Neck Pain: Causes and Solutions
by Eric Winder, DC
Chronic neck pain drags down the quality of life. Whether it causes poor quality sleep, difficulty looking for traffic, or just daily irritation, neck pain is one of the most common reasons people seek treatment in my office. Many different factors can be the root cause of that pain, but fortunately, most of them can be improved greatly with the right solutions.
A patient whom I’ll call Melanie is a prime example of different factors causing neck pain, and the subsequent relief from treatment interventions. She had been in a high-speed car accident, resulting in serious whiplash, and x-rays showed that she also had severe arthritis which was present long before the accident even though she wasn’t aware of it. Her neck pain was disabling, and neck surgery was being considered.
A course of treatment at our office, consisting of fascial release therapy, joint stretching and rehab 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 the need for 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.
A problem that many assume causes neck pain is previous arthritis or joint degeneration, often caused by past injuries. What many people don’t know is there is only a small correlation between how much arthritis you have and how much pain you feel. This means that, just because you have arthritic changes such as disc degeneration or bone spurs in your neck, it doesn’t necessarily contribute much to your pain.
In my experience, most arthritic changes cause only stiffness and achiness in the neck. Melanie, for example, did not have neck pain, despite severe arthritis, until her accident. Of course, the arthritis might have made her injury and pain reaction more severe. Her relief, however, did not come from treating arthritis itself, as that remained the same after treatment.
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 on the body rather than centered over the shoulders. The restrictions that cause forward head posture can also cause neck pain. In fact, for every inch the head is forward of the shoulders, tension at the base of the neck is multiplied 10 times. While postural problems often require professional care, there are some issues with posture that are easily corrected by changing the ergonomics.
Is your computer screen at eye level? If the screen is either too low or too high, then regular usage 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 are problems depend on the frequency of usage. Occasional computer operation is not usually not a problem. However, I have seen patients who use a laptop constantly, and looking down in a hunched position all the time has caused neck problems.
Many of my patients suspect mental or emotional stress as a cause of their neck pain. In my experience, the stress amplifies pain or brings it to the surface, but this isn’t the underlying cause. When the physical cause is properly dealt with, similar levels of stress will no longer cause pain. In Melanie’s case, stressful circumstances greatly increased her pain, but after her successful treatment, stress had minimal effect on her pain.
Fascia as the Root Cause
The single 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 resulting muscle tension can lead to restricted fascia.
Restricted fascia comes in different forms, so there are different types of fascia treatment. Stiffened fascia, usually caused by prior impact injuries, 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 best treated with one of a variety of pulsing pressure or specialized stretch techniques. Restricted fascia is not the same as a muscle knot or trigger point. In fact, trigger points are usually caused by fascia restriction, and when the fascia is released, one or several nearby trigger points will disappear.
The power of fixing the fascia comes from improved proprioception or position sense. The nerve endings that supply the position sense we depend on for coordinated motion are imbedded 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 in relieving pain. For Melanie, releasing fascia restriction was the largest component to her pain relief, and the change 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 perpetuate 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 relieve postural stress in the neck. In some cases, where there is significant arthritis or disk degeneration in the spine, traction or decompression therapy can be relieving. Sometimes this can be done at home with inexpensive equipment upon the recommendation of a qualified healthcare practitioner.
Every case of neck pain is unique, and no two people need exactly the same treatment. However, as a general rule, I find it effective to change the simple contributing factors first (for example, computer screen height), treat fascia restriction next, then strengthen muscles when the joints and tissues are working properly. For the majority of people, this is a successful formula for getting rid of a “pain in the neck.”
Dr. Eric Winder has been practicing chiropractic for 20 years with a focus on fascial treatment and soft tissue therapies for the past 17 years. Dr. Winder’s practice focuses on relieving pain and restoring alignment and motion through soft tissue therapies without forceful manipulation. For more information, call 941-957-8390 or visit GentleBay.com.
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