Dr. Ranjana Nanda

PILLOWS AND MATRESSES.

“My neck pain started two days ago, Immediately I removed my pillow”

This is the very usual dialogue that I hear in my daily practice from my patients who are suffering from neck pain. Is pillow that important factor in causing neck pain or in relieving neck pain?? Let us know the facts.

Neck pain can be caused because of various reasons. Poor neck posture is one of the reasons for neck pain. So, what should be your sleeping posture? How can a pillow alter your normal sleeping posture?

Body needs rest and sleep gives our body rest so that body and mind work efficiently. It is very important that we maintain a normal sleeping posture so that muscles also get rest.

Ideally,

• Spine has to be straight
• Neck has to be in line with the body.
• It is better to avoid sleeping on tummy, as you will be forced to turn your neck to one side to facilitate breathing. Whole length of your sleep is spent with the neck turned to one side, out of alignment with the body, forcing the brain to sense something wrong and you wake up with a stiff neck. Pillow has no role here!!!

So, what kind of pillow can be used?

• Pillow can neither be too hard as it doesn’t absorb the shock/ weight of head, nor it can be too soft as the weight of the head can depress the pillow down and might take neck too low than body.
• Ideally the pillow has to regain its original shape faster once you wake up from lying position. If a pillow takes too long to come back to its original shape or doesn’t come at all or remains in the same shape, its time for you to change your pillow.
• If you are lying on your back, its better to use a thin pillow which supports your head and neck. Please do not use a thick pillow in this position, as it may raise or bring your head and neck forward or higher than body causing stress to your spine.

Not using a pillow when you lie down in this position can take your neck backwards and might cause trouble breathing.

Recommended to use a thin/ lighter pillow when you lie down on your back.

• If you are lying on your side (right or left), its better to go with a thicker pillow. Ideally the pillow should be as thick as the distance between your shoulder and neck, so that when you lie down on your side the neck doesn’t go down or go up and stays in line with the body. Pillow has to be used!!

Recommended to use a thicker pillow when lying on side.

Pillow is not a major cause of neck pain. Its always better to use a pillow than not using at all. Removing the pillow the moment neck pain starts is definitely not a good solution for your neck pain. Chose the right pillow and more importantly consult your Physiotherapist.

Mattress:

As with the pillow for neck pain, mattress is not a major cause for back pain.

• Mattress should not be too hard, should not be too soft either.
• If it is too soft, the broader areas of our body like the hips and shoulders, might press the mattress down thereby reducing the support for other body parts, which strains them as they do not get proper support.
• If its too hard, the mattress wont be able to support the various natural curvatures of our body (broader and narrower areas), forcing the muscles to work more and get strained.
• Its better to change a sacked mattress or too depressed mattress.
• Mattress should be uniform in contour.
• Lying bare on floor wont work!!!!

And more importantly consult your Physiotherapist for back related issues.

Have a pain free life…..

When tissues that usually grow inside the uterus, start growing outside the organ, it is called endometriosis. Painful periods, pain during sex, pain while urinating or bowel movements, extreme bleeding, fatigue, infertility, diarrhea, bloating and nausea are some of the symptoms of endometriosis.

Treating endometriosis usually depends on the following factors

1. Age
2. Severity of symptoms
3. Severity of the disease
4. Future plans for children

Depending on these the doctor might opt for any of the following treatments

1. Medication for Pain: If the symptoms are mild, then the doctor will prescribe some pain killers like Nonsteroidal anti-inflammatory drugs. 
2. Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may come back. Some of the hormone therapies include: 
   • Hormonal Contraceptives: Birth control pills, vaginal rings and patches are useful in controlling the hormones that are responsible for tissue build-up outside the uterine cavity. 
   • Medroxyprogesterone: This drug stops menstruation, which in turn stops the tissue build-up and put an end to all the symptoms. But on the other hand, gaining weight, low bone production and depression are some of the common effects of this drug. 
   • Gonadotropin-releasing hormone (Gn-RH) antagonists and agonists: Hormones that stimulate ovaries are blocked by these. They bring down oestrogen levels and hence prevent menstruation. 
   • Danazol: This drug prevents menstruation and symptoms of endometriosis by blocking the hormones that stimulate the ovaries. However, Danazol may not be a favourable option because of its side effects. The drug should be avoided during pregnancy.
3. Conservative Surgery: If you are trying to get pregnant, but you already suffer from endometriosis, then removing endometriosis surgically is a viable solution. Your uterus and ovaries will be preserved, which might increase your chances of becoming pregnant. Even suffering from severe pain might find relief from conservative surgery. 
4. Hysterectomy: In extreme cases, the only way to deal with the symptoms is to completely remove the uterus, ovaries and cervix. Since a hysterectomy means you cannot have children, it is kept as the last option for women in their reproductive age.