I have recently seen a patient who has an interesting story.
He was referred to see us by his consultant for management of neck pain and dizziness/disorientation. The gentleman is in his 60's and has a rather stiff neck! What was interesting however, is that his neck stiffness was to such an extent that he was not able to hold his head in an front on upright position, i.e. his head was in a constantly side bent position.
One of the very important functions of the neck is to compensate for non-neutral positions and alignment of the rest of the body. Hard wired into our brains are what are called "righting reflexes". These reflexes ensure that our head is always in a vertical and upright position which helps us orientate ourselves in space and ensure that we are always best positioned to respond to our environment.
Due to the level of stiffness in this gentleman's neck, he was no longer able to come back to a middle head position, which was a very likely contributing factor to his disorientation symptoms.
No this level of stiffness (bio-mechanical system change) generally takes place over years rather than months. And while our modern lifestyles and screen time poses a real challenge for our spines and is generally a main cause of neck pain and stiffness, the change in this case is mostly front to back, not side to side (although there will always be changes in all 3 planes of movement).
Therefore, there had to be another underlying cause of this problem... Further questioning revealed that due to a sinus problem, this gentleman had slept exclusively on his right side for the last 40 plus years. Most of us who prefer to sleep on our sides will alternate and therefore generally balance out the position our neck and spine spends time in.
In this case however, spending what amounts to roughly one third of a life in a more or less right side bent position has meant that his neck has stiffened into this position. As I repeatedly say to my patients, we get conformed to the likeness of the thing we do most often, and this is a great example of this phenomenon.
It is also a great example of "seek and you will find" the underlying cause, how living with a sinus condition lead to dizziness/disorientation 4 decades later!
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