For many, chronic neck pain is a serious painful and frequently debilitating problem. Often conventional treatments are of limited help, with medication only masking the symptoms and only providing temporary relief. Unabated neck pain often contributes to head pain, shoulder, arm, wrist, and hand pain. From a Holistic perspective we must consider posture, muscular imbalances, trigger points, biomechanics, prior injuries and trauma to the spinal muscles, especially of the neck as in whiplash. We are all unique and our experience of neck pain unique, hence the therapist must meet the client where they’re at. Simply instructing or educating one to hold there head back on the coronal plain can correct for neck pain and can allow for
sprained cervical(neck) ligaments to recover. By removing the stressor the body can start to recover. This alone is why massage therapy is such a powerful healing modality. Other times especially if the anterior (front) cervical musculature is locked short; bringing the head back will only acerbate the painful neck syndrome, by further compressing the cervical disc and further compromising impingement syndromes on the nerves and vessels that have to traverse this space.
Forward Head Posture (FHP) held for long periods, shorten anterior neck muscles. It is precisely these muscles, the scalenes, the sternocleidomastiod (SCM), the hyoids, longus colli, anterior longus capitis etc. that need to be released, that is lengthened, so that when the head is brought back on the coronal plain, the neck and adjacent structures do not have to compensate for those tight, shortened anterior neck muscles. Alleviating the Anterior neck will bring a more permanent relief for pain experienced in back of the neck and the base of the skull.
Stretching the neck and spine is important, but more important, in pain syndromes, is to extend the neck regularly. By extension, I mean to lengthen the neck both front to back and side to side simultaneously. Stretching usually is an activity where we lengthen one side at the expense of the other side. In fact if our pain syndrome is advanced this is not recommended. The beauty of balanced lengthening is that we are using, training, re-educating our muscles to create space rather than going unabated and allowing muscular tension along with gravity to create compressive forces in our joints. It is these compressive forces that wear away cartilage, create inflammation, causes bone spurs form, contribute to tendonitis and diminished muscular circulation.
With our head over our shoulders the posterior sub-occipitals chronic-neck-pain-huncheddo not need to function to hold the head up, but can get back to its purpose of moving and positioning the head. Trigger points that perpetuate pain syndromes can start to subside and normal muscle tonus restored. For example trigger points in the SCM can further complicate chronic neck pain by referring or radiating pain into the head, jaw, eyes, and brow. Eyes and jaw can fatigue as much from FHP as from interfacing with a monitor or with long periods of driving where we unknowingly hold our head forward. We must be cognizant not only by holding our head balance back over our shoulders but as in driving taking advantage of the head rest. Extended but leaning. I always get laughs in lectures when I explain that we are driving as if our head has to get to our destination first.
Typically neck pain is not caused by anything serious – physical stress of one kind or another is the usual suspect as describe above. Emotional stress (like worrying about your kids or money or suffering grief, depression, anger, or fear) can cause us to clench our neck muscles without even realizing it, every thought or feeling has a corresponding muscle tonus component. Re-occurring thoughts only reinforce physical reactions to those thoughts contributing to chronic painful tonus patterns. Chemical stress (inhaling or ingesting toxins like tobacco, smog, unhealthy foods, preservatives or even medications) can affect muscle tone and the nerves of the neck. When the neck muscles contract, they can apply pressure to the bones/joints of the neck, causing deviations in positioning which can then interfere with the nervous system, resulting in a painful stiff neck and the inability to turn your head. If the stress situation continues, it accumulates.
Very often we take the stress and tension to sleep with us. Not only that we go to sleep in a fetal position, which is on our side with our head forward, physically this position re-enforces the FHP and all postural/physical stresses associated with it. I very often remind clients to consciously relax all musculature, by completely feeling the weigh of your limbs, body and head, on the bed, fall asleep in this way and be better rested in the morning. Further re-enforcing healthy habits and fore go the coffee. Have a cold glass of water with lemon or hot tea if it is cold and snowing in our New England, early spring mornings. In heath, as usual, best regards, -david