Sitting up in bed reading a book at night is a classic aggravating activity. Driving for long periods is also a position that may cause problems. Other aggravating activities include prolonged writing, sewing or knitting, or sitting at a computer, or any activity where the neck is positioned in prolonged flexion.
Pain is eased by any position out of the dural stretch position. The patient will tend to feel stiff in the morning, but can improve with daily dural stretches. These stretched must be progressed carefully as overstretching can cause an increase in pain, while under-stretching will result in no improvement in symptoms.
Physiotherapy treatment can be highly effective in mobilising and eventually stretching out the restricted tissues and improving range of motion of the cervical, thoracic and lumbar spines generally. Postural correction exercises designed to take strain off the spinal joints and encourage good muscular support are also necessary to prevent recurrence. Continuing to sit with poor posture can prevent resolution of the symptoms and result in further weakening of the muscles of the trunk due to pain inhibition and lack of use. Patients with a previous spinal injury or who have had previous spinal surgery where scarring may be present may be more likely to experience slump pain due to dural restriction. Conditions such as fibromyalgia and Ross River Virus may also predispose a person to experiencing these symptoms.