If neck, mid, back, or shoulder blade symptoms are worse with driving or after driving, it’s worth considering your car posture. The same applies to symptoms anywhere in the head, face, shoulder or arm, all the way to your fingers. (The lower portion and bottom seat can play a role in low back and leg problems.) Most cars put the mid back in flexion and the neck in flexion and/or protrusion. In other words, the mid back joints are rounded and the joints of the neck are either bent forward or pushed forward.
If a posture has no effect on symptoms while you’re in the position nor after, and if your movement ability is not negatively affected, then there’s no problem. For a lot of patients with upper body complaints, though, posture in the car does warrant discussion. Many patients note driving is exacerbating and many patients spend a fair amount of time in their cars. The good news? With all of the patients’ cars I’ve assessed, adjusting the ergonomics of the car is easy and inexpensive. The theme is usually (if not always) to get the upper body straight, not flexed. The hardest part is for patients to get used to it - but that beats symptoms! -- Laura
There are muscles encasing our heads and faces. I think people actually understand the concept of referred pain (or non-local pain) when it comes to headaches - they just don’t know they do. Put another way, I don’t hear much about people massaging their head (cranial) muscles, rolling them, stretching them, or otherwise treating those various muscles.
Of course muscles in general can be the producers of symptoms, but it’s rare. I write about this extensively. Everyone loves to name and treat muscles, but, while important, they’re rarely the problem when it comes to orthopedic disorders.
People seem to intuitively comprehend that head pain or headaches can come about for a lot of reasons. Stress, dehydration, allergies, hunger, concussions, and illness to name a few. There are indeed musculoskeletal causes as well - just rarely the muscles. The joints in the neck and mid-back can refer pain (or any symptom) to the head. In rarer cases, the jaw joint can create local symptoms.
If people can understand that their head can hurt not as a result of the muscles in the area and that their chests and arms can hurt due to a heart problem, then hopefully people can start to grasp that arm pain or leg pain is not necessarily due to arm or leg muscles. -- Laura
Dr. Agarwal explains why he uses the McKenzie method in his primary care practice (outpatient and inpatient). One point he makes which I love: the McKenzie method looks to find the cause and understand the problem, especially through focusing on how the patient responds. He gives an example of a patient with headaches and high blood pressure. --Laura
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