Representative image.

NEW DELHI: A haircut at most barber shops in India is followed by a head massage . It often ends with a ‘ neck-crack ’, when the barber holds you by the chin and tilts the neck sharply to the left and right.

Like countless Indian men, Ajay Kumar, 54, came away from the salon feeling refreshed after the haircut-and-massage routine last month. Soon, however, he became increasingly breathless.

It turned out that the neck crack had damaged his phrenic nerves that control the diaphragm, which in turn controls breathing. Kumar, a PSU employee, had to be put on mechanical ventilation. “He has been put on non-invasive ventilation for breathing support and may continue to be on it,” said Dr Anand Jaiswal, director of respiratory and sleep medicine at Medanta – The Medicity.

Jaiswal said Kumar’s diaphragm was paralysed and he may need ventilator support throughout his life because the nerve rarely regenerates spontaneously.

The doctor also cautioned people against getting a neck massage at saloons. “The neck massage and neck-crack that barbers ritually perform after a haircut can cause long-term damage to neck joints and surrounding tissues, muscles or nerves or even cause bilateral diaphragmatic paralysis like in this case,” the doctor said.

Breathlessness is often associated with malfunctioning of the heart or lung. When Kumar came to Medanta with the problem about a month back, doctors said they conducted a series of tests to diagnose the problem while treating him for other suspected causes. When the problem persisted, they looked at medical literature for clues. “While examining him, we noticed Kumar had a paradoxical breathing pattern. His chest was moving inward instead of expanding. This abnormal chest movement affected the breathing pattern and led to a drop in his blood oxygen levels,” Jaiswal explained.

He added, “As we investigated the possible reasons for the paradoxical breathing, a neurological examination revealed Kumar was suffering from a damaged phrenic nerve. Because he had no other existing illness to explain it, and literature had some examples about neck-crack causing such problem, we questioned Kumar and found that his neck massage had caused the condition.”

In a typical Indian barber shop, it is not uncommon to find customers such as Kumar who like to end their haircut with a massage and a customary neck-crack. People get it done because they find it relaxing and believe a neck massage is a good practice to keep the neck loose. Dr Shakir Husain, director, stroke and neurovascular clinic at Neo hospital, said these neck massages can also lead to dissection of the vertebral artery.

“If the dissection or tear is minor, it heals naturally. Blood thinners have to be given for two to three months. But in some cases, surgery has to be done to clear the aneurysm caused due to the tear,” he said. Damage to the artery during neck manipulation is also seen in patients opting for chiropractic therapy for musculoskeletal problems. “It may lead to disabling stroke or fatality,” the senior neurosurgeon said.

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