Hi there I'm Lucy McDonald physiotherapist Welcome back to my virtual clinic! Today I'm
going to be talking to you about pain at the base of the skull, so pain at the very top of the neck
what causes it, what exercises you can do to help it and when it is that you need to go and see a
doctor about it immediately, but before I do move on to those things I want to say thank you so much
as ever for all your lovely messages of support I really do appreciate them, so pain at the base
of the skull what could be causing it? Well if I introduce you to Bob, Bob is a plastic model
of the spine and if we go to the top of the spine and we have a look at the neck what you can see
is that the the vertebra so the bones at the top of the neck becomes smaller and smaller and you can
see that your skull sits on the top there now the junction between the skull and the rest of
the neck is a really important place where lots of muscles insert and as the muscles insert into the
bone they turn into tendons so that there's this big band of tenderness tissue that runs all the
way across that base of the spine and therefore it's a really common place for people to feel
tension or soreness, pain and stiffness now it's also worth bearing in mind the other structures
in that area so you've got lots of ligaments, lots of little joints, the facet joints down
the sides and the discs in the middle if we can see them a bit more clearly in the front there
you've got all those joints and then you've also got these yellow things which are nerves that
come out of your neck, supply your head and your arms and likewise blood vessels that supply the
region as well so it's really important to bear in mind those things when you've got soreness
in there, so what is commonly causing the problems in that area? It's often to do with doing too much
of one thing, so most commonly sitting and also nowadays looking down on our laptops or on our
tablets or smartphones, so those sorts of things will contribute but obviously if you've got a
job where you're looking down a lot or even conversely if you're a decorator for example
and you're looking up a lot when you're working. any prolonged position of the neck it's
going to the neck is not going to like it, so some of those things you'll be able to modify yourself
and if you can please do and unfortunately some of them you just won't so I'm going to be showing
you in a minute some exercises that you can do to alleviate your pain, now before I move on to those
it's really important that I run through a few things because if any of these things apply to
you you must go and see a doctor immediately, so if you have had any kind of traumatic accident
so for example if you've been in a car accident or you've fallen and you have got neck pain as
a result then you absolutely must go and see a doctor because there might be a possibility that
you might have a small bone fracture in there that needs attention immediately, also if your pain has
come on gradually for no particular reason and your pain doesn't respond to any difference in
movement or position, it's just a nagging pain that's constantly there and it's
been going on for a while then that's another reason that you should go and see your doctor
and especially but not only if you are getting pain at night it's waking you up so other things
that you need to watch out for if you're getting any problems with things like your speech so
particularly the articulation of words and with swallowing if you have any visual problems double
vision but any visual problems, any ringing in your ear, any dizziness, any fainting, blackouts and
then things and nausea and then other things like if you have pins and needles in both of
your hands or reduced sensation in both arms or legs it's really important that you go and
see your doctor immediately if the symptoms have come on suddenly and/or the symptoms
are getting worse very quickly then you need to go to your emergency department so go and see
a doctor as an emergency, right all those things aside I'm now going to show you some exercises
that you can do to alleviate the pain in the base of your skull so the first thing that I want you
to do is just some nice gentle movement so first of all the twisting motion of the neck is can
really alleviate all of that tension so just very gently you're going to turn your head all
the way around to the side and give it a little push and then all the way around the other way
and give it a little push, now it's highly likely that you won't have the range of motion that I
have but if it's literally just a small amount of movement and then a little push and then likewise
the other way then that's fine it's all about doing it little and often so if you can do about
ten repetitions every couple of hours then that will ease things for you the next one
is just a gentle chin down to your chest so again take your head forwards and with your hands gently
apply a little bit of pressure to your head just gently stretching out the back of your neck last
but not least it's all about your neck posture and your shoulder posture so often all those muscles
that I talked about at the beginning a lot of them come from or attach near or around the shoulders
and the ribs so it's really important that you get your shoulders and your neck and your head
in the correct position most commonly again because a lot of us are often sitting at our
laptops or computers or on our smartphones we can end up in quite a slumped position so the
first thing to do is just to correct that position by lifting your breastbone up your chest bone up
to correct that upper back posture then bring your shoulders up and back slightly and tuck
your chin in elongating at the back of your neck what you mustn't do is yank your shoulders back
and pull your shoulders down because that will make your neck pain worse and I've seen that many
many times people trying to correct their posture by pulling their shoulders too far back and too
far down if you're not sure of how to do that I have a video if you go onto the octopus clinic
website and you go into the search tool and you put neck posture at the top you will see lots of
videos talking through in great detail how you can correct your neck head and shoulder posture
so I strongly recommend that you do that in fact in that section of the website you've got a whole
range of exercises for your neck and shoulders so I hope that's helpful my last and final tip
is actually to focus on your breathing now surprisingly a lot of those muscles that
attach into the base of your skull and attach into the upper ribs as well as the shoulder so it's a
really good idea to try and focus on breathing from your diaphragm you can go back through these
videos and see specific videos that I've made on breathing from the diaphragm but basically
you place your hands on your upper abdomen and you just practice gently breathing from there trying
to draw the air out push the air out of the lungs and then let the air come back in breathing from
this region to try and reduce the amount that you're breathing from your upper lungs and ribs
so I hope that's been helpful I will do my next video on pain lower down the neck so please do
come and join me for that please do press the big red subscribe key and let me know what you'd like me to do a video on next bye