Neck Pain: What we all should know

Have you ever experienced an episode where you can't move your neck to look over your shoulder backing out the car, or tip your head up to sip out of a soda can? What about just getting a headache that comes from somewhere in your neck? We have probably all had an experience like this. It may have lasted for a day to many months or even years. Like most physical maladies, neck pain has many contributing factors.

These include postural habits, stress, and nutrition, amount of rest, exercise and direct trauma. Because it is a very mobile part of the spine, the segments that make up the neck are prone to trauma and sometimes difficult to heal. Anatomical structures of the neck (cervical spine) include seven vertebras that stack up under the portion of the skull known as the occiput.
Like all joints in the body, the tissues here are subject to wear and tear, compression and swelling with trauma. As the nerves come off of the spinal cord, they come out between the vertebrae on both sides and form a very complex network of nerves that travel down the shoulder, through the armpit and all the way down the arm into the hand. The ligaments all around the bones keep the bones from moving too far apart from each other.

There are multiple layers of relatively small muscles that attach all around the neck from the vertebrae to the head, shoulder blades, ribs and clavicles (collar bones). Buried in all of this are large and small blood vessels, nerves, saliva glands, the thyroid and parathyroid glands and the trachea. In reality, the anatomy of the neck starts at the feet! You know the song "the head bone's connected to the neck bone, the neck bone's connected to the back bone...connected to the foot bone.

How all of your bones fit together is dependent on the balance of your body's alignment in relation to the forces of gravity. We are so incredibly designed with specific shapes of the bones and joints to absorb and transfer forces and to move us through space via the muscle system. When we begin to fall out of alignment, it's like asking a building to be supported by twisted and leaning metal for the life of the building with perfect integrity and strength. Varying degrees of weakness and muscular shortening affect this alignment.

By our daily postures, we contribute to the imbalances, and then usually don't take the time needed to stretch and strengthen ourselves back into balance. As shortening of the tissues occur, compression of the joints and its components causes a loss of fluidity or a hardening of the joints, and eventually less movement capability. At HOPT, we are trained to look at the entire body to assess where there may be compensations at any point in the body structure.

Using Myofascial release, trigger point work, prolonged positional stretching and other manual techniques, we work towards the goal of better balance of the entire body and localized softening of the shortened tissues. Eventually, we can help you along the way to strengthening the weak musculature. We can also problem solve with you in regards to work stations, postures and common or repetitive movements. There are some common postural neck misalignments that give rise to pain and dysfunction.


Here we will describe the postures along with self treatment options to stretch them out.

"Forward head posture: This is where the head juts out in front of the neck and shoulders. From the side, one can see that the ear does not line up over the shoulder, but lines up in front of it. This causes tremendous compression at the base of the skull and shortening of the soft tissues at the back of the spine.

"Kyphosis or rounded upper back: This often occurs with a forward head posture. Over stretching of the upper back muscles causes weakness there and creates compression of the front of the chest. This can limit the amount of movement in the rib cage needed for full lung expansion. It also promotes shortening of the soft tissues on the front of the throat which directly affects the jaw and tongue.

"Rounded shoulders: The rounded shoulders put the humerus (upper arm bone) at the mercy of gravity, pulling it out of the socket and stressing all of the tissues at the shoulder joint. This stress gives rise to pain, dysfunction and range of motion loss that can create problems all the way to the wrist and hand. Self treatment techniques and stretches must include opening the front of the chest, extension (backward bending) of the upper back, retraction of the shoulders and extension of the neck without causing more compression.

Depending on the imbalances, you may need to emphasize opening of the base of the skull. Get help analyzing your work station or postures to see if there is any adaptation that can be made with your environment.

"Neck retraction: Done in sitting or laying on your back, gently shear the chin back toward the throat without flexing the head forward. Hold the stretch for 5-10 seconds and do it up to 10 times.

"Passive extension: With a 10" to 30" ball above or between the shoulder blades, gently lay back over the ball to support the spine while it passively extends over the ball. Let the arms lay out beside the body or above your head. You may need to place a pillow under the head if your head does not relax all the way back. Hold the stretch as long as you can tolerate.

"Corner stretch: Stand in a corner with each of your arms on the walls. Place the bent elbows at shoulder height, forearms flat on the wall above the elbows. Lean into the corner to stretch the pectoral area. This can also be done in a doorway with each of the arms on either side of the doorway.

"Tennis ball mobilizations: Place 2 tennis balls in a tube sock and tie the sock so the balls are close together. Place the balls in the upper back area with the spine between the balls. Move them up and down the spine until you come to an area that feels hard, tight or painful. Soften into the balls as able. Play with arm and leg positions to work even deeper into the areas. Spend 5-15 minutes on this.

For most people, maintaining structural balance takes effort. You must be committed to keeping the harmony or your body will start to talk to you, or scream! If you don't take care of your body, where will your soul live?

Katrina is a Physical Therapist at Hands on Physical Therapy located in Austin, Texas. Hands on Physical Therapy provides a specialized approach that addresses whole body acute and chronic pain patterns. Their staff has extensive training in manual therapy techniques which are utilized for treating structural and soft tissue imbalances within the body. If you would like to learn more about their cutting edge techniques, you may visit them on the web at Handsonpt.net