Neck pain is all too common.
Neck pain is all too common and may be caused by injury to the head or anywhere along the spine, infection of glands or lymph nodes in the neck, inflammation of the joints between the vertebrae, poor posture, overuse or asymmetric use of the neck muscles, cancer (tumor of or near the spine), and arthritis. Whiplash injury is a major contributor to long term neck pain.
Pregnant women often experience neck, back, or pelvic pain due to changes in their posture. These postural changes may be caused by the increasing size of the uterus, the extra weight she is carrying (baby and her own weight gain), as well as the softening of her ligaments to accommodate the growing fetus and prepare her for labor.
Along with neck pain or stiffness, we may experience headaches, mental fogginess, dizziness, blurry vision, difficulty swallowing, voice changes, and even nausea to the point of vomiting.
Neck pain and the other symptoms arise from tight neck muscles.
It’s pretty easy to believe that tight neck muscles will cause neck pain. But what of all the other symptoms?
They may arise from tension exerted by the neck muscles on the cranial bones (head bones), specifically the occiput (back of the head) and the mastoid process (behind the ears) of the temporal bones. As the cranial bones shift they may reduce the amount of space (foramina of the skull) through which the cranial nerves exit the skull.
These cranial nerves allow us to see, hear, smell, taste, chew, move our facial muscles, speak, swallow, and digest food. Stretching or compressing the cranial nerves may result in impaired nerve conduction, causing under- or over-functioning of these nerves, altering the way we experience the world via sight, sound, and taste, or interact with it via speech.
Unresolved neck pain
Chronic neck pain may result from soft tissue restrictions caused by trauma, overuse, poor posture, poor nutrition, or disease. If left unresolved, these restrictions in the fascia, muscle tendons, and ligaments may lead to degeneration of the spine, manifesting in subluxation (misalignment of the vertebrae), disc herniation, osteoarthritis, or bone spurs (osteophytes).
Any of these conditions may lead to nerve pain, tingling, numbness, or weakness of the muscles of the neck, shoulders, arms, hands, or fingers due to compression of the spinal nerves as they exit the cervical spine (neck vertebrae) between the occiput of the head and the first thoracic vertebra to form the brachial plexus. The median, ulnar, and radial nerves emerge from the brachial plexus to innervate the arms, hands, and fingers.
Many muscles when tense may contribute to neck pain and associated symptoms.
The major muscles of the neck commonly involved in neck tension and pain are outlined below:
Tight anterior or middle scalenes may put pressure on these nerves as they exit the spinal cord and spinal canal of the neck. The pain may radiate upward to the head to cause headaches, or down the arms all the way to the finger tips with associated symptoms such as nerve pain, tingling, weakness, or numbness.
A set of four small muscles (forming the suboccipital triangle right below the occiput), as well as the small rectus capitis lateralis and rectus capitis anterior muscles, with attachments to the occiput and the first two vertebrae (atlas and axis) are often overlooked, yet they can lead to tremendous headaches when stressed by overuse, poor posture, or vertebral misalignment. Even a cold draft to the neck or eye strain can set them off.
When these muscles don’t work in harmony with one another, they may pull the head slightly “off kilter”, affecting one’s sense of balance. Excess tension in these muscles may also feel like the occiput (back of the head) is being pulled down over the back of the neck.
These small muscles flex, extend, and side bend the head. Moreover, they relay back to the brain information about body position (proprioception).
The semispinalis capitis muscle and the splenius capitis muscle, which allow neck extension (chin up), attach at the neck vertebrae as well as the back of the head (occiput). Tightness of either muscle not only makes it difficult to put your chin to your chest (neck flexion), but may also lead to headaches that travel from the neck to the top of the head or forehead.
The longus colli and longus capitis muscles are the major players in neck flexion (bringing the chin to your chest). They attach to most of the neck vertebrae as well as the first 2-3 thoracic vertebrae.
The neck extensors and the neck flexors are particularly vulnerable to whiplash injuries. When injured, these muscles will lock up the neck because of their attachments to many of the neck vertebrae (cervical vertebrae).
A tight sternocleidomastoid muscle makes it difficult to turn the head (head rotation) to the left or right, as well as tilt the head to the side (side bending, lateral flexion). Since it attaches to the mastoid process right behind the ear, it may also lead to headaches radiating up and forward from behind the ears. Tight scalenes will also restrict side bending of the neck to the opposite side.
The levator scapulae raises the shoulder blade (scapula) and assists in lateral flexion of the neck. Thus, a tight levator scapulae results in a raised shoulder and head tilt to the same side, as well as a feeling of tightness, discomfort, or pain in these areas.
The beautiful trapezius muscle raises, lowers, and rotates the shoulder blades, as well as assists with neck extension and side bending (lateral flexion).
Because of its attachments to the occiput, the spine of the neck and thorax, the shoulder blades, and the collar bone (clavicle), tension in the trapezius may lead to neck pain or tightness, and even pain in the shoulders or head.
Poor posture can also cause neck strain and pain.
Poor posture is a major player in developing upper back or neck pain. Slouching when sitting or standing leads to tension in all the neck muscles, which are trying to keep the head centered over the neck. Shortening of the muscles not only creates a feeling of tightness and discomfort, but also pain as the muscles press on the pain receptors of the sensory nerves embedded in the muscles. Moreover, poor posture over time can lead to functional scoliosis (distortion of the spine), or exacerbate (worsen) existing scoliosis.
Carrying a bag over one shoulder primarily will cause neck muscles to shorten on that side. Slinging a bag diagonally over the torso is just as harmful, adding diagonal tension across the spine.
Craniosacral therapy and energetic unwinding are gentle and very effective treatment options for neck pain.
While there are many therapies that help to alleviate neck pain and stiffness, craniosacral therapy and energetic unwinding, two related therapies, promise to resolve neck pain issues more effectively because they help the body to release the tension and restriction in the fascia (connective tissue) that weaves through, and envelops, all the cells, tissues, organs, muscles, and other structures, such as blood and lymph vessels, nerves, and meridians (energy pathways of the body).
The fascia creates compartments for all structures of the neck.
The neck contains many structures, such as blood and lymph vessels, nerves, the vertebrae, the larynx (voice box), the hyoid, the trachea, the upper portion of the esophagus, the thyroid, and the parathyroids. These structures are separated from each other, and enveloped, by the connective tissue (fascia). The fascia thus protects all these structures by allowing each its own space. Moreover, the fascia permits a certain amount of glide of the structures relative to each other when we move the neck, swallow, or take a deep breath.
Trauma of any kind injures the fascia.
When there is trauma to the tissue, whether it be muscle, tendons, or ligaments, the fascia will sort of “shrink wrap” around these structures as a protective measure to prevent further injury. Dehydration, inflammation, or infection, on the other hand, change the consistency of the connective tissue, making it more sticky and less resilient or flexible.
In either case, the fascia becomes distorted, creating a sort of stranglehold on these structures and reducing the amount of glide possible between the various muscles and other structures. This has the effect of “gluing” the muscles together, depriving them of their independent movement and resulting in neck pain.
Some examples are:
- the anterior scalenes and the overlying sternocleidomastoid (SCM) muscle
- the posterior scalene and the levator scapulae
- the semispinalis capitis and the splenius capitis muscles
In order for the structures to regain their health and function, as well as independent movement, the tension and restriction in the fascia needs to be resolved.