Why Neck Pain is Such a Pain in the Neck…and What to Do

Neck Pain likes to sneak up on you. It drops in for a visit, nibbles on your nerves, annoying you for a few days, then scampers away giggling the whole time.

Kind of like unwelcome guests over the holidays.

But Neck Pain isn’t done with you. It often comes back again and again and each time it does, it takes little more of a bite. What was a day or two of annoyance, runs into a week or two of misery.

Then maybe a month.

A year.

Even a lifetime.

It moved in with me one time but I finally out smarted it. And I want to share with you what I did so maybe you can beat it too.

There are two parts to Neck Pain: the pain and the problem or the root cause. Pain is rarely the problem. You don’t have any nerves that sense pain. Out the nearly 47 miles of nerves in the human body, not one of them senses pain.

So how could that be? How is it that when I slam my toe into a piece of furniture, my toe hurts but yet there aren’t any nerves that can sense the hurt?

Pain is in the brain. The signals come into the brain on the same nerve fibers that carry other sensations like itching. Your brain decodes the signal and decides if it’s something to pay attention to (pain) or not.

So, one way to scramble the signal is to activate other receptors that tell the brain to pay attention to their signal instead.

This is where massage, heat, various forms of manual therapy, taping, electrotherapy, stretching, active-release. myofascial release, strain-counterstain, ice / cold come into play. These types of treatments treat the pain part of Neck Pain. It’s like turning down the volume on your radio (does that make me sound dated? Should I say SmartPhone instead?). The signal is still there but you can barely hear it.

In Garden Variety Neck Pain, pain that shows up without trauma – an accident, a car wreck, fall, too much exercise, etc – the problem appears in the soft tissues – fascia and muscle (yes, joints can be involved too but today it’s about soft tissues).

And yet, even that is a misdirection.

Like I said, Neck Pain is sneaky.

As an example, many years ago, we had a booming physical therapy private practice. We had clients from all over the country and many of them were famous sports athletes. Life was good. The practice was full, busy, fun.

Then managed care arrived in Austin with big, doctor invested / owned clinics and over a one month period our practice dropped almost 40%.

We had been through dips like this before, although not this bad, and we always worked our way out of it. But this time, the referrals didn’t come back up.

That’s when I noticed some nasty neck pain.

I hadn’t had an accident or any trauma. It just showed up one day.

In hindsight,  it’s easy to see how the stress of the practice could be connected to neck pain but I couldn’t see it then if you had painted it on the wall of the clinic.

My neck hurt during the night (“oh crap, that’s a bad thing, night pain, bad things with night pain, do I have a bad thing?” -> neck pain got worse) and during the day. I tried all the things I listed above but it just kept on nerve nibbling and giggling.

One of my patients was an anesthiologist. He said he had just the thing. He sat me down and then stuck his thumb, or maybe a better way to say it is dug his thumb, into my upper trap on the left side. Tears welled up in my eyes. I think he was pressing on my first rib. A lot of people mistake the first rib under the upper trap for a “knot” and press like hell. Of course, all it does is hurt like hell.

That didn’t work.

It went on for a long time, this Neck Pain.

I tried NSAIDs…Aspirin….Tylenol. Nope. I didn’t have pain or symptoms anywhere else either.

Just this nagging neck pain.

What shifted it for me was thinking differently about the problem. I was focused on the muscles that hurt instead of what was causing the muscles to hurt. I know that might sound odd but hang in here with me for a minute.

When you’re stressed, your Sympathetic Nervous System (SNS) ramps up. This is the infamous “fight or flight” system. It’s not under your control at least directly. The SNS is part of the Autonomic Nervous System which helps regulate things like your heart rate, blood vessels, breathing, etc.

I didn’t have anyone to fight but my brain and body didn’t know that. So it geared up anyway.

Certain stress hormones like Cortisol get released under stress. Your body, under physical stress, needs the quick energy that Cortisol can help muster. Muscle tension rises. Breathing becomes more shallow. Heart rate goes up.

As a result, the tension in the muscles and fascia gradually create a local hypoxia or low oxygen. Low levels of oxygen activate receptors that send warning signals to your brain, something is off. The brain then interprets this as pain.

To add to the complexity, unconsciously, I could focus on my neck pain more than focus on the disaster all around me. This happens a lot. It’s easier to turn your attention to the physical pain than the pain of the problem you must solve.

And this keeps the pain going.

When I figured this out, I had to get creative and DO something about the practice. So, we did. We launched new programs, recruited a new set of MDs to refer to us and gradually built up enough cash flow to cover our costs.

That was part one.

Part two was focused, deep breathing.

Slow deep breathing tames the SNS which in turn increases the part of the ANS responsible for relaxation. It’s sometimes referred to as the “relaxation response”.^[1]Vlemincx E, Van Diest I, Van den Bergh O. A sigh of relief or a sigh to relieve: The psychological and physiological relief effect of deep breaths. Physiol Behav. 2016 Oct 15;165:127-35. doi: … Continue reading

Here’s one way to do it:

1. Get a timer and set it for 3 minutes.
2. Lie down on your bed, get comfortable. Place a pillow under your head. If you have enough pillows, place one or two under your knees.
3. Close your eyes.
4. Place a hand on your belly.
5. Now, breathe in slowly and steady over the count of 5 – your belly should rise.
6. Hold for 5 seconds.
7. Exhale over 5 seconds.
8. Keep doing this for the 3 minute period.
9. Do the whole thing 3-5 times per day.

You may find other techniques, different timing, on the Internet. I’m not sure how much it matters if it’s 4 seconds or 5 or 6. This technique helped me feel more in control and that might be one of the most important parts of the technique. When you feel like you can DO something, when you have options, the intensity of the problem subsides

Since that period of time, I’ve had several more “crises” and the deep breathing seems to work almost every time. It takes a few days for your SNS to calm down but, in my experience, it eventually does.

I use different tactics for neck pain from trauma, overuse, etc and I’ll get into that in future articles.

I hope this helps.

That’s all I have for now.

Thanks for reading.
DK

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