This article was originally published in Positive Health issue 112 – June 2005

Why do we have a neck? Creatures such as fish manage very well without one (their head and trunk move as one). But some animals moved from water to land and won by a neck! Its formation was a necessary adaptive response to a radically new environment. A true neck is made of several vertebrae, including the two which are specialized: atlas and axis. It is a movable junction which links the head to the torso and allows independent movements of the former. The earliest reptiles are the first animals to have developed it. Being around 300 million years-old, this anatomical invention deserves some respect.

Most mammals possess seven ribless vertebrae in their necks. So, the long-necked giraffe and the short-necked elephant share the same number of cervical vertebrae. We too, mammals par excellence, have seven vertebrae in our neck. Birds are more ambitious. To compensate for their rigid trunk they usually have a long and very flexible neck. Take the swan, for example. It boasts up to 25 ribless neck vertebrae forming a beautiful S-shape neck. Owls, in spite of their short-necked appearance, can rotate their head in three-quarters of a circle. That’s rubber-necking for you and would be handy to park the car.

Compared to birds, our neck is relatively stiff. Nevertheless, it’s a very fidgety structure: it moves about 600 times an hour, even when you are asleep. An Olympic feat that no other part of the musculoskeletal system can achieve. But when we indulge in our favourite pastime – misusing ourselves – things start to become a pain in the neck. Yet, the nucleus pulposus, present in the cervical intervertebral discs at birth, disappears progressively to become absent around the age of 40. That means that there is practically no risk of herniating a nucleus pulposus in your neck past this age, as it has disappeared. Moreover, there is little risk that disc problems from C3-4 in this body segment could lead to nerve roots compression as the root exits below the disc (although the posterior roots can become compressed in cases of enlarged and osteophytic facet joints). Add to that the fact that the posterior longitudinal ligament is much thicker than its counterpart in the thoracic and lumbar regions, it explains why disc herniation in the neck is a rare occurrence.

Yet neck pain is a very common complaint. Unfortunately, the usual tools for clinical investigation (X-rays, CT scans and MRI) rarely show any correlation between what is found and the existing symptoms. This is because most of these symptoms originate from muscle imbalance. For example, the osteopath who referred Lesley to me warned me that her neck was very unstable and fragile, and wondered if the Mézières’ Method was indicated at this stage (showing a lack of knowledge of this method). Yet, the radiological images of her neck did not reveal any source of possible pain.

A keen horse-rider and huntsperson since childhood, Lesley was by nature highly-strung and competitive, breaking her neck to get her goals. Almost literally speaking as, after a few falls on her head (from both horse and skis) which almost killed her, she found herself, at 28 years-old, suffering from ME and head, neck and back pains. Riding and working were no longer possible.

During her third Alexander session, whilst I was making gentle adjustments to achieve a better head-neck-back relationship, she felt her headache disappearing. On that day, she drove back home still headache free even though driving used to be a sure headache trigger. After that, we added in Mézières’ sessions. Although not completely out of the woods, her condition has greatly improved and she has started to resume an almost normal life, including riding. The problem with her neck was that it lacked the normal lordosis (concavity) which was transferred to the upper thoracic region. Many tension headaches are caused by a lordotic area between the shoulder blades.

During movements of the body, the head remains remarkably stable in a position which depends on eye level. This stability is the result of antagonist contractions of the anterior and posterior muscles of the neck. When too tight, these groups of muscles play a tug-of-war which, in due course, is responsible for most neck troubles. Sometimes the body escapes pain by twisting and bending the neck sideways. Thus, a recent patient of mine came to me for chronic backache. Unbeknownst to him, his head was bent to the side and turned to the right. As soon as I gently realigned his head, while he was in a supine position, pain and paraesthesia appeared in his right shoulder and arm which increased with each deep exhalation. We often distort our bodies to prevent pains we are not even aware of!

A 300 million year-old structure that moves 600 times an hour! The mind boggles. So “let your neck be free”, as FM Alexander advises.

References
Edited by Berthoz A, Graf W and Vidal PP. The Head-Neck Sensory Motor System. Oxford University Press. 1992.