Dr. Kristen Mitteness
Your neck and depression. What's the connection?
The position of your body, and thus your spine, is always giving your brain information on what's going on in your world. When you (or your dog) wake up in the morning, you may stretch into extension, tipped your head back and reaching your arms over head (while your dog gets into a good downward or upward facing dog position), alerting and waking up your brain. When you are going to sleep, you curl into a flexed, fetal position, allowing your brain to relax and deactivate.
These are normal, physiological and neurological reactions between your body and your brain. What happens we sit all day in a flexed forward position, similar to when we are sleeping? We sit to eat breakfast, we sit to check our computers in the morning, we sit on our way to work, we sit at work, we sit on our way home from work, we sit to eat dinner, we sit watch tv or on our computers in the evening and we go to bed. We might spend an hour at the gym somewhere in there. If this is our day, it means our neck is constantly in a flexed forward position, arguably the opposite of where it should be (upright, extended with a beautiful forward curve or lordosis, more on spinal curves here). Does this mean our brain is always in sleep mode, too?
When you think of the posture of someone who is sad, you probably picture him leaning forward, shoulders slumped inward and head hanging heavy. When someone is happy or excited he is upright and extended. The research on posture and mood is growing rapidly!
Let's dig further into the research as it relates to the spine.
The article titled, Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain, published in 2019 looked at 300 patients under the age of 40 and found that those who lost their cervical curves were at higher risk of cervical disc herniations and neck pain. Makes sense to me. If your spinal curves aren't within normal or moving well, degeneration (in this case, disc herniation) is a risk factor. With a higher risk of degeneration, pain is often, but not always, present. In fact, this research concludes, "These findings may indicating a link between cervical curvature and degenerative changes which have important clinical implications."
Unfortunately, I see way too many patients (I would estimate more that 70%) with a decrease in their cervical curves. It can be seen with someone who has a forward leaning head posture, in young men who just straight up have extremely poor posture or in my patients who sit at a desk ALL. DAY.
Let's take this a step further. So, now we know that a decrease or degeneration of a cervical curve may result in pain and dysfunction. What might happen next? A paper published in 2018 titled, Association of Depression and Cervical Spondylosis: A Nationwide Retrospective Propensity Score-Matched Cohort Study, looked at just this. Based on over 30,000 Taiwan health insurance claims, it was found that the overall incidence of a cervical spondylosis, defined as progressive degenerative disease of the cervical vertebral bodies and intervertebral discs in the neck, was 76% higher in the depressed group. The incidence was even higher if comorbidities were present. The researchers were not sure if poor posture and spinal degeneration encouraged depression or if the depression encouraged the poor posture and spinal degeneration.
So what now? The solution is simpler than you might think. Just maybe not so easy...yet. We need to move more. That's it, that's all (basically). We need to stand up straight, lift our arms overhead, do more back extensions and less sit ups. Get adjusted. Go for walks. Take frequent, brief breaks from your desk job. Play. Dance. Anything! Set your timer. Get up and move more often than you do now. The results could be incredible.
Here is my favorite series of neck and shoulder stretches. You can do it every day and you'll feel better in no time.