Swan neck: getting rid of the double chin

Most often, this is not some serious pathology, but so-called mechanical pain in the neck. It is also called nonspecific, axial. Essentially, minor carelessness is enough for it to appear. She made some awkward movement, pulled a ligament, became hypothermic, or did not change the position of her head for a long time - and here they are, painful shooting pains.

If the pain literally “sits on your neck,” don’t rack your brains over how to get rid of it. We have already done this for you. We explain in simple terms the complex connections between neck anatomy and pain and tell you how to cope with the disease.

Neck structure and pain: how they are connected

Pain in the neck area can be aching, sharp, shooting, or throbbing. When tilting the head, turning or touching, the sensation may intensify. It can be localized on the right, left, front or back. Because of it, mobility may be limited, and sometimes the head is in the so-called forced position. Often pain in the neck is complemented by pain in the head, back of the head, right and left shoulders, arm, back, heart, face.

Do you know how your neck works and what exactly can hurt you? Well, let's fast forward a few minutes to the past, to an anatomy lesson in high school. Remember!

The neck consists of:

• The cervical spine, which is 7 vertebrae
• Muscles, 10 of them
• Bundles
• Larynx
• Thyroid gland

The cervical vertebrae are small in size and consist of a body and processes with attached ligaments and muscles. There are discs between the vertebrae. Discs have an outer part (hard, consisting of fibrous fibers) and an inner part (soft nucleus pulposus, which provides shock absorption to the spine).

Look at the picture. It clearly shows where which neck muscles are located.

The conclusion from this short excursion suggests itself. Neck pain can occur due to a malfunction:

• cervical spine,
• muscles and ligaments,
• internal organs (larynx and thyroid gland)

What kind of violations are we talking about? These may be spasms, inflammation, degenerative changes (degradation of tissues and organs), configuration disorders (for example, displacement of the vertebrae) and other types of anomalies. For example, pinching of the vertebral artery, spinal roots, and small vessels may occur.

And! Neck pain can become a side symptom of diseases of the heart, lungs, upper respiratory tract and other ailments.

Why does a double chin appear?

It is generally believed that extra chins are caused solely by excess weight. There is some truth here: fat easily accumulates in this area, it is distributed unevenly here and is very difficult to lose when losing weight.

That's why it's so important not to gain excess weight.

However, this is far from the only reason. A double chin appears due to the following factors:

• heredity,
• age,
• posture,
• hormonal disorders.

Types of neck pain

Let's delve into the topic, understand the types of pain.

Depending on the duration, neck pain is divided into acute (lasts up to 10 days) and chronic.

Another classification of neck pain is based on such a criterion as the source of pain. Here we cannot do without a new term - “vertebrogenic”, that is, emanating from the spine. Will you try to determine on your own how vertebrogenic neck pain differs from non-vertebrogenic neck pain? Absolutely right:

• Vertebrogenic neck pain is associated with changes in the cervical spine.
  These may be lesions of the intervertebral discs (for example, a hernia), compression (pinching) of the spinal roots and spinal cord. Such pain radiates to the occipital region, shoulders, and further to the fingers. Numbness, impaired mobility, and sensitivity are often observed. Since neurological disorders can develop, sometimes neck pain is accompanied by dizziness, attacks of loss of consciousness and headaches.
• Nonvertebrogenic neck pain is associated with changes in the functioning of all other elements of the neck that do not form the spine (muscles, ligaments, internal organs), as well as other systems and organs.
  And the nature of these changes is very diverse: from simple clamps to inflammation and infections.

Neck organs

Anatomy of the larynx
The structure of the human neck includes the location of vital organs. They are placed in such a way that no neck movements can harm them.

Larynx

It is the part of the respiratory system that connects the trachea to the pharynx. The larynx consists of nine cartilages, three of which are paired. Cartilage is connected to each other by ligaments and joints. The largest cartilage is the thyroid. It consists of two plates. In women they are located at an obtuse angle, and in men they are located at an acute angle, since the Adam's apple is located on the neck.

The upper border of the larynx fits tightly to the hyoid bone, below it connects to the trachea. On both sides, as well as on the outer part, there is the thyroid gland, and at the back is the laryngopharynx. With the help of tension in the muscles of the larynx, a person is able to reproduce sound. The muscles begin to compress the larynx, its volume and the gap between the ligaments change. As a result, the sound of the voice is formed as you exhale.

Pharynx

This organ is a funnel-shaped canal 12 cm in length. It is positioned with the wide end down. The upper part of the pharynx is fused to the bones of the base of the skull, and the back is attached to the protrusion of the occipital bone. On the sides, the pharyngeal canal is attached to the bones of the temple. At the level of the fourth vertebra, the pharynx begins to narrow and passes into the esophagus.

The organ has certain functions:

• Inhaled air passes through it.
• With the help of contraction, food moves through the organ, which is first crushed in the mouth and then enters the esophagus.
• The timbre, pitch and volume of pronounced sounds depend on the functioning of the pharynx. When an organ is diseased, the sound changes; with severe inflammation, a person loses the ability to speak altogether.

The mucous surface of the pharynx is covered with many cilia, which have the function of protecting the body from bacteria and microorganisms.

Trachea

This is the organ responsible for breathing. It is located between the bronchi and larynx. The length of the trachea varies. It can vary from 11 to 13 cm. The tracheal tube consists of half rings of cartilage, there can be up to 20 pieces. They are connected to each other by connective tissue, and the inside is covered with a mucous membrane.

The function of the trachea is also to provide protection against foreign substances entering the body. On the mucous membrane there are cilia that will cause coughing in order to push unnecessary elements out of the larynx.

Thyroid

Thyroid gland
This is one of the most important glands in the body. It is located on the lateral and anterior region of the trachea. The thyroid gland consists of two lobes, which are connected to each other by an isthmus. The organ is so small that it is impossible to detect it by palpation. The main task of the organ is to produce hormones. Their number is regulated by the work of the pituitary gland. If it malfunctions, a person has a problem with the thyroid gland. Often treatment consists of surgery.

Esophagus

The cervical region contains one third of the entire esophagus. The organ is a canal formed from muscle fibers. Its main task is to ensure the movement of food into the stomach. The length of the esophagus varies between a child and an adult. In adults, it can reach 30 cm. The organ is limited above and below by sphincters - valves. Thanks to them, food moves in only one direction. The valve prevents food from entering the mouth and larynx from the stomach.

Spinal cord

The organ is designed to ensure motor activity, maintain digestive and respiratory function, and regulate cardiac activity. The spinal cord is located in the spinal canal; in the area of ​​the cervical vertebra it passes into the region of the medulla oblongata, but there is no clear boundary.

In the cervical region, the diameter of the spinal cord becomes larger in the place where the nerve bundles exit, which go to the upper limbs. The widest area is at the level of the fifth and sixth vertebrae.

Pain in the neck from the back, front and side: what is evidenced by

Pain in the back of the neck.

This is perhaps the most common location of pain in the neck. Remember at the beginning of the article we mentioned mechanical neck pain that can occur in healthy people simply due to carelessness? They occur mainly in the area below the back of the head. Most often, pain in the back of the neck is caused by:

• Spasms and inflammation of the trapezius and splenius muscles,
  which are responsible for turning the head, straightening the cervical spine, and moving the shoulder blades. The algorithm is simple: I sat for a long time at the computer in a frozen position, the muscles spasmed, the soft tissues swelled, and aching pain appeared.
• Osteochondrosis
  (changes in the intervertebral discs in the form of their shortening and decreased strength) and its complications, including intervertebral hernia.
• Myofascial syndrome.
  This is the formation of compactions in muscle tissue in the form of pain (trigger) points due to overstrain and muscle spasms. Characterized by acute pain during movements and when pressing on certain points in the neck area.

Pain in the side of the neck.

It can be tingling, burning, pulsating. Characteristic conditions are when pain in the neck radiates to the ear and shoulder. It is also often mechanical in nature. May indicate:

• muscle spasms due to sudden movements, excessive stress, hypothermia,
• disturbances in the functioning of blood vessels,
• malignant formations in organs.

Pain in the front of the neck.

Pain may be localized in the area under the chin or spread to the entire front of the neck. May indicate:

• inflammatory processes in muscles, ligaments and nerves,
• pinched blood vessels or nerves due to deformation of parts of the spine and tissue swelling,
• lesions of the lymph nodes,
• thyroid diseases.

Atrophic changes in the dermis and epidermis

Reduced thickness of the dermis, thickening of the stratum corneum of the epidermis, decreased elasticity and turgor of the skin.

The appearance of dyschromia, manifested in both hyperpigmentation and the appearance of hypopigmented areas. The appearance of multiple telangiectasias in the décolleté area, vascular malformations, pigmented nevi. All these signs indicate a decrease in the proliferative and synthetic activity of fibroblasts, the accumulation of elastic collagen bundles, and a decrease in the fractions of young collagen.

Score in points:

0 – no changes, no pigmentation, no vascular disorders. 1 – minimal changes, expressed in dryness, decreased barrier properties. The pinch test is negative. There is no pigmentation. 2 – moderately significant changes. With the pinch test, the skin returns to its original position in 1–2 seconds. Slight pigmentation. Single telangiectasia. 3 – significant changes in elasticity, decreased turgor, tissue sagging, severe dry skin. The pinch test is clearly positive. Pigmentation is pronounced. Multiple telangiectasia.

Causes of mechanical neck pain

Let’s summarize and focus on the most common causes of neck pain, since they can affect everyone. That is, we will focus only on mechanical, non-pathological pain. And this is what causes them:

• Overstrain of the neck muscles and blocking of the facet joints (these are the joints that allow movement between the vertebrae and prevent the discs from stretching). Such changes occur due to the head being in one position for a long time. This is the scourge of office workers who spend hours frozen with their heads bowed over their desks. Every unconscious movement of the head forward to peer at the computer is a strain on the muscles. An uncomfortable posture during sleep can also be detrimental.
• Sprain and slight deformation of the neck ligaments.
• Sudden head movement.
• Forced flexion of the neck followed by extension or, conversely, extension-flexion, causing the so-called whiplash injury (microtears of muscles).
• Hypothermia of the neck. Leads to muscle inflammation.

Risk groups for neck pain:

• People with problems with the spine and feet (flat feet)
• People with poor posture
• Professionals engaged in activities that require repetitive actions/severe bending of the cervical spine or prolonged holding of the head in one position.
• Smokers.
• People over 40 years old.
• People experiencing stress, mental trauma, overwork.

All this leads to muscle spasms and severe neurotic pain in the neck.

Condition of subcutaneous fat

When assessing subcutaneous fat, the practitioner needs, as we said above, to determine the morphotype of neck aging.

The distribution of subplatysmal and subcutaneous fat is very different in deformation and fine wrinkling types of neck aging.

Score in points:

0 – optimal amount of subcutaneous fat. Mesosomatotype. 1 – with the deformation type, local hypertrophy of the pancreas is observed; with finely wrinkled – hypotrophy of the pancreas. 2 – with the deformation type, subtotal hypertrophy of the pancreas is observed; with finely wrinkled – subtotal hypotrophy. 3 – with the deformation type, total hypertrophy of the pancreas is observed; with fine wrinkles – atrophy of subcutaneous fat.

Preventing neck pain

It is easier to prevent any problem than to solve it. Same with the neck. We adjust our lifestyle a little so that we don’t have to suffer from neck pain.

What is required for a healthy neck:

✓ Correct posture and kneading, straightening the back, turned and lowered shoulders, relaxed trapezius muscles

✓ Breaks in activity and warming up the neck muscles. Take a break from the computer and move around so that your muscles don't stagnate.

✓ When talking on the phone, do not hold it between your shoulder and ear.

✓ Do not carry large, heavy bags with straps over your shoulder.

✓ During sleep, keep your head at the same level as your body, change your position. Ideally, love sleeping on your back.

✓ Avoid drafts, air conditioning, hypothermia.

✓ Be attentive to your health during the period of exacerbation of colds.

Treatments in the salon

A cosmetologist can also offer you solutions:

• myostimulation;
• injections;
• radio wave lifting.

A lift can be considered as a last resort. But remember that if you don't change your habits, the problems will return very quickly.

It is better to groom the swan neck from a young age. But even at a more mature age, persistence and control can significantly improve the condition of the neck. Don't neglect the procedures in the salon either.

Clinically Relevant Anatomy

Deep neck flexors

• Longus capitis muscle.
• Longus colli (superior oblique, inferior oblique and medial vertical).
• Anterior rectus capitis muscle.
• Lateral rectus capitis muscle.

Superficial neck flexors

• Sternocleidomastoid muscle.
• Scalene muscles (anterior, middle and posterior).

Superficial extensors of the neck

• The levator scapulae muscle.
• Upper portion of the trapezius muscle.
• The splenius capitis muscle.
• The splenius muscle of the neck.
• Semispinalis capitis muscle.
• Semispinalis muscle of the neck.

Suboccipital muscles (deep extensors)

• Rectus capitis posterior major muscle.
• Rectus capitis posterior minor muscle.
• Superior oblique muscle of the head.
• Inferior oblique muscle of the head.

Objective assessment

You can read more about the examination of the cervical spine here.

Craniocervical flexion test

This test assesses motor control and isometric endurance of the longus capitis and colli muscles in comparison with the sternocleidomastoid and scalene muscles.

The patient is positioned in a supine position. A pneumatic cuff (biofeedback) is placed in the suboccipital region and inflated to 20 mmHg.

• The patient is instructed to slowly press the chin into the neck, as if performing a nodding movement with the head. This action causes the pressure in the pneumatic cuff to increase - in the first stage the pressure should increase by 2 mmHg. (superficial muscles are relaxed).
• Next, the patient should stay in this position for 10 seconds.
• He then relaxes (the cuff pressure decreases to 20 mm Hg) and again makes the head movement described above, increasing the cuff pressure to 24 mm Hg. and holding this position for 10 seconds. The patient should repeat this action until the pressure in the pneumatic cuff reaches 30 mm Hg.

Cervical flexion requires activation of the GFS. The superficial flexors should not be involved during this movement. With each stage, the range of movements should increase.

People who do not have neck pain can hold the muscle contraction for 10 seconds at stage 3 (26 mmHg) or higher. Those who experience neck pain usually reach stage 1 or 2 before they lose neutral position or begin to use the superficial muscles.

Endurance testing of neck flexors

• The patient is positioned supine with knees bent. He needs to perform craniocervical flexion (CCF). The person then raises the back of the head 2.5 cm, keeping the chin pressed into the neck.
• This is a good test to use to evaluate people with neck pain. This test has been shown to be a reliable tool for measuring the rehabilitation progress of patients with neck pain.
• Various studies have recorded the following rates for this test: Asymptomatic men - average 25 seconds, asymptomatic women - 20 seconds (Olson, 2016).
• Asymptomatic group - mean = 39 seconds, neck pain group - mean = 24 seconds (Harris, 2005).
• Male patients with neck pain have greater neck flexor endurance than females.
• Although retention times can vary, numerous studies have shown that men have longer retention times than women and that this should be taken into account when interpreting the test.

Endurance testing of neck extensors

• The patient is placed in a prone position on his stomach, with his head extending beyond the edge of the couch (forehead resting on the chair), arms along the body. Then he is asked to perform the CSC (press his chin into his neck) and hold this position, the chair is removed. The task is to keep the head with the chin pressed into the neck in a horizontal position.
• When comparing the neck flexor endurance test with the neck extensor endurance test, it can be concluded that the extensor muscles have significantly greater endurance than the flexor muscles in the neck pain population. These results are the same for both patients with acute and chronic neck pain, regardless of age.