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Stiff Neck, manyastambha

25 Apr 2016   Shanti Gowans
Because of the pace of life, business and a hectic work schedule, people increasingly suffer from complaints such as neck rigidity. Those people who work with machines, computers and heavy objects (lifting, pulling etc), and people involvedi n sporting activities are more prone to stiffness of the neck. 
Stiffness of the neck (manyastambha), or rigidity, is a consequence caused because of aggravated Vata Dosha when lodged in the cervical region (neck). Though this is observed as a complication in many neurological and orthopedic disorders, it is also found in mumps, cerebral haemorrhage, cervical dislocation, osteoarthritis of the neck joint, acute otitis media (ear infections) and so on.
Causes may include:
- Use of hard or a thick pillow
- Keeping the arm beneath the head while sleeping
- Keeping the arm beneath the pillow while sleeping
- Activities involving prolonged raised arms such as flying a kite for a hour
- Direct neck injury
- Regular day sleep
- Improper lying or sitting postures
- Lifting heavy objects in shoulder or head
- Heavy exercise to, or impacting, the neck and shoulder
- Constant pressure over the cervical region
- Constantly watching a far object for a long period of time
- Excessive intake of Vata-kapha dominant food, such as coolants, cold, sweet and salty in taste, heavy to digest, oily food stuff, frozen foods and so on
- Pulling heavy objects forcefully, with neck and shoulders strain.
Origin of the disease:
Because of the above said factors, the joints, veins and nerves get fatigued or lose their tension. Meanwhile if Vata causing food and habits are followed, the vitiated Vata gets blocked in the neck location, causing stiffness. As the back, or nape of neck (manya) is commonly involved, it is called as Manyasthambha. Often the disease Manyasthambha is also correlated with Torticollis (wry neck).
Clinical features of stiff neck may include:
- Severe and persistent pain in the neck
- Inability to rotate the neck
- Difficulty to see objects overhead
- Inability to bend the neck down
- Heaviness of the neck
- Often there is swelling in both the sides of the neck
- Radiating pain to the shoulder or back
- Sleeplessness because of the pain
- Morning stiffness and so on are the features of this condition.
X-ray and MRI scanning are useful to know the exact mechanism and possible extent of the diseased condition.
The causative factors are to be withdrawn immediately. The affected part must always be kept warm. If hospitalied, traditional Ayurvedic treatment would be to proceed with Nasya (errhines) therapy,  herbal smoking (Dhumapana), with significant results.
In addition, local mild massage (abhyanga) and sudation (swedana) are advised with proper medication and appropriate time duration.
Formulations for abhyanga (massage):
- Mahanarayana taila
- Vishagarbha taila
- Dhanvantara taila
- Dashamoola taila
- Pure Shanti taila
Formulations for nasya (nasal drops)
- Anu taila
Wholesome diet and habits
• Exercising the stiff neck, in the initial stages can make it more painful. So avoid the causative factors, and exercise.
• Hot water bath is better for this condition than a cold water bath.
• Apply any of the above mentioned oils and do a 10 minute, gentle massage, before your bath, to the entire part of neck and then take a hot water bath.
• Include shashtika shali (red rice), godhuma (wheat), milk, or medicated milk prepared out of garlic, coriander etc.
• Rest the neck and shoulder area for an appropriate time, when pain is acute..
• Start the program of proper and systematic exercise to the neck as outlined in Shanti Yoga neck and shoulder exercises. 
• Care and caution during the job and weekly Ayurvedic massage will reduce the chances of neck stiffness.
Unwholesome diet and habits to be avoided include:
• Day sleep
• Intake of curd, yellow cheese.and sticky substances
• Fried and oily food
• Dry substances
• Heavy exercise and exertion
• Two wheeler driving
• Improper positions
• Potato, sweet potato, jack fruit, yellow and red gram, peanuts etc.
Single herbs useful to treat stiff neck:
• Bala, sida cordifolia. Useful to soothen nerves
• Bilva, aegle marmelos. Balances Vata, relieves inflammation (one among dashamoola).
• Rasna, alpinia galanaga. Relieves pain
• Gokshura, tribulus terrestris. Anti inflammatory
• Shallaki, bosswellia serrata. Relieves pain and inflammation
• Guggulu, commiphora mukul. Relieves pain and inflammation
• Saindhavalavana, rock salt. Specific to relieve stiffness
• Tilataila, sesame oil. Good Vata balancing oil
• Rala, shorea robusta. Relieves stiffness
• Shaliparni, desmodium gangeticum. Anti inflammatory (one among dashamoola)
• Prishiparni, uraria picta. Anti inflammatory (one among dashamoola)
Internal medication
- 101 Avartita ksheera balataila
- Maharaja prasarin taila
- Gandha taila
- Gokshuradi guggulu
- Yogaraja guggulu
- Ekangaveera rasa
- Maharasnadi kwatha
- Sahacharadi kashaya
- Rasnaiaranadi kashaya 


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