Cervical Osteoarthritis – my first symptoms

As an IT professional, I’ve been using computers daily since the 80s and was used to the occasional twinge…”nothing that a few days rest wouldn’t cure” I thought.  I worked 50 miles from home in York, in northern England, which was typically a 90 minute commute from home.

Work was busy and a bit stressed and one Friday afternoon, I became aware of a pain in the outer muscle of my left forearm. I took some Ibuprofen but that didn’t touch the paid much.  At home time, I got in the car and quickly found driving difficult. The pain seemed to be building and building and at one point I would have cheerfully driven my car into a wall if that would have stopped it!

That was the start which came out of nowhere with no real warning at all!

Over the next three weeks, I gradually became more and more disabled – unable to drive, unable to use my PC, unable to use a phone or even sit pain-free in a normal desk position for more than a minute or so or sleep properly.  I was also more aware of other symptoms – slight numbness and tingling in my thumb and fore finger, elbow pain and stiffness in my neck.

Diagnosis

Of course I sought medical help from every quarter I could find – my general practitioner, the works doctor, physiotherapy.  My general practitioner had a hunch that my arm pain was referred from my shoulder or neck area and so sent me to see a specialist. I was lucky at the time to have private medical insurance which limited my diagnosis period to two months, I’m sure it could have been far longer!

I had nerve conduction tests, MRI scans and various others.  Nerve conduction tests are a bit of a ‘shock’ – they put 100 volts or so at one point on your body and measure the voltage received at other points.

MRI (Magnetic Resonance Topography) is the original “revenge of the Polo mint!” – you get slid (usually on your back) into a giant ring which is ok but noisy and not good if you’re claustrophobic.  I would recommend you take a MP3 player to take your mind of it.

What is Cervical Osteoarthritis?

My surgeon diagnosed me as having Cervical Osteoarthritis (Neck Arthritis) affecting my cervical spine (upper backbone/neck) at vertebra C5.  This is essentially advanced aging – my neck vertebra were now more like a 70 year old than in my mid 40s!

This erosion tends to lead to spurs of bone or at least a rough surface and when you think your nerves to your arms pass through this gap, you can see how problems in your neck give you pains down your arms.

What caused it

I am clear that for me and computer users, its a combination of factors that brings you to this state. Further down I recommend specific tools that I have found have helped me enormously.

The BAD LIST

• maintaining set postures for long periods (mostly at the PC but driving is a similar posture so part of the problem).
• mice with wires can be held unconsciously with your arm tense for long periods
• mice which are called ergonomic but have buttons on the top of the mouse
• laptops (with power supplies and other stuff) in a bag on one shoulder – this skews your frame
• inadequate breaks and working at a PC for too long daily (remember home as well as work)

Prognosis

Cervical Osteoarthritis won’t get better and go away.  That said, it isn’t a reason to despair and resign yourself to being disabled. It is something of a voyage of discovery in many ways. You find the things you really can’t do and things you can continue to do, perhaps with some modification.

My Works Doctor told me “you won’t be able to do this for much longer”. The Surgeon told me that he could fuse my vertebra with some metalwork, however that comes with a low risk of substantial disability. How would you react?  OMG! Is a typical response and it was mine!

I had seen a few physiotherapists and my advice would be to seek a Sports Physiotherapist as they seem to be positive people who are more willing to give your body work out. Avoid a Physio who’s interaction seems to stop at giving you exercises to do. You will need some serious massage and mine was fantastic, he said he’d get me working almost normally again and over 3 to 4 months, and he did!

My limitations

I can no longer ride a bicycle, something which I enjoyed and would do on a regular basis through the warmer months. I can’t work above my head, the act of tipping my head back to look up for more than a few seconds will trap the nerves and set the pain off.

Driving, the cinema and situations where I am stuck in a posture for long periods, will give me a flare up which can mean I’m unable to work for a couple of weeks.

However, I can still drive hundreds of miles – I now have to ensure that I don’t drive for longer than an hour; I get out of the car, move my arms around a bit and then I can continue although ideally with a break of 5 or 10 minutes.

My treatment and voyage!

Physio certainly got me mobile again and there were some limitations which I have got used to…

1. Sleeping

   You may well be prescribed Codeine and other drugs to help you with the pain and some of these may help you sleep.

2. Pillow-talk!

   Imagine that you are trying to keep your head and spine roughly in line and not bending your neck much.  Achieving this is difficult: if you are laying on your back you want minimal pillow support for your neck area; if you are laying on your side, you want very little head support.  You can’t really address both well. Don’t be tempted to go for all those special pillows – I did and found they caused more problems than they cured!  If you’ve been used to using 2 pillows, you may do better with 1 pillow and try a few out.

3. Driving

   I wish I’d bought a car with automatic transmission now and my next will be. I tried to move my steering wheel and seat such that my arms were mostly at rest while driving, no reaching etc.  You might hear “hold your hands at ten to two or twenty to four”.  If you hold the wheel too high, you’re more likely to have your muscles tense and so cause yourself pain so “twenty to four” is my preferred option.  I don’t drive for more than about an hour without taking a break of 5 minutes or so – an opportunity to give your muscles something different to do.

4. Supermarket Shopping

   No more deep trolleys for me, always shallow ones as that action of stretching isn’t good (unless as part of your daily physio routine!).

5. DIY and Gardening

   Here is your get out of gaol-free card if you hate DIY    Seriously though, manual shears, painting/hammering etc above your chest, stretching to screw something etc are all thing I avoid as much as I can.  So where possible opt for electric tools or other willing helpers.

But I need to carry on working and earning!

I had a few months of being unable to work, I’ve had many flare-ups since then but you do learn what works and what doesn’t. Continuing to work has been essential for me with a mortgage to pay and an expensive family to run.

I was made redundant from my previous work which was difficult in a recession but I decided I needed more control over how and when I worked and so I started my own business, still with computer work, which is now growing well.  I learnt that certain tools and aids make it possible for me to continue working with a PC and so my main message is “don’t despair!“.

I set up the website Computer Posture UK which is not for profit and exists solely as a means of helping others avoid RSI and work with computer posture injuries. Computer Posture UK has sourced many products that I know help. Computer Posture UK doesn’t supply these directly, it just take you to where they are and gains a 3% or so referral fee from the supplier which keeps the website running and helping others.  These are things that I use and have found to be of great help…

The GOOD List

• Address your computer posture – you need to move around frequently and having your PC look after your interests is a good idea. Here are two Posture Software options; I strongly recommend one of them as it has been designed by a Specialist Medical Practitioner and it has lots of useful features.
• Most computer mice (including many that are called ergonomic) are potentially dangerous. There are much better alternatives that are available which cause significantly less tension in your body and you will notice the improvement within 15 minutes of use. Again here are two ergonomic mice options which I’ve used and recommend.
• Laptop travelling can give you many twisting problems, stretching some muscles and under using others creating rounded shoulders and weaknesses that bring rise to back, shoulder and neck pain.  A laptop bag with wheels can take a lot of that strain away. I use mine as my mobile office with more stuff in it than I used to be able to carry!
• Aiding movement and reducing your keyboard activity is key. When I’m struggling, I use Speech Recognition software which will read my emails to me while making a cup of tea and I can reply to them without all that typing. I’ve tried many versions of this type of software and they have come on enormously just in the last three years.  My current favoured method is to use a dictation machine now, simply because it is so forgiving of my long thinking gaps!
• Vibration therapy is good for reducing the tension that is strangling your nerves. I use a vibration plate which is a great help for many arthritis conditions.
• Wear a scarf or neck warmer whenever there is a nip in the air. Unconsciously you tense your muscles when its cold and this action can bring on a flare-up of the painful conditions. Here are some neck warmers that may help you. Ladies can get away with nice silk scarves at all times of the year which is great. For gentlemen, maybe you can embrace your inner panache and style and wear a cravat!

Anywhere else to turn?

I have my gloomy days when my cervical osteoarthritis makes everything difficult and that wears you down.

Over the last year, I have learnt about two alternative therapies – one being Alexander Technique and the other being Tension Myositis Syndrome (TMS) also known as MindBody. Although both therapies take a completely different tack, they both consider that your condition is being multiplied by what’s going on in your head. “That cannot be!” I’m sure you say but I’ve learnt it to be true.

Alexander Technique is centred around the need for working using postures that have your muscles in an essentially relaxed state.

TMS or MindBody has been formulated by the work of a professor and specialist in RSI conditions and rehabilitation and is centred around the unconscious mind – I have found that this has been a huge benefit to me personally.  After reading his book, I had no flare-ups through a bitterly cold winter when I would have expected to have had significant problems otherwise.

Have a look on the Computer Posture UK not for profit web site for further ideas to help.

Good luck and don’t despair!