by Eric Winder, D.C.   

Chronic neck pain can affect someone’s quality of life in numerous ways. Whether it causes poor quality sleep, difficulty looking for traffic, or just general daily irritation, neck pain is one of the most common reasons people seek help at my office. Many different factors can be at the root of the pain, but most of these causes will respond to the right treatment. 

A patient I will refer to as Melanie is an ideal example of how different factors cause neck pain, as well as how relief comes with the right form of care. Melanie had been in a high- speed car accident, resulting in severe whiplash, but x-rays showed that she had been suffering from severe arthritis long before the accident, although she wasn’t aware of this. Her neck pain was disabling to the point where surgery was being considered. 

A course of treatment at our office, consisting of fascial release therapy, joint stretching, and rehabilitation exercises, improved Melanie’s pain from an average of nine out of 10 (where 10 is the worst imaginable) to two out of 10. She was able to return to work, and surgery was avoided. She had several issues contributing to her pain—as do many people with neck problems—so let’s examine some of those underlying issues.  

Arthritis? 

Many people (including doctors) think of arthritis as a major cause of neck pain. What many people don’t know is there’s only a small correlation between how much arthritis you have and how much pain you might feel in your neck.  This means that just because you have arthritic changes, such as disc degeneration or bone spurs in your neck, this doesn’t necessarily cause the pain you feel. In my experience, most arthritic changes cause only stiffness and mild achiness in the neck. Melanie, for example, did not have neck pain, despite severe arthritis, until her accident.  Of course, the arthritis could have made her injury and pain reaction more severe. Her relief, however, did not come from treating arthritis itself. We’ll discuss this below when we look at the connective tissue called fascia.  

Posture and Pain 

Another issue that relates to neck pain is posture. Many people with neck pain also have a forward head posture. This means their ears are positioned forward rather than centered over the shoulders. The restrictions that cause forward head posture can certainly cause neck pain as well. In fact, for every inch that the head is forward of the shoulders, tension at the base of the neck is multiplied ten times.  

While postural problems often require professional care, there are some issues with posture that can easily be corrected by changing ergonomics. Is your computer screen at eye level? If it is too low, or especially if it is too high, then regular use can lead to neck pain. Some people situate their computer screen off to one side, so their neck is always turned when they use it, and this can also cause pain.  

Whether or not these factors lead to pain will depend on the frequency of use. Occasional laptop computer use is not usually a problem. However, I have seen patients who use a laptop for hours each day, so looking down in a hunched position for this much time results in pain. 

 While postural problems can trigger neck pain, not everyone with poor neck posture will suffer from neck pain. For instance, some of my patients suspect mental or emotional stress as a cause of their neck pain. In my experience, stress amplifies pain or brings it to the surface, but it isn’t the underlying cause.  

When the physical cause is correctly dealt with, similar levels of stress will no longer cause pain. In Melanie’s case, stressful days exacerbated her pain, but after successful treatment, stress had minimal effect on her pain levels.  

Fascia as the Root Cause 

The most common issue that I find at the root of my patients’ neck pain is fascia restriction. Abnormal tension, stiffness or distortion in this fibrous connective tissue can alter muscle tension, joint alignment and joint stability, resulting in stiffness and pain.  

Fascia restrictions are frequently caused by prior injuries, postural stress or repetitive motion injuries. While mental or emotional stress itself is not a direct cause, the muscle tension that it brings can lead to stiffness or restriction in fascia. 

Restricted fascia is most easily treated with gentle hands-on compression techniques, such as Residual Strain Therapy. Densified fascia—where the connective tissue is thicker, less pliable and tender to the touch—is most effectively treated with pulsing pressure or specialized stretch techniques. Restricted fascia is not the same as a muscle knot or “trigger point.” In fact, trigger points in muscle are usually caused by fascia restriction, so when the fascia is released, one or several nearby trigger points will disappear. 

The powerful results of fixing the fascia come from improved proprioception, or “position sense.” The nerve endings that give us the position sense that we use for coordinated motion are in our fascia. When we correct restricted fascia, we improve proprioception which allows for better muscle coordination, joint alignment and stability. This can make all the difference in the world for a problem like neck pain. For Melanie, releasing fascia restriction was the key to her pain relief, and the relief was lasting rather than just temporary.  

Complete Neck Care 

In addition to fascia release and ergonomic changes, other therapies can be important to relieve neck pain. Stiffness and pain can lead to weakness in the neck muscles which, in turn, can exacerbate the pain. Learning how to safely strengthen your neck is vital in this case. Sometimes whole-body posture affects the neck, so a person might need to strengthen their core muscles, or even their hips, in order to help relieve postural stress in the neck.  

In some cases when there is significant arthritis or disk degeneration in the spine, traction or decompression therapy can offer relief. Sometimes this can be done at home with inexpensive equipment, upon the recommendation of a qualified healthcare practitioner. 

  Each case of neck pain is unique, and no two people will require the exact same treatment. However, as a general rule, I find it effective to change the easy lifestyle habits first (for example, computer screen height), treat fascia restriction next, then strengthen muscles when the joints and tissues are working correctly. For most people, this is a successful formula to get rid of a “pain in the neck.” 

Dr. Eric Winder has been practicing chiropractic for 25 years. His practice focuses on relieving pain to restore alignment and motion through gentle soft tissue therapies. For more information, call 941-957-8390 or visit GentleBay.com.