Neck pain has become more prevalent and rampant in our society and mainly it is because of the inappropriate posture like forwarding head posture (FHP). As IT technology develops, it is not unknown that many people are suffering from neck pain due to FHP because they use their computers or mobile phones for long periods with an improper position. FHP is characterized by an excessive anterior protrusion of the neck, and therefore, the spine alignment changes due to unusual pressure on the vertebrae. Neck pain is a musculoskeletal disorder that accompanies functional limitations like the limited cervical range of motion (ROM) and neck stiffness that occur from the inferior margin of the occipital bone to thoracic vertebra, T1. There are a plethora of possible reasons why FHP happens. For example, prolonged sitting with excessive use of computers in the workplace and sleeping with the head elevated high occur FHP easily. Therefore, most physiotherapists have different views on the effective treatment on neck pain associated with FHP because clinicians usually examine the severity of the abnormal alignment with subjective standards and classify from mild to severe based on their own visual thoughts. This essay will discuss four major treatments, two passive and two active treatments, and evaluate their effectiveness in terms of pain relief. (213 words)
The most common passive treatment is therapeutic thermal modalities such as cryotherapy and thermotherapy. Generally, physiotherapists use moist heat packs or cold packs which are a routine method of direct application to the body. It provides analgesia and helps eliminate the neck pain because topical heat or cold performs as a counterirritant. There are two main reasons why this treatment is common. First, it is easy, relatively cheap, and widely available procedure to reduce irritation and pain associated with FHP because the application of modalities helps the pain threshold increase (Garra, 2010). Also, hot packs help muscles around the neck relieve, and this process raises cervical ROM. Hou (2002) states that the combination of treatments like heat pack plus active ROM is an effective way to ease neck pain and increase cervical ROM. However, the weak points outweigh the good points. Garra (2010) claims that there is not enough proof of the efficacy of this treatment although the subjects positively reported symptoms. Also, there is a consensus that no form of heat energy can have a depth of penetration greater than 1cm. According to this general agreement, Yadav (2015) empathizes that the application of thermal modalities only has an immediate effect. (+226 words = 439 words)
The other passive treatment is myofascial release (MFR) technique to relieve shortened muscles which cause neck pain. Unlike therapeutic thermal modalities, MFR is a manual therapy to stretch from fascia to muscle. Physiotherapists grasp sternocleidomastoid tendon, rotates the head, and glide down through tissues. This process breaks the inter-fiber linkage.
By applying MFR, soft tissues enhance extensibility and pain intensity is diminished (Aggarwal) Physiotherapists choose MFR to boost the circulation of blood (Kim)