The effect of improved sleeping posture with respect to cervical spine as an intervention in patients of cervical pine

Background: Specifically, poor cervical posture during sleep, which is believed to increase biomechanical stresses on the cervical spine structure, can produce cervical pain, stiffness, headache and scapular arm pain resulting in low quality of sleep. A neutral position of spine maintains cervical spine curvature prevents any cervical waking symptoms by minimizing end range positioning of spinal segments. Maintenance of normal cervical curve is a good cervical posture and will maintain a healthy neck. Normal lordosis with neck in neutral position with respect to rotation and side flexion leads to relaxed spinal cord. Alterations in the cervical posture can lead to headache, arm pain, maybe even mid back pain problems. So it is important to know about the type of pillow being used by the person. Foam pillows tend to retain their shape and have more bounce; they do not offer much support to the spine. The type of mattress a person uses also affects the cervical spine curvature. All these factors may lead to increased stresses on the cervical spine. Objectives: To analyse and compare the effect of improved sleeping posture with respect to cervical spine as an intervention to pharmacological treatment on a. Pain at rest and movement in cervical region. b. Ranges of motion of cervical flexion, extension, side flexion (left and right) and rotation(left and right). c. Tightness of trapezius, sternocleidomastoid, levators, scalenes and pectorals in patients of cervical pain. Methodology: Patients coming to Orthopaedic OPD, GMCH Nagpur and complaining of cervical pain and who fulfilled the inclusion criteria were divided into two groups. The patients were shown the proforma of study in a language they understood and their consent was taken. There was random allocation of subjects into two groups, that is, the patients who fulfilled the inclusion criteria, were divided as per the following- Even number of patients were alloted to Group A and odd number to Group. They were assessed for the sleeping posture assumed by them during sleep by asking them about their sleeping posture as per the proforma and were asked to demonstrate their sleeping posture on the treatment table. The patients were enquired about type of pillow used by them, surface on which they slept and the position of neck in Supine, Side lying and Prone. Group A and Group B received pharmacological drugs namely analgesics, antacids and calcium as prescribed by the orthopaedician. Group B was put on an intervention of modified sleeping posture and head support conjunction with pharmacological treatment. Pre intervention measures of cervical range of motion, pain at rest and movement and tightness of the muscles were taken at the start of the study and post intervention measures were taken 7 days later for Group A and B. The results of the two were compared. Results: The relief in pain at rest and movement post 7 days for Group A was not significant but was significant for Group B. However the cervical range of motion and tightness of muscle showed no significant difference pre and post intervention for Group A and B. Conclusion: From this study, it can be concluded that modification in the sleeping posture as an intervention to pharmacological treatment seems to be better at relieving cervical pain but seems to haveno effect on increasing on range of motion of cervical spine and relieving the tightness of the muscles, specifically trapezius, pectorals, scalene, sternocleidomastoid, levators.