Neck Pain May Begin In Your Upper Back

In the past months several people have consulted me about aching pain in their shoulders and upper traps. As I  looked at their postures, I found that all of them bent their necks forward, and some of them jutted their chins.  When a person's head is forward, obviously the muscles in the back of the neck have to work harder to keep their head up; ergo, pain in the back of the neck and upper traps.

The first order of business is to give people some relief with Graston Technique or some other deep-tissue therapy and traditional chiropractic therapy if appropriate.  After a treatment or two, most people are feeling much better.  The next step is to figure out a way to balance the muscles (strengthen some and stretch others.)  For many years, I would develop a rehab plan focussing on the muscles in the neck.  This generally works very well.

However, what I am so grateful to these particular patients for, is that they showed me a key to this therapy.  Each of them had a particular stiffness in their spines: The 4th thoracic vertebra (counting down from the big vertebra you feel at the bottom of your neck, i.e. "T4") was unusually flexed forward on the next one down, and its ability to straighten out was restricted for one reason or another.

Think about this situation for a second.  If your back is bent forward and you can't straighten it out, your eyes will be looking at the floor unless you extend your neck and maybe jut your chin.  The kink in one part of the chain means that its motion must be made up somewhere else.  These particular people solved the problem by shifting their heads a bit forward, but unfortunately this solution caused their neck muscles to work overtime and eventually start to ache.

The real solution for them was to concentrate the first portion of rehab on their backs, not their necks.  The vast majority of people do not have changes in their bones that prevent them from straightening up.  Usually it's a simple matter to get things moving properly again.

Now comes the strengthening/stretching stuff.  Everyone's mom told them to sit up straight, and mom was right about the importance of posture.  The problem is that you can sit up straight as long as you're thinking about it, but as soon as your attention wanders, you'll slump into whatever position your muscles pull you to.  The trick is to tighten or stretch the various muscles so that your posture is properly maintained without even thinking about it.  I rely heavily on Egoscue's method because his exercises are very understandable (and people seem to like doing them.)

Moral of story: The place that hurts might not be the place that's causing the hurt, and the thing that's causing the pain might not be painful.