain. Also the reporting can act as a nocebo, creating new area of pain which you never had or can delay your recovery as you might get relatable anxiety and fear-avoidance behavior leading to reduced activities.

• Electrotherapy like TENS, IFT or Diathermy doesn't have supporting evidence in treatment of prolonged neck pain.

• Therapeutic Ultrasound can provide deep tissue heat and micro-massaging effect in case of acute pain for some days but does not qualify as a treatment for neck pain.

• Wide use of mechanical traction device for neck pain has been stopped by many western countries because of associated consequences and negligible results.

• Manual (Hands-On) techniques like mobilization, manipulation and massages via osteopathy or chiropractic techniques have some effect in initiating recovery but only gives you short term relief.

• Postural Correction is also over-rated as you tend to force your weaker muscles in order to sit upright. And that conscious effort will last only for couple of minutes the moment you get busy with other things around you.

• Stretching is helpful in temporarily DE-Stressing the muscular tension and helps in regaining the range of movement.

• Strengthening the weaker muscles can help in sustaining the correct posture for long time as it reduces the stress on postural muscles. Strength training in full range of movement can help with improving your neck motion as well.

Feel free to connect with me and discuss a lot more in detail about various types of neck pain and their solutions.

Dr. Kunal Vashist,PT

MPT (Ortho), Manual Therapy

Dry Needling Practitioner

kvashist.physio@gmail.com / 9968302757

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