If you suffer from neck pain or you have a stiff neck, then you’ll be pleased to know that I can offer you a proven approach to resolving it.
Neck pain is one of the most common musculoskeletal complaints of the modern world. Markedly, in any one year around 40% of Australian adults will experience it. Poor posture and holding static positions for prolonged periods of time causes most neck pain. Issues within the neck can also lead to other problems like headaches, jaw pain (TMJ), shoulder pain, tingling, numbness and weakness in the arms and hands.
I encourage you to make an appointment if you experience any of the following:
- neck pain or a sore neck
- a stiff neck, for example when looking over one shoulder whilst driving
- neck pain from sleeping, or neck pain after sleep
- grinding or crunching when moving your neck
- neck pain and headache
- sore neck and shoulders
- shoulder pain
- tingling, numbness or weakness in the arms and hands
- jaw and neck pain
Neck Pain Causes
The causes of neck pain are many, and in most cases there are several factors at play. If you’re experiencing chronic neck pain, or you’ve had a recent neck strain or other neck injury, below I categorise the likely reasons for your pain.
It’s not hard to see from the image below how poor posture could easily contribute to neck pain. Markedly, the head weighs a hefty 5Kg. When it sits on top of an aligned spinal column, your spine can best meet the force of gravity. Consequently, as the head migrates forward it places progressively greater strain on the muscles and joints of the neck. Eventually this strain causes a stiff neck and/or neck pain.
A condition defined as ‘Upper Crossed Syndrome’ exhibits a ‘Forward Head Posture’, as described above. In addition, Upper Crossed Syndrome refers to a common pattern of muscular imbalances found at the neck, shoulders and upper back.
In this condition we find tightness in the following muscles:
And we find weakness in:
An example of this is displayed in the below image. As you can see, a ‘cross’ is formed between the weak and and tight muscles, hence the term ‘Upper Crossed Syndrome’.
There are many cases where a patient presents with a persistent stiff neck and/or neck pain, even though there has been no specific injury. In these cases there is almost always a degree of muscular imbalance in the area.
In addition to a Forward Head Posture, Upper Crossed Syndrome sufferers usually exhibit the following postural deviations:
- Increased thoracic kyphosis – abnormal upper back curve. An extreme case is a “hunchback”
- Rounded shoulders – the shoulders round in and lessen the broadness of the chest
- Scapula winging – the shoulder blades pull away from their natural resting position against the ribs
In most cases holding static positions brings on neck pain. For example, sitting at a desk or driving for prolonged periods of time. Indeed having a stiff neck after a day at the desk is probably all too familiar for many of my readers! Although in the past there has been a lot of focus on sitting in a ‘good posture’, we now know that movement is also a vital factor if you wish to become and stay pain-free.
The exact reasons why movement is so therapeutic for the body is an evolving scientific discovery. Suffice it to say that the human body feels and works best when regular movement:
- circulates the blood
- lubricates joints
- contracts and stretches muscles
- causes variations in the position of the fascia
Ergonomics refers to the arrangement and design of furniture in relevance to the people who use it. Time spent at a desk is what primarily aggravates the vast majority of neck pain conditions. Therefore, it is thankfully a growing trend to have standing desks and other equipment designed specifically to ‘fit’ well with the end user. The best ergonomic set ups allow you to work in a number of different positions. For example, shifting back and forth between sitting and standing throughout the day.
Ergonomics is a whole industry in itself. Regardless, a good practitioner that treats neck pain should be able to give you clear advice about basic ergonomics at work.
Neck Pain From Sleeping
Many people complain of neck pain from sleeping, or neck pain after sleep. This is often due to a mattress and/or pillow that is unsuitable for that individual. Finding the best mattress and pillow for neck pain can become a very complex and expensive business. Unfortunately, changing bedding can also produce varying and unpredictable results. My advice on pillow and mattress choice is simple – go with what feels good!
We can blame stress for many health issues, including neck pain. The effects of stress on the nervous system often create a prolonged and unconscious low level muscle tension. This can be difficult to shake even when the stress has reduced. Many people go to bed with a stiff neck, still carrying the tension from the day. This can accumulate over time and become a persistent chronic muscular tension.
Perhaps linked to stress, the way we breathe may also cause neck pain. This might sound strange, but bare with me and I will explain!
The major muscle responsible for breathing is your diaphragm. This is the muscle that should cause expansion and contraction in the abdomen area when you take a deep breath. In addition, there are other ‘accessory’ muscles that contribute to breathing, these are mainly:
- sternocleidomastoid of the neck
- scalenes of the neck
- pectoralis major and minor of the chest
- serratus anterior of the thorax
- latissimus dorsi
These accessory muscles mainly contribute when you are ‘puffing’. They help increase the speed of breathing in order to maximise oxygen intake. Not surprisingly, this becomes relevant when stress is present, and our fight or flight response kicks in. During these times we can easily begin to over-use the accessory muscles by taking shallow breaths. The over-use of the accessory muscles tends to coincide with them being chronically tight. Of course, this tightness often leads to chronic neck pain.
Neck injury can come in many forms. We separate these injuries into two major categories:
- muscular – whiplash, neck strain etc.
- skeletal – cervical disc bulge, facet joint injury
Many cases of neck injury are a combination of both of the above categories. Where the primary issue is skeletal, an acute neck muscle pain can also develop as a result of muscle guarding. This often presents as a sudden neck pain that comes on in the morning, and a stiff neck that can be difficult to turn in one direction.
Yes! Technology use is a significant factor in many cases of neck pain. How many hours do you sit in a static and awkward position looking at a screen? Does playing with your smartphone on the tram bring any familiar images to mind? Picture all 5Kg of your head slumped down looking at your Facebook feed for countless hours a day and you’ll get the idea?!!!
A picture is worth a thousand words. Here’s one for the IT folk!
Neck Pain Treatment
There are many ways to achieve neck pain relief. Naturally, the methods used depend very much on what the cause is. For example, whiplash treatment will be very different to chronic neck pain treatment, or treatment for a stiff neck. Below I describe the various techniques and approaches that I readily use in clinic.
Addressing posture should be fundamental in chronic neck pain treatment, and in some cases where sudden neck pain comes on. Your therapist can use the various techniques and self-help methods to correct the muscular imbalances that lead to poor posture, and the consequential aching neck and shoulders.
Simply varying your posture regularly throughout the day will also be very beneficial. Remember this – “your best posture is your next posture!”. This means you should look for opportunities to change your working position as regularly as possible.
Myotherapy is a very effective treatment for neck pain. It encompasses most of the techniques listed below, therefore I will go into more detail under those specific headings.
Massage for neck pain works by targeting tight muscles in the neck, shoulders and upper back. This is a go-to for many people. It is also extremely beneficial for stress relief. And let’s not forget that stress is probably part of what got you to this point in the first place! Forms of massage include:
- remedial massage
- deep tissue massage
- myofascial release
- trigger point therapy
Dry needling (otherwise known as myofsacial dry needling) can often give instant neck pain relief. Your therapist can apply various techniques to target muscles in the neck, shoulders and upper back. Dry needling benefits include:
- pain relief
- relaxation of tight muscles
- stress relief by activating a ‘rest and relax’ response from the nervous system
In the below video I demonstrate a basic dry needling approach to treating neck pain.
Muscle Energy Technique (MET)
MET is a technique that involves the patient doing gentle isometric muscle contractions. The therapist applies a small amount of resistance to these contractions. MET works with the concept of reciprocal inhibition. This means that muscles on one side of a joint will relax to accomodate contraction and movement of the muscles on the other side of the joint. MET is a painless and effective way of releasing tension in the neck, and restoring movement to the joints.
Mobilisation works by manually introducing movement to stiff joints. The feeling of having a ‘stiff neck’ is often a combination of joint restrictions and muscle tension. Mobilisation targets the joints specifically.
‘Manipulation’ is also known as ‘adjustment‘, and is an effective method of increasing the mobility of joints. This is where the therapist applies a sudden movement to a joint, which produces an audible ‘popping’ sound. Manipulation to the upper back is safe and effective when treating neck pain. However, there are certain risks that go with manipulating the neck itself. Consequently, many practitioners avoid manipulation in that area. They will use more gentle methods of mobilisation for the neck. Generally speaking, these methods are just as effective.
Stretching to relieve stiffness in the neck and shoulders can be very effective. Your therapist can apply stretches as part of treatment, or you can simply do them at home by yourself as a maintenance measure. I would advise against stretching if you’ve had a recent neck injury, until a qualified practitioner has assessed you. This is because in some cases stretching may aggravate symptoms. In the below video I demonstrate the four best stretches to relieve neck pain.
Neck exercises are yet another way to relieve tension and mobilise the neck. Exercises for neck pain include stretching and strengthening certain muscles to improve posture. They may also include gentle movements to relieve symptoms. In the below video I demonstrate simple movements for an acute neck injury.
The effects of deep breathing can be very beneficial if you’re suffering from a sore neck and shoulders. This is because by redirecting your breath to the abdomen, you do a number of positive things. This type of breathing is called ‘abdominal breathing’.
When you employ abdominal breathing, you:
- correct faulty breathing patterns that overuse the muscles in your neck
- take your mind off your stress
- calm your nervous system down
You don’t believe me? Try doing ten deep breaths now and see how you feel!
Stress reduction involves finding out what your particular stressors are, and working out ways to reduce their effect. Thus, a good therapist will address your pain in a comprehensive way. They will gain an understanding of your particular circumstances and act on them. As such, there’s no such thing as ‘one size fits all’ when it comes to neck pain treatment.
Perhaps surprisingly, stress reduction does not necessarily mean changing your work or home life. In most cases simply developing awareness around your stress, and then finding coping mechanisms is enough.
Neck pain has many variable causes and solutions. Your number one call to action if you’re suffering from neck pain should be to move more. Beyond this, your therapist can apply a variety of techniques to help you find relief. So what are you waiting for? Get your eyes off the screen and your feet on the ground! If that doesn’t work, I’m here to help…