Cervical Disc Herniation in a “Typical” New Yorker
With thousands of New Yorkers working 8+ hours per day sitting behind a computer screen, there is never a shortage of patients suffering from neck pain and upper extremity radiculopathy. Upon my own simple questionnaire, I asked 50 patients in my clinic if they experience neck pain (these weren’t even patients being treated for neck pain at the time). Forty-two of them said they indeed experience neck pain to some degree (84%). I also asked these same 50 people to rate their posture from a 1-10 (1 being lousy and 10 being perfect). This averaged out to approximately 5. In my opinion, and at face value, what an average person considers a 5, a Physical Therapist (or other healthcare professional) would probably consider a 3. I say this because I often ask the person to demonstrate what they consider to be a “5.”
Sitting at a computer desk for long hours and in poor posture puts tremendous eccentric strain on the posterior musculature, ligaments, and discs of the cervical spine. With this type of strain occurring approximately 9 hours per day x 5 days per week x 48 work weeks per year, the typical New Yorker is slowly beating up their neck for at least 2,160 hours per year. I find that the first symptoms of neck pain in this type of person are of myofascitis, and can quickly be treated with soft tissue manipulation and postural correction. However, it is extremely common for the pathology to progress to something more severe; usually cervical hyper-mobility or degenerative disc disease. The weakening of the posterior structures in the neck is progressive, and often times a person in a deconditioned state may perform one simple movement with their head or shoulders and then experience a sudden sharp pain in their neck. This “ah ha” moment usually progresses to the inability to move one’s neck, as well as the initiation of upper extremity radiculopathy. The progressive strain and weakening of the cervical stabilizers creates the inability to stabilize the bony structures (including the cervical disc) in the neck, and accompanied with progressive straining and degeneration occurring to the discs, a cervical disc reaches a point of maximal strain and can tear.