Dr Kez Patient file! Stubborn neck pain

In the video

• 01:55 - Introduction of Topic
• 02:40 - Story of a patient
• 05:08 - How to select a pillow?
• 07.54 - Different types of Pillows and issues related to them
• 10:02 - What happens when your Pillow is too low? 
• 11:00 - Basic Understanding of Pillow
• 12:41 - Correct Pillow
• 16:39 - Impact of your Pillow choice on the thoracic spine
• 17:30 - What happens to your lower back?
• 18:40 - Important Note
• 24:18 - Dr Kez pillow
• 27:07 - Question and Answer Session

01:55 - Introduction of Topic

When being treated by a chiropractic, we need to be aware of everything that your body goes through on a regular basis, including what demands you have on your body in your occupation, what recreational activities you put your body through and even how your body is positioned when you sleep.  All of these things can help us to understand what needs to be done to not only treat you to be able to assist your physical recovery and elimination of pain and inflammation, but it also helps to prevent reoccurrence.  We cover everything in Chiropractic because your body is intertwined with everything else.

02:40 - Story of a patient

A new patient came to see me at the clinic as they had a reoccurring neck problem that just wouldn't resolve with their current Chiropractor's treatment techniques. Their history was nothing out of the ordinary, and the assessment revealed a neck issue, similar to what I see on many of my patients, not significantly worse to account for the stubborn nature of this patients neck pain.  Admittedly, their Chiro used a different method of treatment to what I use, being manual (twist and crack) neck adjustments, as opposed to the low force, gentler treatments that I use along with a strong focus on muscular work as well.  The patient reported that they would feel better temporarily, for that day, but the next day they would wake up with the same neck pain again. 

It became clear to me that this was more than just an adjustment issue, so we delved into the important of a supportive pillow.  We spend a lot of time on our pillow sure that it is providing optimal support.  This patient brought in her pillow on the next visit and I can honestly tell you, I have never seen an adult using a pillow as flat and unsupportive as this one.  It was about as supportive as sleeping directly on the mattress without a pillow at all 🤦‍♀️ .  

This was the turning point in her treatment.  A new, supportive, contoured, Chiro pillow resulted in her adjustments holding and her neck pain and stiffness disappearing.  All because of her unsupportive pillow.  Although this case was extreme, I can't begin to tell you how common this problem is.

05:08 – How to select a Pillow?

From a spinal perspective, the purpose of sleep is to allow your spine to rest in a neutral position, not twisted or tilted to one side of the other.  This gives your joints a chance to rest, recover and repair if needed, and it allows your muscles to rest also, so that they can be fully rested to start from scratch the next day to hold your head up.  Your spine is responsible for keeping you upright.   Good posture encourages adequate blood flow and energy in your body.  We will show you the technique to select the ideal profile of pillow shortly.

07:54 - Multiple Pillows and issues related to it

On each side of our bed we have three types of pillows, one triangular shaped pillow for sitting up and supporting my body when reading in bed, another is a large fluffy pillow to make the bed look nice when we're not in it and the third and most important, is our contoured Chiro pillow which has been specifically fitted to support my neck when I sleep at night.

If the pillow is too high and you sleep on your back, it will close off your trachea (the breathing tube).  This can create breathing issues, and if your pillow is too low and your neck is tilted backwards when sleeping on your back, this can also affect your breathing and snoring might occur.   Yes snoring may simply be the result of your pillow being too low, resulting in your head being tilted back so far that your epiglottis falls backwards and partially occludes your trachea, or your head is raised too high and compression occurs.  Furthermore, it constricts the neck muscles at the front of your neck and stretches the muscles at the back, meaning that they are not resting effectively over night.   Given that so many of us spend a lot of out time either staring at a device all day with our heads tilted forwards like this, we really can't afford to assume the same posture all. night as well.  

10:02 - What happens when your Pillow is too low?

You can see that Em's head drops backwards on a low pillow and her chin is tilted upwards and backwards. As a result, abnormal stretch and tension occurs in the front region of neck muscles, this can result in headaches, as can sleeping on a pillow that is too high.  When your anterior neck muscles become fatigued by sleeping on a low pillow with your head tilted backwards, the muscles really struggle with holding your head upright the next day.  Much of your energy is used up trying to stop your neck from falling backwards when you wake up with these muscles already overworked.  Fatigued during the day????  This could be why!

As a result, it's critical that you get into that neutral posture, which is essentially where you lie down as if you are standing up.  With your neck straight ahead, chin not tucked down or up and back.  

11:00 - Basic Understanding of Pillow

You have a curve on the side of your neck when you sleep on your side, and there is a lot of space between where your shoulder rests on the mattress and your face or head reaches the pillow, when you sleep on your side.  Your pillow needs to be able to take up this space precisely so that you neck isn't tilted passed the neutral position.   You also don't want your pillow to be too high, as this will put strain on your neck.  The side closest to the high pillow will have stretched muscles and the other side will have compressed muscles.  Stick to the same guidelines as for sleeping on your back.   It needs to make you neck neutral while you sleep, not too high and not too low.

If your pillow is too soft, it will compress when you lay on it.  Likewise many of these down pillows might be comfortable when you shove them into your neck as you get into bed, but overnight they move and end up being completely unsupportive. 

Side note - please do not sleep on your stomach as this requires you to turn your neck to the spine to breathe, which results in your spine being twisting all night 🙅‍♀️  Entirely the opposite of what we are trying to achieve with a neutral, relaxed spine. Incidentally, I have found in my 20+ years of clinical experience as a Chiro, that tummy sleeping is a very common cause of people's neck problems.

12:41 - Correct Pillow

Having the appropriate profile pillow is important. Because it supports your neck to remain in this neutral posture all night, to ensure complete muscle relaxation and repair and regeneration.  If you have a broad shoulder like Em and are sleeping on a soft bed with a pillow top, your shoulder will sink further into the mattress so you need to select a higher profile pillow.  It is ideal to be able to fit the pillow at home on your own mattress to get a true indication of what height your pillow should be, as your shoulder will sink deeper into a soft mattress than it will with a firm mattress.

 

Having someone look at your neck and spine from behind when lying on your side facing away from them, and then turning the pillow accordingly to find the best fit is ideal.  You can also remove the middle inserts if the pillow is still too high on the low setting.  You can also remove the noodles on the surface of the foam for a softer feel on your face without affecting the support and profile of the pillow.

 

 

16:39 - Impact of your Pillow choice on your thoracic spine

If your pillow it too high or too low, the muscles of your neck are not the only ones that are affected.  The pull of these tight muscles will continue down your spine and affect your thoracic spine (between your neck and lower back).  Tight muscles for a prolonged period of time can cause the vertebrae or ribs in this area to subluxate, causing pain and potential dysfunction in the heart and lung systems.   Having the appropriate profile pillow is extremely important and a worthy investment, especially if you are experiencing any type of spinal pain or stiffness, including the lower back believe it or not!! 

17:30 - What happens to your lumbar spine?

The outside membrane of the spine, called the dura, attaches the cranium and upper neck vertebrae and then it is free floating until it gets down to the sacrum area. This membrane protects the brain and outer spinal cord. It is fixed at the top of the spine and the bottom of the spine, to ensure it is held appropriately in its place, but preventing it from being damaged by issues at each individual spinal level.   As a result of this, any pull of your neck area, will inadvertently pull on your lower back.  Your lower back will be pulled like a rubber band if you have tension and pressure in your neck, for example, by sleeping on a pillow that is too high or too low.

This makes selecting the appropriate pillow profile and contour such a critical factor, because if we don't sleep with the appropriate balance of neutral posture, it will produce pressure in the neck, ribcage-related discomfort in the thoracic spine, and subsequently tension and pain in the lower back. This might be perceived as  stiffness in your lower back or tightness when you get up in the morning.  Just remember if your muscles are not resting in a neutral position overnight, their ability to support your spine during your daily activities is affected and the risk of injury becomes greater.

18:40 - Important Note

• Electrical signals from your brain control blood pressure throughout your body, including bowel motions, sexual activity, and so on. The brain is in charge of managing and coordinating all of your body's systems. You will become exhausted if your spine is always under strain due to fatigued muscles that are not recovering completely at night time with decent sleep posture. Not only because you aren't getting enough sleep, but also because your brain isn't receiving enough rest. There's a higher danger of getting hurt.
• During restful sleep, our body has the opportunity to decrease the stress hormones that might have been released during our waking hours. Decreasing these stress hormones helps us to empty our stress bucket so that we can reboot for the next day. 
• Our body is quite busy when we sleep, our immune system is boosted and our body also has the opportunity to repair and regenerate itself during sleep. It also consolidates memories, and makes sense of events that have happened throughout the day.  While we are resting our nervous system is also re-energized.  All of these reasons and many more, is why we don't function as well if we don’t get quality sleep.

There are so many ways to adjust your Dr Kez Chiro Pillow.  Having someone assess you from behind to determine the ideal height for your neck and spine is the first step.  There are two heights to begin with, one is high and the other is about an inch lower.  If the pillow is too high, you can remove the foam inserts from the middle of the pillow to lower the profile and once again have someone assess you from behind to determine the best side once the inserts are removed.  If the pillow is too low on the high side, you can double up the inserts from the inside to raise the height of the pillow.  

The surface of the pillow also has one more adjustment that you can make to assist with making the pillow feel softer on your face.  There are little foam noodles that can be removed from the top surface.  You can remove them all or every second one or none at all, it’s your choice.  This does not affect the support offered by the pillow at all.

27:07 - Question and Answer Session

An interactive session with the live audience took questions from audience and answered them. Watch full video here https://www.facebook.com/drkezchirolab/videos/500706395059095/