Paul Manley Back Pain and RSI Clinic

Hairdressers are in a number one position to observe neck problems in their clients.

Most hairdressers will know that some people get neck strain and headaches from the use of the 'backwash' sink when shampooing their clients hair.

A client with a 'dodgy' neck will usually complain about neck pain and discomfort when they are having their hair washed. This is a sign that they need to take extra care not to press too hard whilst shampooing and to ensure that adequate padding on the sink is present.

Many times I have got up from my wonderful 5 minute shampoo and head massage with an aching, stiff neck and an uncomfortable low back. Sometimes the 45 degree angle of laying back on the shampoo chair will aggravate a latent back problem through compression on the facet joints of the low back.

The connection between backwash sinks and migraine
I first made a connection between migraines and 'back-washing' many years ago in myself. I realised that 2-3 days after a haircut a migraine would come on which would last for 2-3 days. Through the night it would persist and still be there each morning this was very unusual for me and very worrying. Although it didn't happen every time I went, which at that time was about once every 2 months, the correlation became clear.

The top of the neck is very prone to injury caused by the forward pressure on the top two vertebrae. It struck me that most people seem not to be affected by the backwash method, thus I recognised that not everyone is equally prone to this type of strain. So I noted those patients who did suffer against those who didn't yet had a problem high in the neck, atlas and axis to be precise.

One precipitating factor was the degree of 'overhang ' of the skull at the back of the head. Some people are flat heads, some are more the shape of a boulder. The scaphocephalic (long skull) or large overhang seems to be more prone to this syndrome. The spine is in a much further forward position in relation to the brain stem within it and thus any further movement forwards will trigger pain from the joints and muscles as well as triggering the vasomotor reactions which end up as a migraine. Often the effects of backwash neck strain are not felt for a couple of days after the shampooing. This confuses cause and effect and we often don't connect the two events.

However, when a hairdresser hears a client complaining of this sort of problem they should take it seriously. All too often the client doesn't realise the source of the problem. This is where they will appreciate your observance of the do's and don'ts of back-washing

Thereafter I ensure that adequate neck cushioning is used and that the shampooer isn't too heavy handed. I warn patients with certain types of neck problems to ensure full neck support whilst in the recumbent position of the backwash.

Unfortunately there is not much that can be done about this problem by the salon. Usually space is at a premium therefore the smallest of spaces tends to be allocated to the hair washing area. The equipment is standardised and without much variation in ergonomic design. There may be a long wait before the manufacturers wake up to the importance of the need to improve fundamental design.

Usually there is the sponge type of neck cushion available but often they are in ill repair and of an incorrect shape to provide adequate support.

It appears that there is little alternative for the salon owner and its sylists and shampoo-ers but to make the client as comfortable as possible within the limits of their abilities.

Prevention of backwash injury.
Ask for a small towel, fold it into a pad about 6 inches around and place it behind your neck up to the base of the skull, this extra padding does the trick for me and most people. Of course you could create a 'scene' by asking for your hair to be washed in the 'face down' position, not pleasant in a back wash sink, I know, I've tried it!

Of course, you can always have your neck alignment and tension patterns examined and altered by a competent practitioner of Physical Therapy if you suspect a connection of this painful kind with your hairdresser.