Tips on Pushing While Delivering a Baby |

The most important thing to remember while pushing during delivery of your baby is to have confidence that you can do it. Stay positive, and trust that your body knows what to do. These tips on pushing while delivering a baby are from Darren Salinger, M.D., OB/GYN.

There are only two ways to deliver a baby:  

  1. A natural delivery, or 
  2. Cesarean section.  

“Aah, push it, push it good.  Aah, push it, push it rea’ good.  Oooh, baby, Baby, baby, Oooh, baby.”

Salt N Pepa, 1987

These are tips to effect a natural delivery.  Sometimes even after a long time of pushing, a person may need a cesarean delivery.

There are a few steps to remember to make pushing more effective, which means less time in labour.  

  • Positive thinking is important.  
  • Your body knows what it needs to do.
Childbirth methods chart - vaginal delivery, vacuum assisted, forceps, and Cesarean.
Childbirth at hospital. Ways to deliver baby at hospital by doctor or obstetrician. Methods are vaginal delivery, vacuum assisted, forceps, and Cesarean.

Specific information for when a contraction begins: 

First, take a deep breath like you are going under water.  This step gives you power.

Second, hold your breath and curl up around your baby while lying on your back with your head at a comfortable elevation.  This means bring your chin forward to your chest and bring your knees back toward your chest.  

Note:  This is when people (at the hospital where you are delivering) may help hold the bottoms of your feet.

Third, bear down like a bowel movement.  

To repeat these three steps:

  1. Take a deep breath and hold it.
  2. Curl up.
  3. Push down.  

Counting during the contraction:

Some people like a slow steady count while pushing, such as when doing exercise.  A steady push for three sets of counting from 1 to 10 is a common practice.  Another method is to have someone time 10 seconds and let the person pushing down know when the time is up.  

Some other considerations while pushing:

  • Rest your shoulders; 
  • Rest your face;
  • Try not to push with your legs;
  • Try not to waste energy by hyperventilating, extra motion, extra sounds 
Pregnant woman doing exercises preparing for pushing during delivery of her baby
Exercise during pregnancy is great preparation for pushing during delivery of your baby

Dealing with your support people during labor and delivery:

Keep in mind people may say words such as “harder” or “faster” or “give more effort”.  Don’t get frustrated.  Keep your focus.  

You do not need to push harder, or faster, or more.  

Slow, steady, controlled pushing is the way to go.  

Fear and anxiety during labor and delivery:

There comes a time when people worry that if they continue pushing, they may hurt themselves.  

Please remember this is what the body is made to do.  When you get to the time when this sensation is felt, push past the point of fear; and have confidence that you will not hurt yourself.   

Mother strolling with newborn on the waterfront
Mother strolling with newborn after success pushing and delivering her baby

Dyspareunia or Painful Sex in Women & Men |

Dyspareunia is defined as genital pain that occurs before, during or after intercourse. This is a common sexual problem. Dyspareunia can occur in women and men. Some sources estimate dyspareunia occurs in two-thirds of all women. The medical literature does not quantify the number of men with this condition. Vaginal infections or infections of the prostate are the most common successfully-treated causes of dyspareunia.

Dyspareunia – Painful Sex in Women & Men 

Couple, man and woman, ripping the same paper showing the word "SEX."
Sex problems, dyspareunia, impotence, prostatitis, or sexually transmitted disease can cause relationship problems.

What is Dyspareunia?

Dyspareunia can be defined as difficult mating.  It is  not a well understood condition.  This problem  can be lifelong or acquired.   Dyspareunia usually occurs ten years after the start of sexual activity unless it has always been present.  Causes can be an infection, a skin problem, trauma, dryness, male factors, such as prostatitis as well as other physical and psychological factors.

“I hold it true, whate’er befall;

I feel it when I sorrow most;

Tis better to have loved and lost

Than never to have loved at all.”

Alfred Lord Tennyson

“Dyspareunia (difficult mating) is defined as genital pain that occurs before, during, or after intercourse.  The repeated experience of pain during intercourse can cause marked distress, anxiety, and interpersonal difficulties, leading to anticipation of a negative sexual experience and eventually to sexual avoidance.” 

American Psychiatric Association, 4th ed. 1994
Continue reading “Dyspareunia or Painful Sex in Women & Men |”

Hemorrhoids are a pain in the butt |

Hemorrhoids are much more prevalent in the Western World as compared with Third World Countries. Hemorrhoids are associated with constipation, heavy physical work and the effects of erect posture. Hemorrhoids are common during pregnancy. In addition to hemorrhoids, industrialized countries are at an increased risk for colorectal cancer. If you suspect you have hemorrhoids, always talk to your doctor. Do not self-diagnose!


Hemorrhoids are one of the most frequent problems people in westernized countries face.  An estimated 50 percent of those over the age of 50 years require some type of conservative or operative therapy.  (4)

There are estimates of up to 75 to 90 percent occurrence rates of hemorrhoids in the U.S. population (1, 2, 3, 4, 5).

The cost to the community, both financial and in lost work days, is great; and by any standards, this condition must be considered a major health hazard (7).

The thinker sitting on a cactus - representing people with hemorrhoids
It’s hard to think when you sit on your hemorrhoids. Sit Better, Feel Better.

Hemorrhoids have plagued men and women for centuries, inflicting pain equally on individuals at all levels of society and of all occupations: Emperors (Napoleon); U.S. Presidents (Jimmy Carter); baseball sluggers (George Brett); judges; policemen; truck drivers; cab drivers; and jockeys (6).  It has been said that Napoleon’s hemorrhoids were troubling him during the battle of Waterloo (7, 9).

“I saw a sign one time that said ‘Hemorrhoids awareness week’ at the doctor’s office.  Let me tell you, if you got hemorrhoids, I am sure you are aware of it.  You don’t need a sign to tell anybody about it.”

Larry the Cable Guy

What are hemorrhoids?

A hemorrhoid is defined as “a mass of dilated, tortuous veins in the ano-rectum involving the venous plexuses of that area.”

Taber’s Cyclopedic Medical Dictionary, Edition 18
Info-graph of Hemorrhoid symptoms and treatments
Hemorrhoids line icon Infographics. Symptoms, Treatment. Vector signs for web graphics.

There are internal hemorrhoids and external hemorrhoids.  Internal hemorrhoids are higher up in the rectum and cause rectal bleeding.   External hemorrhoids protrude into and beyond the anal opening and cause itching, swelling, bleeding and pain.  People with external hemorrhoids seek relief from products such as “Preparation H.”  

Hemorrhoids in The Western World 

Today, hemorrhoids are considered to be one of the most common ills of men and women, a judgment made by those with vision limited to the Western World (7).

Hemorrhoids in “Third World Countries”

The high rate of hemorrhoids in westernized societies contrasts sharply with Third World countries.   Only about one in 25 to one in 30 individuals is thought to have hemorrhoids compared to one in two individuals in Westernized societies. One doctor recounted in 30 years’ practice in Africa, one of the only two patients he saw with severe hemorrhoids was a prince taking a semi-European diet (5, 7).

What causes hemorrhoids?

Hemorrhoids are thought to be caused by, or associated with, increased intra-abdominal pressure resulting from:

  • chronic straining to pass constipated stools,
  • heavy physical work, or
  • the effects of erect posture (3).

If constipated, hemorrhoids tend to worsen.  Try not to strain when you have a bowel movement.  Eat a diet high in fiber; and, if necessary take a fiber supplement daily with a lot of water.  

Dalmatian dog with red glasses on toilet reading newspaper - hemorrhoids
Dalmatian dog sitting on a toilet seat with digestion problems or constipation that could lead to hemorrhoids if human.

Pregnancy is a risk factor for hemorrhoids

“About 40 percent of pregnant women develop symptoms they attribute to hemorrhoids (Simmons, S. C. 1972).” 

Pregnancy may predispose women to hemorrhoids because of:

  • a) increased intra abdominal pressure from the pregnant uterus, 
  • b) constipation, 
  • c) hormonal venous dilation (hemorrhoidal tissue contains high levels of estrogen receptors, Saint-Pierre, A., et al., 1982), and 
  • d) increased circulating blood volume (3).
Pregnant woman holding back in pain
Pregnancy Pain. Pregnant Woman Feeling Back Pain, Discomfort.

Hemorrhoid problems are more common in pregnancy.  The large uterus can compress veins which return blood from the legs and rectum promoting swelling.   Also labor and delivery generates tremendous stress on hemorrhoids.  Manage hemorrhoids the best you can before and after labor and delivery of your baby.

Hemorrhoids are common among driving workers  

External compression from poorly designed seating concentrates forces on small areas of the body. This results in high localized pressure. 

The pressure can compress nerves, vessels, and other soft tissues, resulting in tissue-specific damage. These changes may themselves result in disease or predispose other tissues to damage.

Medical studies have shown a high rate of hemorrhoids among truck drivers, cab drivers, and even police officers.  This could be due to the additional ergonomic risk factor of vibrations during driving.  

Trucker Standing in front of a Truck. Driving and hemorrhoids, prostatitis.
Driving is a risk factor for hemorrhoids and prostatitis.

Heavy lifting, standing in the cold and medications can aggravate hemorrhoids

Heavy lifting aggravates the problem.  Try to avoid it.  

Standing out in the cold with insufficient clothing causes you to shiver and tense your abdomen, which is considered to be straining by some doctors.  The recommendation is to stay bundled up when standing out in the cold.

 Also medications, such as codeine, can cause constipation which could cause a hemorrhoidal flair up.

Lifting can cause hemorrhoids
Heavy lifting can cause hemorrhoids and back pain

Minimize external compression to reduce risk factors for hemorrhoids

Preventative measures to reduce risk factors for the development of hemorrhoids should be taken before it is too late.  It is important to minimize external compression from poorly designed seating as much as possible. 

Defective chair upholstery being repaired
Poorly designed seating can cause hemorrhoids

Standing can cause hemorrhoids to swell

“Also, when you are standing, the pressure in your hemorrhoids increases, and they tend to swell more.  Periods of rest — sitting and especially lying down — can be very beneficial if you are suffering with hemorrhoids.” 

Joseph R. Duba, M.D., “Understanding Hemorrhoids”
Toilet paper guy surprised standing is a risk factor for hemorrhoids while holding a roll of toilet paper.
Toilet paper guy is surprised standing is a risk factor for Hemorrhoids.

Hemorrhoids are the most common cause of rectal pain and/bleeding

The term hemorrhoids can be misleading because patients often attribute all rectal complaints to hemorrhoids.  Rectal pain and/or bleeding are common complaints among the general population.  Hemorrhoids are the most common cause of these complaints.  

Discuss hemorrhoidal symptoms with your doctor

The public and some members of the medical profession deem these symptoms, which are commonly attributed to hemorrhoids, harmless.  However, the same set of symptoms can herald serious colorectal disease.    Feelings of embarrassment or apprehension about treatment may make individuals reluctant to discuss rectal symptoms with their physician (4). 

Do not be embarrassed to discuss rectal problems with your care-giver because if it is discovered to be colorectal cancer, and it is detected early, there is an 85 percent cure rate (2).

Industrialized Countries at Increased Risk of Colorectal Cancer

Industrialized countries are at a relatively increased risk (for colorectal cancer) compared to less developed countries that traditionally had high fiber/low fat diets.  

“This point is exemplified by the fact that persons from a low risk country who migrate to the United States over time develop colorectal cancer rates similar to those among native U.S. citizens.”

Fry, R., et al., 1989;  Levin K., et al., 1991

Smoking Increases Risk of Colorectal Cancer

“Cigarette smoking and alcohol consumption have been reported to increase the relative risk of an individual to develop colorectal cancer, (Kune, G., et al. 1992; Martinez, M., et al., 1995).” 

Complaints that can be Confused with Hemorrhoids

“Anorectal disorders represent some of the most common yet poorly understood conditions in primary care.” (2)  Patients often attribute all anorectal complaints to hemorrhoids.

Cartoon man with pained expression holding his low back & butt
Cartoon man holding holding his lower back and butt with a pained expression

Other conditions include:

  • Anal fissures (tares);
  • Anorectal abscesses (infection);
  • Fistula (channel) ;
  • Incontinence;
  • Pruritus ani (itching and burning of the anal skin);
  • Infectious proctitis (rectal inflammation);
  • Hidradenitis suppurativa (disease of sweat gland);
  • Condyloma acuminatium (genital warts); 
  • Anal carcinoma (cancer).

Anal fissures

Anal fissure – A fissure is a crack or tear in the anal mucosa usually caused by the passage of a hard stool.  “Nearly half of the patients present with the complaint of hemorrhoids,” (Mazier, WP, 1994).

Anorectal abscess

Anorectal abscess – An anorectal abscess results from cellulitis or infection  (Stahl T.H., 1992).  Anorectal abscesses usually are obvious, producing diffuse swelling, redness, and pain around the anus.  Most abscesses are aggravated by sitting, coughing, sneezing and defecation (Goligher, J., et al., 1984).

Anal fistula

Anal fistula – A tract from the rectum to the surrounding skin that bowel contents can escape from.  Anal fistulas are predominantly found in middle aged men. (Goligher J. et al., 1984)

Anal incontinence

Anal incontinence – Loss of control of flatus and feces.  Young patients with incontinence may suffer enlargement of the colon from chronic constipation or trauma to the anal sphincter apparatus (Goligher, J. Et al. 1984).

“Older women are particularly at risk for incontinence due to progressive denervation (loss of nerves) of the pelvic floor musculature (muscles) from prior birth-related injury.”

Toglia, M.R., 1996

Pruritus ani 

Pruritus ani – intense itching and burning discomfort of the perianal skin.

Excessive cleaning of the anal area with soap and water can cause big problems if you are suffering with hemorrhoid pain / irritation because you remove the natural oils from the area.  The area should be kept lubricated with Vaseline if necessary.  

  When you are having external hemorrhoid pain/irritation, make sure that you use toilet tissue with added lotion, (for example Puffs Plus).

Guy holding toilet-paper making ok gesture
Toilet paper guy says it will be okay. With luck, your Hemorrhoids will go away.


Proctitis – an inflammation limited to the distal 10 cm of the rectum (Centers for Disease Control and Prevention, 1993).

Hidradenitis suppurativa

Hidradenitis suppurativa – a chronic inflammatory disease of the sweat glands of the skin (Goligher, J. Et al., 1984).   It is usually common in people with oily skin.

Anal condylomas 

Anal condylomas – warts are caused by the human papilloma virus (HPV).  It is known that HPV is linked to cervical cancer in women. “Anal warts appear to be most common in young men especially those engaging in anal intercourse,” (Tedesco, F., et al., 1980).


1. Primary Care, Volume 26, Number 1, March, 1999, “Hemorrhoids,” by Joy N. Hussain, M.D., Cairns Base Hospital, Australia.

2.  Family Medicine Principles & Practices, 1998, Fifth Edition: Chapter 91, “Diseases of the Rectum and Anus,” by Thomas J. Zuber; 2b.

3. Family Medicine Principles & Practices, 1998, Fifth Edition: Chapter 92, “Colorectal Cancer,” written by Gregory L. Brotzman and Russell G. Robertson.

4. MJA, Vol. 167, July, 1997, Clinical Practice, “Hemorrhoids: A Clinical Update,” written by Adrian L. Polglase, M.S., FRACS, Clinical Associate Professor and Colorectal Surgeon, Australia.

5. American Family Physician, September 1, 1995, “Non-surgical Treatment Options for Internal Hemorrhoids, written by John Pfenninger, M.D., and James Surrel, M.D.

6.  Surgical Clinics of North America, Vol. 65, No. 6, December, 1988, “Hemorrhoids, Non-operative Management,” written by A. R. Dennison, M.D.; D.C., Wherry, M.D.; and D.L. Morris, M.D., Ph.D.

7.  Southern Medical Journal, Vol. 81, No. 5, May, 1988, “Alternatives in the Treatment of Hemorrhoidal Disease,” by Emmet F. Ferguson, Jr., M.D., University of Florida, School of Medicine, Jacksonville, F.L., U.S.A.

8.  Postgraduate Medical Journal, September, 1975, 51, 631-636, “Hemorrhoids – Postulated Pathogenesis and Proposed Prevention,” written by D. P. Burkitt, C.M.G., M.D., F.R.C.S., F.R.S., and C.W. Graham-Stewart, MS, F.R.C.S.

9.  The American Journal of Proctology, Vol. 21, No. 3, June 1970, “An Epidemiological Investigation of Hemorrhoids, written by John Philpot, Ph.D., Rutgers, The State University, New Jersey, U.S.A

10.  “Napoleon’s Hemorrhoids and Other Small Events that Changed,” History by Phil Mason

Woman laughing holding Buttpillow™ at beach
Anka holding Buttpillow™ at the beach when we had photoshoot for “How to Become an Inventor” by Mr. Daniels

A 5,000 year History of Seating |

“A History of Seating in the Western World,” is a research paper written by Kim Gurr, who was seeking her Postgraduate Diploma in Ergonomics Research under the supervision of Leon Straker, Physiotherapy and Phillip Moore, Social Sciences; however, Ms. Gurr died before completing her ergonomics research. This research paper covers the 5,000 year period beginning with the Egyptian Era through today’s modern ergonomists.

A History of Seating in the Western World

“A History of Seating in the Western World,” is a research paper based on the Postgraduate Diploma in Ergonomics Research project performed by Kim Gurr under the supervision of Leon Straker, Physiotherapy, and Phillip Moore, Social Sciences, at the Curtin University of Technology in Perth, Western Australia.

Unfortunately, Kim died before finalizing her research.

History of Seating is Important for Ergonomics

Seating is an important issue for contemporary ergonomics. Its frequent use by humans and its association with musculoskeletal disorders are just some of the reasons for its importance.

To understand the place of seating in modern Western societies, it is useful to understand its history.

This paper presents an overview of the ancient history of seating and the modern history of Western seating with particular emphasis on the design influences over the past 5,000 year period.

History of Seating begins with the Egyptians

The history of supporting sitting or seating has a long and colorful history beginning, at least, with the Egyptians some 3,000 B.C.

The historical knowledge summarized here is distilled from a great variety of texts, for it seems our fascination with the chair is as alive today as it was in ancient times.

It should be noted that despite the huge amount of information documented on seat types, only three types of distinctly different seats developed.

These were:

  • the stool (both fixed and folding);
  • the bench, and
  • the chair
Continue reading “A 5,000 year History of Seating |”

Buttpillow™ – Patented Ergonomic Seating Cushion

The Buttpillow™ “Patented Ergonomic Seating Cushion” has a hidden wave-form cut-out that elevates the peri-anal area for individuals suffering with hemorrhoids, vaginal pain, dyspareunia, and prostatitis. The Buttpillow™ has an ergonomic wedge shape to help sitting individuals maintain the natural curve of the spine (lordosis) to minimize risk factors for low back pain, and pelvic pain. It is made with medium density open-cell foam for maximum buttock envelopment and pressure-reduction to minimize risk factors for the development of pressure sores, DVT, varicose veins, and sciatica.

Is All This Sitting . . . A Pain in the Butt?

The Buttpillow™ is designed to relieve and prevent pain and problems while sitting.  

Pretty woman sitting on a Buttpillow™
Anka (Ergo-Woman™) on a Buttpillow™-Ergo Giraffe

Sit on The Buttpillow™ . . .  Patented “Ergonomic Seating Cushion”

Patent drawing of Ergonomic Seating Cushion
Image of Patented Ergonomic Seating Cushion from Google Patents

The Buttpillow™ “Patented Ergonomic Seating Cushion” features:

  • The Buttpillow™ reduces sitting surface pressures.  
  • It is made with medium density open-cell foam topped with soft, convoluted foam for maximum buttock envelopment and pressure reduction to minimize risk factors for the development of pressure sores, DVT, varicose veins, and sciatica.
  • The Buttpillow™ elevates the peri-anal area with its patented hidden “wave” peri-anal and tailbone cut-out to relieve and prevent pain associated hemorrhoids, vaginal pain, pain after childbirth, dyspareunia, and prostatitis.
  • The Buttpillow™ has an ergonomic wedge shape to maintain the natural curve of the spine while seated (lordosis) to reduce risk factors for low back pain caused by sitting.

Relieve and Prevent Pain & Problems While Sitting!

  • Low Back Pain
  • Tail-bone Pain
  • Sciatica
  • Hemorrhoids
  • After surgery
  • After childbirth
  • Prostate Pain
  • Erectile dysfunction
  • Pelvic/vaginal Pain
  • Varicose veins
  • Pressure sores
  • Deep vein Thrombosis
Woman standing next to No Life Guard On Duty sign
“No Life Guard on Duty” Sit at your own Risk! Minimize ergonomic risk factors to prevent future pain.

Pregnancy – Things to Know |

The changes that take place during the short span of human pregnancy are profound.  Many of these changes occur soon after fertilization and continue throughout the entire pregnancy.  Most of these incredible adaptations are in response to the growing fetus and the hormonal changes the fetus produces in its mother.

Changes…Start at 4-5 Weeks of Pregnancy

Most women will notice subtle changes as early as four to five weeks of pregnancy.

The first changes to be noticed are:

  • Breast tenderness (sometimes with nipple discharge);
  • Heightened sense of smell (your favorite food or perfume may be intolerable);
  • Nausea with or without vomiting (this is called morning sickness, but often this problem can occur throughout the day);
  • Increased frequency of headaches;
  • Increased frequency of heartburn; and
  • Pelvic cramping or tenderness.

Usually these conditions go away spontaneously at about 14 to 16 weeks.

Pregnant woman on exam table
Simple element illustration. Pregnant woman on table symbol design.

Should I listen to what my friends and family say?

Most pregnant women are given more information than they care to hear from family and friends during the entire course of the pregnancy.  Many statements often told are not true and only serve to heighten anxiety and stress.   Just because a family member has a bad story about a complication does not mean that it is going to happen to you.

Continue reading “Pregnancy – Things to Know |”

Back Pain Causes, Categories, Risk Factors & Red Flags|

Prevalence of Back Pain

Up to 75 percent of the population experiences low back pain lasting more than one week at some point in their lives. By the age of 50 years old, about 85 – 90 percent of adults will have degenerative changes in their vertebral discs, and these changes begin to occur in the third decade (in their 30’s) of life.

Office worker with back pain from office syndrome
Office syndrome Infographics. 

In a one year period, the estimate of people with an episode of back pain is about 17 percent. Also the estimate of the people 18 to 24 years having back pain in a one year period is 13 percent.

Continue reading “Back Pain Causes, Categories, Risk Factors & Red Flags|”

The Ergonomics of Neck Pain |

Neck and shoulder pain are common among younger and younger men and women. Neck and shoulder pain can be caused by musculoskeletal disorders of the upper extremities. Preventative measures should be taken to minimize risk factors for neck and shoulder pain before you are in pain. The risk factors for and causes as well as preventative measures for the development of neck and shoulder pain outlined in the research are listed here.

Neck pain is a very common condition that affects nearly 50 percent of people over the age of 50 years at some point in their lives.  With the increased use of computers and other stationary-designed workplaces, more and more younger persons are faced with this problem.

There are many structures in the neck that can cause pain. There are also multiple sites, when problematic, that can cause referred pain to the neck.

It is important to note the following:  Whether pain is felt outside the neck; whether pain is felt in the shoulders, whether pain is felt down the arms, or whether pain is felt in the hands.

Incorrect and correct positions for talking ergonomically via phone
Incorrect and correct positions for talking via smart phone. Neck and shoulder pain.

Signs to Seek Medical Attention for Neck Pain

Signs to seek medical attention as soon as possible include the following:

  • Numbness,
  • Weakness,
  • Tingling of the upper extremities,
  • Severe headaches,
  • Visual changes,
  • New neck pain lasting more than three weeks,
  • Persistent neck pain.  

The Anatomy of the Neck 

The anatomy of the neck is made up of the cervical spine which, in turn, is composed of seven vertebrae (bones) which are joined by intervertebral discs. These discs are made up of a gel-like material that absorbs increased pressure. During the fourth decade of life (40’s), progressive degeneration of these discs occurs. The end result is a decreased ability of the discs to absorb shock and pressure.

Two Common Causes of Neck Pain 

Two common causes of new or persistent neck pain are bulging discs and bone spurs.

Bulging Discs

As the disc loses some of its shock absorbing ability, it grows; and at times will bulge on the structures surrounding it.

Bone Spurs

It is also common for the vertebrae themselves, which are made of bone, to grow additions called bony spurs. The spurs may grow in such a way as to compress nerves in the neck.

Bulging Discs and Bone Spurs May Cause Neck Pain to be Referred

Both May Cause Neck Pain to Be Referred

People with either condition may experience pain that can be referred to any level of the back of the neck. 

Muscle Spasms may Cause Neck Pain

Also, spasms of any of the many muscles of the neck are common causes of neck pain.

Try to Date When Your Neck Pain Began

It is helpful to date when the neck pain began. Once a specific activity can be linked to neck pain, treatment is easier.  Most people with neck pain have no objective findings on physical exam.    The history of the neck pain is an important tool for you and your health care provider to use to diagnose the cause of each pain.

Bending your head forward can cause Neck Pain / Spasm

Prolonged sitting with the neck flexed (bent forward) in one position, such as work on computers, is a common occupational cause of neck pain. A sustained position (without moving regularly) can cause spasm of the neck muscles and resulting pain.

Prolonged sitting with the neck bent forward (for example, on social medial, looking down at your phone) increases your risk for twisting injuries which may not hurt for 24 – 48 hours after the incident.

Bending your head back can cause Neck Pain

Prolonged neck extension (bent backward, looking up) is another common occupational situation that can give rise to neck pain in people doing overhead work.

The physical exam of the neck demonstrates that most people can easily place their chin on their chest, touch both shoulders with the chin and bend sideways to touch ear to shoulder on both sides.

Sitting woman doing neck exercises to minimize risk of "computer syndrome"
woman doing exercises to minimize risk of neck and shoulder pain, office worker syndrome, computer syndrome

Normally, the neck can be extended so a person is looking up at the sky.  Sometimes, slight neck extension causes pain and this could be caused by disc degeneration, which is common.

Studies show that degenerative changes in the spine of the neck (cervical spine) in people without complaints are evident in over 90 percent of people over 50 years old.

Treatment for Neck Pain 

Treatment of the neck differs if the neck needs to be immobilized with a collar. If this is you, you most likely will know who you are.

If your neck hurts, the first treatment is:

  • aspirin (as long as you are not pregnant) or Tylenol-related products;
  • and — believe it or not — performing as much of your daily activities as possible.

Muscle Relaxants May Be Prescribed

If neck pain lasts for more than three to four days, a course of muscle relaxants prescribed by your physician may be helpful.

People may seek manipulation therapy for neck pain. Be aware that the value of this type of treatment is uncertain.

Workplace Design is Critical to Minimize Neck Pain

One of the most important treatments is one of the least recognized. It is observation of your surroundings to determine what may be causing the pain.  Workplace design and body motion are critical elements that can worsen pre-existing conditions or create / prevent new ones.

Workplace Design can minimize Ergonomic Risk Factors 

The study titled, “Physicial Risk Factors for Neck Pain”  concluded that there is a positive relationship between neck pain and the duration of sitting and twisting or bending of the trunk.

“It was concluded that there is some evidence for a positive relationship between neck pain and the following work-related risk factors:

  • Neck flexiom,
  • arm force,
  • arm posture,
  • duration of sitting,
  • twisting or bending of the trunk,
  • hand-arm vibration,
  • workplace design.”

If you feel you may need to see a doctor, check out these links:

The American Academy of Orthopaedic Surgeons:–conditions/neck-pain/



The Mayo Clinic: 

References with Quotes:

1.  Physical Risk Factors for Neck Pain

“Ergonomic risk factors for different types neck and shoulder disorders, such as:  —  

– Cervical spondylosis;

– cervical syndrome a/k/a cervical disc disease;

– thoracic outlet syndrome;

– shoulder joint osteoarhorosis;

– rotator cuff tendinitis;

– tension neck syndrome  a/k/a “tendomyotic pressure pains in shoulders and neck”    —    can be minimized.

Scandinavian Journal of Work and Environmental Health, 2000; 26(1):7-19, “Physical Risk Factors for Neck Pain,” by Geertje A.M. Ariens, Msc; Willem van Mechelen, PhD.; Paulien M. Bongers, PhD; Lex M. Bouter, PhD; and Gerrit van der wal, PhD.

2.  Risk Factors for Musculoskeletal Disorders Among Newspaper Employees

“A total of 973 workers completed the survey.  The one-year period prevalence rate for any musculoskeletal disorder of the upper extremities was 41 percent.  Neck symptoms (26 percent) were the most frequently reported, followed by hand or wrist (22 percent), shoulder (17 percent), and elbow (10 percent) symptoms.”  

Scandinavian Journal of Work and Environmental Health, 1994; 20:417-26, “Job Task and Psychosocial Risk Factors for Work-Related Musculoskeletal Disorders Among Newspaper Employees,” written by Bruce Bernard, M.D.; Steven Sauter, PhD; Lawrence Fine, M.D.; Martin Petersen, PhD, and Thomas Hales, M.D.

3. Ergonomics Method for Prevention of the Musculoskeletal Discomforts Among Female Industrial Workers:

“Five main factors were associated with musculoskeletal discomforts: 

1) Lack of worker selection and lack of appropriate training to prevent occupational hazards or work-related diseases;

2) Poor ergonomic design of the workplace and tasks, including organization;

3) Poor working posture;

4) Lack of task variation;

5) Insufficient rest breaks.”  

Journal of Human Ergo., 1993: 22:95-113, “Ergonomics Method for Prevention of the Musculoskeletal Discomforts Among Female Industrial Workers: Physical Characteristics and Work Facts,” written by P. Chavalitsakulchas and H. Shahnavaz, Center for Ergonomics of Developing Countries, Luled University, Sweeden.

4. Workplace Ergonomic Factors and the Development of Musculoskeletal Disorders of the Neck and Upper Limbs

“The rise in frequency of these (musculoskeletal) disorders is believed to be associated with the advance of automation and specialization in work (National Occupational Health and Safety Commission, 1988).  Much faster work rates and the redesign of jobs often require that a production worker or data entry clerk do a single task or a very limited number of tasks repeatedly, commonly tens of thousands of times per day.  Although new technologies have generally reduced the workload and fewer jobs entail heavy lifting, the repetitiveness of today’s ‘light work’ concentrates the work load on fewer, smaller muscle groups.”  

American Journal of Industrial Medicine. 1991; 19:87-107, “Workplace Ergonomic Factors and the Development of Musculoskeletal Disorders of the Neck and Upper Limbs: A Meta-analysis,” written by Susan Stock, M.D.:

5.  Prevalence Rates and Odds Ratios of Shoulder-Neck Diseases in Different Occupational Groups 

Cervical Spondylosis

“Cervical Spondylosis – degenerative arthritis (osteoarthritis) of the cervical vertebra and related tissues.  If severe, it may cause pressure on nerve roots with subsequent pain or paraesthesia (numbness and tingling) in the arms.  

Cervical Syndrome (cervical disc disease)

“Cervical Syndrome (cervical disc disease) . . .for data entry operators the diagnostic criteria was; a) neck pain radiating to one or both arms; and b) numbness in the hands in addition to:  c) limitation of neck movement and radiating pain provoked by test movements.  Pain in the neck radiating to the arm with a segmental distribution was our concept of Cervical Syndrome. 

British Journal of Industrial Medicine, 1987; 44:602-610, “Prevalence Rates and Odds Ratios of Shoulder-Neck Diseases in Different Occupational Groups,” by M. Hagberg, National Board of Occupational Safety and Health, Medical Division, Sweden; and D. H. Wegman, Division of Environmental and Occupational Health Sciences, University of California, Los Angeles, U.S.A

Thoracic Outlet Syndrome

“Thoracic outlet syndrome – a symptom complex caused by conditions in which nerves or vessels are compressed in the neck or under the axilla (underarm).  Anatomically, the cause is compression by structures, such as the first rib pressing against the clavicle (collar bone).”   

Tabers Medical Dictionary 

Shoulder Joint Osteoarthrosis

“Shoulder Joint Osteoarthrosis – our concept of shoulder joint osteoarthosis is that of a reduction in the articular cartilage height (cushions between the bones) and sclerosis (degeneration) in the structures of the glenohumeral joint (shoulder joint).  

British Journal of Industrial Medicine, 1987; 44:602-610, “Prevalence Rates and Odds Ratios of Shoulder-Neck Diseases in Different Occupational Groups,” by M. Hagberg, National Board of Occupational Safety and Health, Medical Division, Sweden; and D. H. Wegman, Division of Environmental and Occupational Health Sciences, University of California, Los Angeles, U.S.A

Rotator Cuff Tendinitis

“Rotator Cuff Tendinitis Shipyard welders, plate workers, and male office workers  had the following the criteria for this condition:  localized shoulder pain and tenderness of the humeral head (top of the arm bone).  

Tension Neck Syndrome

“Tension Neck Syndrome- A constant feeling of one or more subjective symptom.  

“For example neck pain or headache in addition to signs of at least two tender spots or palpable hardening (feeling hard bumps in your neck muscles), or both, plus muscle tightness in neck movements — were the diagnostic criteria of Tension Neck Syndrome for the Finnish studies of slaughterhouse workers, data entry operators, assembly line packers, shop assistants, and female office workers.

British Journal of Industrial Medicine, 1987; 44:602-610, “Prevalence Rates and Odds Ratios of Shoulder-Neck Diseases in Different Occupational Groups,” by M. Hagberg, National Board of Occupational Safety and Health, Medical Division, Sweden; and D. H. Wegman, Division of Environmental and Occupational Health Sciences, University of California, Los Angeles, U.S.A

Tension Neck Syndrome a/k/a tendomyotic pressure pains

“For the Swiss, data entry operators, ‘conversational terminal operators,’ typists, and office workers, the medical finding listed as ‘tendomyotic pressure pains in shoulders and neck’ was regarded as Tension Neck Syndrome.”  

Tension Neck Syndrome is most common shoulder-neck disease

“It should be noted that Tension Neck Syndrome had the highest rates of all shoulder-neck diseases studied and women tended to have higher rates of Tension Neck Syndrome than men.”

British Journal of Industrial Medicine, 1987; 44:602-610, “Prevalence Rates and Odds Ratios of Shoulder-Neck Diseases in Different Occupational Groups,” by M. Hagberg, National Board of Occupational Safety and Health, Medical Division, Sweden; and D. H. Wegman, Division of Environmental and Occupational Health Sciences, University of California, Los Angeles, U.S.A