What is causing my neck pain?

A huge portion of my practice revolves around treating neck pain and tight neck muscles.  I hear excuses such as “I think it’s where I hold my stress,”  “I know I have bad posture,” and “It’s because I sit at a computer all day.”  I’d have to agree-all of those things could absolutely be causing neck pain.  But what if correcting stress, posture, and ergonomic training all fail to relieve neck pain?   What if there is something else causing or contributing to the problem?

A self test: Am I at risk for neck pain?

Before I reveal the secret cause behind neck pain, please humor me and complete a short exercise (If I tell you the secret ahead of time it will ruin the exercise!).  It will take less than a minute, and it may teach you something about how your body works.

Go stand in front of a mirror (shirtless is best if you can) and watch yourself take a DEEP breath in.  Do it a few times, paying attention to your shoulders, upper chest, lower rib cage, and abdomen.  What part of your body moved first?  What did your belly do when you breathed in?  Now breathe normally, paying attention to the same things.

If you noticed that your shoulders or upper chest moved first, or that your abdomen sucked in (rather than pushed out) when you breathed in (both signs of dysfunctional breathing), you may be at risk for neck pain and/or shoulder tension in the future.

Dysfunctional Breathing: the unexpected cause for neck pain

photo courtesy of: www.merckmanuals.com

There are many muscles involved with breathing.  The main muscle that should be used during respiration is called the diaphragm.  As we inhale (breath in), the diaphragm muscles contract and push the abdominal contents down, which allows the lungs and rib cage to expand and fill with air.  With the abdominal contents pushed down and compressed, this looks like the belly is sticking out.  As we exhale (breath out), the diaphragm relaxes, moves upward and releases the pressure in the abdominal cavity.  This will give the appearance of a slimmer abdomen (as the abdominal contents have more room to spread upward and not out like during inspiration).

photo courtesy of: http://spinalcolumnblog.com/2009/12/11/a-sigh-of-relief/

During times when we need to quickly expand the chest and/or breathe in a lot of air (like when sprinting or during heavy exercise), there are accessory muscles of respiration.  These accessory muscles run from the neck to the upper rib cage, and help expand the upper part of the chest for maximal chest expansion.  These muscles should be used fairly infrequently, and only after the diaphragm has done most of the respiratory work.

More often than not, I find that my patients use only the accessory muscles (in the neck) to help them breathe, and don’t use their diaphragm at all!  In fact, many of them suck their bellies in when breathing in, which practically makes it impossible for the diaphragm to do its job.  When the accessory (helper) muscles take over the job of the diaphragm (main) muscle, they have to work harder than they’re designed to work, which can cause tightness, discomfort, and pain.  These muscles can get so tight and painful that they inhibit the deep neck muscles (aka the muscles from the “double chin” exercise) from working the way they’re supposed to, which causes even more neck pain!

Why women might be at a greater risk for neck pain

I took a sample of 30 of my female patients, and 22 of them reported to me with neck pain as their primary complaint. 73% of my (sampled) female patients have neck pain.  Then I took a sample of 30 of my male patients, and only 8 of them have neck pain.  This means only 26% of my male patients have neck pain.  I realize these numbers are not representative of the entire population, but it’s still pretty intriguing.  I have a theory as to why my female patients have more neck pain, and it comes from my own personal experience as a woman.  In order to breathe in properly, the abdomen has to expand.  This is not the most attractive “lady-like” look, as the belly sticks out and is no longer tight and flat. Many women I know, including myself, were taught from a young age to keep their abdomen “sucked in” and tightened, because this is a more visually appealing image.  As we’ve seen above, this makes it virtually impossible for the diaphragm to do its job.  We have to breathe somehow, so the accessory muscles (in the neck) take over, which leads to the aforementioned neck pain.  Now I’m not saying this is the only reason- just the reason I’ve noticed.

photo courtesy of: www.breathtakinglady.com

To further complicate this vanity and neck pain issue, the most important muscles of your neck (deep cervical flexors, which help hold up the head) are the ones that make you look like you have a double chin when you strengthen them.  I often see women jutting their chins out to avoid having a “double chin” in pictures.  Constantly avoiding the “double chin” muscles weakens them, which puts even more stress on the other muscles of the neck! This combination of sucking the belly in and jutting the chin is a perfect recipe for neck pain.

How to help relieve neck pain at home

photo courtesy of: www.theglutenfreeyogi.com

1.     Practice belly breathing and/or diaphragm release.  This consists of letting the diaphragm drop and expanding the belly while keeping the upper part of the chest still.  Sometimes practicing breathing through a straw works.  Sometimes, if belly breathing seems impossible, the diaphragm may need to be “released.”  I do this in my office and can teach you how to do this on yourself if you wish (though I bet you won’t want to do it on yourself because it’s not the most comfortable thing in the world).  I will likely make a video of this in the future, so check my youtube page soon!

2.     “Release” tight neck muscles.  Without getting too technical, this consists of finding the tight and painful muscles in the neck, and pressing on them with something until they are no longer painful (or are 50% better in terms of pain.  Typically this will take between 30-90 seconds.  I like to use lacrosse balls, golf balls, or something like a Theracane or Back Buddy. You may also find it hard to do this to yourself as well, because it will be uncomfortable. I also do this in my office and am happy to oblige.

3.     Do double chin exercises.  I do mine in the morning, in the car, and sometimes when I’m in the gym.  Yes, people see me, and no, I don’t care anymore.  I’m not ashamed of my double chin (If you are a patient of mine, you have likely seen this beautiful display).

So ladies (and gentlemen), when you’re tired of your neck pain…  come see me and get ready to push out those bellies and flaunt those double chin exercises!