“The main things we see associated with using a laptop are headaches, neck pain and back pain” said Rupert Clements one of the chiropractors at C1 “and it’s starting to become an epidemic.”

Rupert adds: “most people have vague notion that that their computer is the cause of their ailments – but once diagnosed and fully explained they really get the problem. Unfortunately they are often unable to do much about it – if you have to use a laptop for work, you have to use a laptop.”

There are some troubling trends with school kids and students using them to do online home work often sitting in bed, way before they hit the workplace so many of our patients have years of postural abuse to deal with and no wonder its hurting.

“At the conventional computer, you sit at a desk and everything is as good, ergonomically as possible” said Leni Rautenbach who works at C1 “But with a laptop it’s all in one.” Because of their combined structure, Leni said that the problem with laptops comes from people’s extended use with their bodies in a scrunched position. Prolonged use of a laptop with bad posture can lead to issues such as headaches, neckaches, carpal tunnel, tendonitis and back pain.

Some tips to prevent “laptopitis,” or neck and back pain from working on a laptop:
1. Take a break about every 20 minutes, stand up, walk around, maybe even stretch a little.

2. If you’re going to use a laptop, try to sit at a desk or table.

3. If you can, use a desktop computer for those long, gruelling assignments or papers.

4. Switch out your laptop for a desktop. This may seem crazy, but it may prevent long-term damage.

5. If you have pain, see your chiropractor and get some help.

A recent study snappily called:

Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial

By Haas and co-workers was published in the uber serious Spine (The Spine Journal 2010; 10:117-128) which said that chiropractic was good at sorting out headaches.

As we all know, headaches are very common (with up to 16% of the population having one at any one time) and can very disabling (leading to work-days-lost, absenteeism costs and increased medical benefits spend).

Headaches are broken down into primary and secondary. The primary group is made up of:
• migraine,
• tension-type
and
• cervicogenic headache (CGH).

This last lot, CGH, account for a significant proportion of the 16% point estimate of those suffering primary headaches (but Nilson and Sjaastad have estimated the point to range from 0.4%-4.6%). Whatever. They are linked to neck pain and mechanical dysfunction and so, it is theorized, treating neck pain and mechanical dysfunction through manual therapies will help reduce headache symptoms.

Systematic reviews have been conducted on the usefulness of spinal manipulative therapy (SMT) in the treatment of CGH, however the treatment plans offer great variability: from once per week for three weeks to twice per week for 8 weeks. This, clearly, demonstrates a lack of clinical understanding and consensus in the research. This prevents us from being able to confidently set out the prognosis and expectations with respect to SMT.

The purpose of the study was to determine the efficacy of spinal manipulation in CGH and compare a high-dose and low-dose SMT application to a light massage.

One group received low-dose SMT (8 treatments), high-dose SMT (16 treatments), low-dose light massage (8 treatments) and high-dose light massage (16 treatments). The study showed some interesting things:

• While treatment dose had no effect on the use of medication, those receiving SMT used 1/3 less medication at 24 weeks.

• With respect to the number of cervicogenic headaches experienced, those receiving SMT experienced 2.6 fewer headaches per week compared to those receiving light massage.

• At the end of 24 weeks, those receiving SMT experienced 2.1 fewer ‘other’ headaches per week compared to those receiving light massage.

• While dose effects were small, those who received high-dose SMT experienced a greater improvement in neck pain (-5.9 at 12 wks; -10.6 at 24 wks)

• CGH pain, the number of headaches experienced per week and the amount of medication intake all reduced, with sustained reductions, favouring the SMT group.

• Lastly, by eight weeks, the number of weekly headaches was reduced 50% in those patients receiving SMT and on secondary analysis, a 50% reduction in symptoms (obtained via the outcome measures) was achieved in 80% of those receiving SMT.

The authors point out several key limitations to this study:
• The study design was highly complex and multifactorial.
• There was a small number of patients within each subgroup.
• Multiple headache classifications were present within many patients.

Interestingly, for us as chiros, there was no difference between the two dosages of SMT (though SMT proved to be more effective than light massage, irrespective of dosage.). And, as we’d expect, the differences between the SMT and the light massage group were not only statistically significant, but clinically significant as well.

This study is highly relevant and helpful to clinical practice as it strengthens the use of cervical spine manipulation in the treatment of CGH. It is also helpful as it demonstrates that patients do not tend to be cured by this intervention alone, indicating that CGH may require a combined intervention approach which includes exercise, soft-tissue therapy, spinal manipulation and education.

1. The comercially available ice pack – like the James Barton ones we sell;

2. A load of smashed up ice from the freezer in a freezer bag;

3. Some good old frozen peas.

And here is the best way to apply it.

We advise that you use it for no more than 20 minutes on and 40 off in any one hour so that you don’t ice burn your back (to add to your woes). Locate the centre of your pain and place the pack against it – simple, really.

If you are using the pack through clothing have a layer of thin cloth (handkerchief not T-shirt) between you and the ice pack. If you are applying it without clothes then a thin layer of warm cloth can be applied first this will make the whole experience less terrifying as the cooling effect will slowly chill the warm cloth and then start its work.

It has been shown that patients icing within the first 24 hours of an acute injury have an approximate 6-day recovery time with grade 2 injuries and 13-day recovery time with grade 3 injuries. By waiting 48 hours to begin icing the recovery time almost doubles for grade 2 and 3 injuries! The application of heat can triple the recovery times for both grade 2 and 3 injuries.

So, go with ice first of all and fast unless told otherwise by someone who knows better – so, not your mate int he pub!