What to do with neck pain on a road bike?
Question from TOUR reader Erwin A.: I used to race a lot as a hobby and now - at 63 - I would have enough time for racing bikes. But now I have health problems with my cervical vertebrae. After about 60 to 70 kilometres on the road bike, I suffer from severe neck pain and the onset of migraines. There doesn't seem to be any conventional medical remedy for this - apart from taking tablets; osteopathy brings slight improvement, but after just a few training sessions I have problems again. What should I do?
Dr Christian Merkl: The cervical spine often changes over the decades due to wear and tear. Bony growths and disc displacements then constrict the nerve exit points, which is exacerbated by the backward tilt of the head in the aero position on the bike. The nerve roots are irritated, resulting in neck pain radiating from there and muscle tension. In principle, you should try to eliminate or minimise the causes of irritation as far as possible - on the bike, for example, by adopting as upright a posture as possible, even if this may be frowned upon among cyclists.
For example, shorten the stem and adjust the handlebar level to the saddle level. Change your position frequently and often ride in an upright position to relieve the strain. Physiotherapy and, as you have already done, osteopathic measures are also useful. The aim should be to stretch the cervical spine and stretch the deep front neck muscles in order to counteract neck pain when riding a road bike. Depending on the situation, a magnetic resonance imaging scan may also be useful to determine the extent of the narrowing. In the case of severe changes, sometimes only surgical interventions are helpful.
