A number of my patients ask me if there such a thing as osteoporosis in the neck? Can you experience osteoporosis neck pain? Are there osteoporosis neck symptoms you should be looking out for?
Osteoporosis in Neck
When I probe them further for more information, they tell me that their DEXA Bone Mineral Density (BMD) test results measured the bone density of their neck. Their results indicated a low bone density score in that area, so the discomfort they feel in their neck must be the result of the reduced bone density in this location.
Is there a correlation between the results in the neck of the femur and your neck (the one that supports your head)? Not really.
They do not have osteoporosis in the neck. This is a common source of confusion. Let me clarify what is happening.
You get those results, and it really feels very stressful, you almost feel like your bones have abandoned you.
That stress, that anxiety, we carry a lot of that in our necks.
Although the results of the neck of the femur doesn’t directly correlate with your neck, the fact that your bone density test is low can be causing you some stress and anxiety.
Does Osteoporosis Neck Pain Exist?
They do have neck pain, but it is not a result of their osteoporosis. The “neck” that they see in their DEXA BMD results is actually the neck of the femur (or femoral neck) — not the neck on their shoulders that supports their head.
In a nutshell, osteoporosis neck pain does not exist. Although it is a source of confusion, the concern is still an important one for patients mainly around a number of important topics. The balance of this blog is dedicated to explaining each of these in more detail for you.
- How to interpret and understand your bone density test scores.
- FRAX score interpretation.
- Are there safe neck exercises for someone with osteoporosis or osteopenia?
- What stretches can you do to lessen your neck pain?
- How to sleep to avoid neck pain.
- How can you increase bone density in the femoral neck?
Osteoporosis Neck Symptoms and Bone Density Test
Your Bone Mineral Density DEXA test shows readings taken of these main locations:
- Lumbar spine (usually first through fourth lumbar vertebrae)
- Hip, or more precisely, the top portion of your thigh bone. This bone is referred to as your femur and the top portion is known as the neck of the femur.
Within the hip measurements, different areas of the hip are identified. One of those areas is the neck of the femur. It is referred to as the neck of the femur because, like your neck, it connects the head of the femur to the shaft or body of the femur.
FRAX Score Interpretation
If you want a deeper understanding of your bone density test, I have written a detailed blog post on how to use the FRAX Calculator. I have also written the Complete DEXA Guide so you can understand how bone density is measured.
Exercise Recommendations for Osteoporosis
Exercise is vital to bone health and osteoporosis. But what exercises should you do and which ones should you avoid?
A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis. After you provide your email address, you will receive seven consecutive online educational videos on your bone health — one lesson each day. You can look at the videos at anytime.
To register for this free email course, simply click on the image of the couple or click here and provide your email address.
I cover important topics related to osteoporosis exercise including:
- Can exercise reverse osteoporosis?
- Stop the stoop — how to avoid kyphosis and rounded shoulders.
- Key components of an osteoporosis exercise program.
- Key principles of bone building.
- Exercises you should avoid if you have osteoporosis.
- Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
- Core strength and osteoporosis — why is core strength important if you have osteoporosis?
Safe Neck Exercises for Osteoporosis
On a separate but related (and important) topic, if you have osteoporosis you should be careful when doing certain exercises — particularly those that involve flexion.
A fitness professional (she is a Pilates, dance and aerobics instructor at a gym) recently contacted me with a question regarding neck exercises, neck stretches and osteoporosis. She was specifically interested neck flexibility exercises, the cervical spine, and neck flexion in clients with osteoporosis.
She had a very good question that I thought I should share with everyone. Thankfully, this fitness professional was concerned enough about her clients to look into this question and contact me. Here is her question:
Safe Neck Exercise Question
I am an instructor at a gym in Toronto and I just finished your five day professional email course.
I am aware clients with osteoporosis should avoid flexion. But in the five day course, much of the talk of fracture was associated with the thoracic compression fractures or lumbar compression fractures.
How much should a client stretch his or her neck? Or should they even stretch their neck at all? I have stopped teaching neck stretches (by placing your chin on your chest) and instead have been doing side tilts and looking left to right side rotation.
Thank you for this website and your response.
Safe Neck Exercise Answer
This is a great question. It is a good thing that this fitness professional is being cautious. Here is my response:
Several years ago the same question was asked to me by Osteoporosis Canada. Since there is no research in this area I forwarded the question to several Physical Therapists who have done extensive research in the area of Osteoporosis and Exercise.
The overall opinion was that neck flexion (within limits) was safe to do. I will often give my clients semi-circles to do from shoulder to shoulder which incorporates the flexion movement.
Exercises that encourage flexion of the back (particularly the thoracic and lumbar regions) should be avoided — particularly by people with osteoporosis. Neck exercises and neck stretches that promote flexibility are safe for people with osteoporosis.
In Exercise for Better Bones, I cover a wide range of exercises that improve flexibility and those that improve posture. Below are two stretching (flexibility) exercises that are safe exercises for osteoporosis.
Stretches that Reduce Neck Pain
Just because there is no such thing as osteoporosis in neck or osteoporosis neck pain, this does not lessen the importance of identifying the cause for the neck pain. Maybe you have neck pain because of stress, anxiety or poor posture? Perhaps your bone density test DEXA score is the cause of your anxiety and worry. If that is the case, here are several things you can do to reduce your neck pain:
Two Stretches for Your Neck Pain and Posture
Before we start the stretches, here are two recommendations:
- First thing, as with all your stretches, I need you to stand really tall. This is because the position of your spine all the way up to the base of your neck dictates how your head is sitting over your shoulders. That’s really critical when doing your stretches.
- Second, I don’t want you sitting or standing slouched. I need you tall and bring your ear as close to your shoulder as you can before you begin these stretches.
Let’s start with the first stretch to reduce neck pain. I’m just going to demonstrate one on each side. The important part here is I want you to think about hinging from one vertebra at a time.
- Take a breath in and then exhale as you bring your ear over your shoulder.
- We have seven vertebrae and we want each one of them to be part of the movement.
- Ear to shoulder.
- Nice and tall.
- Breath in.
- Exhale as you go in the opposite direction.
- Bend one vertebra at a time and bring my ear as far as I can over my shoulder.
- I want to feel a delicious stretch in the opposite side.
- This should not be painful in any way.
- You come back up one vertebra at a time and eventually return to your tall posture.
That’s a great stretch for your upper trapezius.
Here is the second stretch you can do to reduce neck pain.
- Go back towards the first stretch with ear toward shoulder.
- Before we get into a really deep stretch, we bring our chin over our nipple line.
- As you come over, you want to feel the stretch in your levator scapulae — which is a muscle that helps elevate your scapula — or your shoulder blade.
- You’re going to come down.
- Enjoy that stretch.
- I won’t make you watch me for 30 seconds, but you might want to hold it 30 seconds or longer.
- Repeat the same thing on the other side, last one.
- Ear to shoulder.
- While you’re doing ear to shoulder, nose is always pointing straight ahead, and then your nose and your chin come down towards your nipple line, towards the center of your collarbone.
- Enjoy that lovely stretch, and then come back up.
So despite your results in your neck of your femur, you can help your neck feel better.
How to Sleep to Avoid Neck Pain
If you have neck pain (or back or shoulder pain), you might have problems sleeping on a regular basis. I have prepared a video blog on sleeping positions and how to sleep to avoid neck pain.
Build Bone Density in the Femoral Neck
Now that we have dealt with the question regarding osteoporosis neck pain, are there things that you can do to increase your the bone density in the femoral neck (also know as neck of femur). What life and exercise modifications should you do to reduce your risk of a femoral neck fracture — especially if you practice yoga? The video below explains some steps you can take:
Osteoporosis in Neck Pain • Conclusion
Even though you can experience neck pain while having osteoporosis, you now know that osteoporosis neck pain does not exist. In this article I explain why there is no such thing as osteoporosis neck pain, I recommend several stretches to help you with any neck pain you are experiencing and show how to build bone in the femoral neck.
For more information on osteoporosis, visit my Osteoporosis Guidelines page.