Chronic neck pain can affect someone’s quality of life in several ways. Whether it causes sleep disturbances, range-of-motion issues, or general daily irritation, neck pain is one of the most common reasons folks come into my office. Many different factors can be at the root of the pain, but most of these causes respond well to the right treatment.  

A patient, whom I will refer to as Melanie, is one example of successful neck pain treatment. Melanie had severe neck pain from whiplash caused by a recent car accident. However, x-rays also showed that she had been suffering from severe arthritis long before the accident, although she was not aware of this. Her neck pain had become debilitating to the point where talk of surgery was on the table. 

Fortunately, before choosing this route, she opted for a course of treatment at our office. This consisted of fascial release therapy, joint stretching, and rehabilitation exercises. Melanie’s average pain improved from nine out of 10 (where 10 is the worst imaginable) to two out of 10. She was able to return to work without the need for surgery.  

Several issues contributed to Melanie’s pain, as is the case for many folks who deal with neck problems. Let’s examine some of those underlying issues.   

Posture and Pain  

Posture can be a significant factor in neck pain. Those with neck pain often have a forward head posture as well. This means their ears are positioned forward rather than centered over the shoulders. The restrictions that cause forward head posture can also contribute to neck pain. In fact, for every inch that the head leans forward in front of the shoulders, tension at the base of the neck is multiplied ten times.   

While postural misalignment often requires professional care, there are some issues with posture that can be corrected with optimal ergonomics. Is your computer screen at eye level? If it is too low or too high, this can lead to neck pain. Some folks situate their computers screen off to one side, so their necks must turn when they use it, which can also cause pain.   

Whether or not these factors cause pain hinges on the frequency of use. Occasional computer use is not usually a problem. However, I have seen patients who use a computer for hours each day. Looking down in a hunched position for this much time results in pain.  

 While postural issues can activate 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 can intensify pain or bring it to the surface, but this is not the main 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.   

Arthritis 

Many folks (including some doctors) view arthritis as a major cause of neck pain. While spinal arthritis often causes stiffness, it rarely intensifies neck pain on its own. Evidence of this lies in the fact that many folks with arthritis have little to no neck pain, just as our patient Melanie who had arthritis without pain until her accident. In fact, two large studies have shown that there is only a mild correlation between arthritis in the spine and actual spinal pain. One person can have terrible arthritis with no pain, while another can have no arthritis but terrible pain. 

The explanation for this is that the same problems causing “wear and tear” arthritis can also cause pain. But in some cases, they cause one and not the other. In other words, muscular weakness, joint instability, and uneven muscular tension can cause both pain and arthritis, or either one independently. Just because you have arthritis and pain, does not always mean that arthritis is causing the pain. They might, however, share a common source.  

In my experience, most arthritic changes cause only stiffness or mild achiness in the neck. Melanie was not suffering from neck pain—despite severe arthritis—until her car accident.  Of course, the arthritis might have weakened her neck, causing her injury and pain reaction to be more severe. Her relief, however, was from treating the arthritis itself. We’ll discuss this below when we look at the connective tissue called fascia.   

Fascia and Pain 

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

Fascia restrictions are frequently caused by prior injuries, postural stress, or repetitive motion injuries. While mental or emotional stress is not a direct cause, the muscle tension 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. In fact, muscle knots are usually caused by fascia restriction, so when the fascia is released, they disappear. 

The powerful results of treating the fascia come from proprioception, or “position sense.” The nerve endings that create our position sense are located in the fascia, and they give us an internal “picture” that allows us to move with coordination.  

When we correct restricted fascia, we increase proprioception, which allows for better muscle coordination, joint alignment, and stability. This can make all the difference for a problem such as neck pain. For Melanie, releasing fascia restriction was the key to her lasting pain relief—depite the fact that her arthritis remained unchanged. 

Though fascial restrictions are a likely cause of arthritis, treating the restrictions will not reverse arthritis, as that is a permanent tissue change. However, I have seen many patients whose arthritis stopped worsening after a comprehensive fascia treatment.  

Complete Neck Care  

In addition to fascia release and ergonomic shifts, other therapies can be beneficial to relieve neck pain. Stiffness and pain can cause weakness in the neck muscles, which could exacerbate the pain. Therefore, learning how to safely strengthen your neck is vital. Sometimes whole-body posture affects the neck, so a person might also need to strengthen their core muscles—or even their hips—to 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 affordable equipment, at the recommendation of a qualified healthcare practitioner.  

Each neck pain case is unique, and no two patients will require the exact same form of treatment. However, as a general rule, I find it effective to change the practical 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 folks, this is a successful formula to get rid of that “pain in the neck.”  

Dr. Eric Winder has 29 years in practice and focuses on relieving pain and restoring alignment and motion through fascia release therapies. For more information, visit https://gentlebay.com/ or call 941-957-8390.