Chronic neck pain can affect someone’s quality of life in a lot of ways. Whether it causes a poor quality of sleep, difficulty looking for traffic, or general daily irritation, neck pain is one of the most frequent issues I see in my office. Many different factors can be at the root of this pain, but most of these causes will respond to the right treatment.  

A patient I will refer to as Melanie is one example of how various factors cause neck pain, as well as how relief comes with the right kind of care. Melanie had severe neck pain from whiplash caused by a recent car accident. However, x-rays also showed that she had been suffering from severe arthritis long before the accident, even though she was not aware of this. Her neck pain was so disabling that she had started to contemplate surgery. 

She underwent a course of treatment at our office, consisting of fascial release therapy, joint stretching, and rehabilitation exercises. Melanie’s pain improved from an average of nine out of 10 (where 10 is the worst imaginable) to two out of 10. She was able to return to work, and no surgery was required. Several issues contributed to her pain—as is common with neck problems—so let’s examine some of those underlying issues.   

Arthritis 

It’s a frequent assumption that arthritis is a major cause of neck pain. However, what many don’t know is that research shows only a small correlation between how much arthritis you have and how much pain you might feel in your neck.   

That’s because the same underlying causes of “wear and tear” arthritis can also result in pain, these two issues are not always interconnected. Muscular weakness, joint instability, and uneven muscular tension can cause both pain and arthritis simultaneously—or either one independently. In other words, just because you have arthritis and pain, this doesn’t mean arthritis caused the pain. More likely, there’s a deeper root cause. In my experience, most arthritic changes only lead to stiffness or mild achiness in the neck.  

Despite severe arthritis, Melanie had no neck pain until her accident. Of course, the arthritis could have weakened her neck, causing her injury and pain reaction to be more severe. Her relief, however, was not a result of treating arthritis itself. We’ll discuss this below when we look at the connective tissue called fascia.    

Posture and Pain  

Another issue that relates to neck pain is posture. Many neck pain sufferers also have a forward head posture. This means their ears are positioned forward, rather than centered over the shoulders. The restrictions that cause forward head posture can contribute to neck pain as well. In fact, for every inch that the head is forward of the shoulders, this unnatural position will multiply tension at the base of the neck by 10. 

While postural issues often require professional care, some can easily be corrected with ergonomics. For instance, is your computer screen at eye level? If it is too low, too high, or positioned off to the side, this can lead to neck pain.  

Whether or not these factors lead to pain is contingent on the frequency of use. Occasional computer use is not usually a problem. However, I have seen patients who use a computer for hours on a daily basis, and looking at the screen in a hunched position for this much time each day will often result in pain.  

 While postural issues can activate neck pain, not everyone with poor neck posture will suffer from neck pain. For instance, some of my patients believe that mental or emotional stress is a cause of their neck pain. In my experience, stress amplifies the extent of pain or brings it to the surface, but it isn’t the underlying cause.   

When the physical cause is dealt with correctly, similar levels of stress will no longer cause pain. In Melanie’s case, stressful days exacerbated her pain, but after successful treatment, stress had minimal effect on her pain levels.    

Fascia and Pain 

The most common issue that I find at the root of my patients’ neck pain and arthritis is fascia restriction. Abnormal tension, stiffness, or distortion in this fibrous connective tissue can alter muscle tension, joint alignment, and joint stability. This results in stiffness and pain, leading to the tissue breakdown that results in arthritis.  

Fascia restrictions are frequently caused by prior injuries, postural stress, or repetitive motion injuries. While mental or emotional stress itself is not a direct cause, the muscle tension that it brings can lead to stiffness or restriction in fascia.  

Restricted fascia is most easily treated with gentle hands-on compression techniques, such as Residual Strain Therapy. Densified fascia—where the connective tissue is thicker, less pliable, and tender to the touch—is most effectively treated with pulsing pressure or specialized stretch techniques. Restricted fascia is not the same as a muscle knot or “trigger point.” In fact, trigger points in muscle are usually caused by fascia restriction, so when the fascia is released, one or several nearby trigger points will disappear.  

The results that come from treating the fascia are due to improved proprioception, or “position sense.” These nerve endings contribute to the position sense we use for coordinated motions, and these exist within the fascia. When we correct restricted fascia, we also improve position sense, which enhances muscle coordination, joint alignment, and stability.  

This can make all the difference for a problem such as neck pain. For Melanie, releasing fascia restriction was the key to her lasting pain relief. However, while fascial restrictions are a likely cause of arthritis, treating the restrictions will not reverse arthritis, as this condition is a permanent tissue change. Still, I have seen many patients whose arthritis stopped worsening after a comprehensive and successful fascia treatment.   

Complete Neck Care  

In addition to fascia release and ergonomic improvements, other therapies can also relieve neck pain. Stiffness or pain can lead to weakness in the neck muscles which, in turn, can exacerbate this pain. Learning how to safely strengthen the neck is vital in this case.  

Sometimes whole-body posture affects the neck, so you might need to strengthen the core muscles—or even the hips—in order to relieve postural stress in the neck.  In some cases, when there is significant arthritis or disk degeneration in the spine, traction or decompression therapy can offer relief as well. This can often be done at home with inexpensive equipment, upon the recommendation of a qualified healthcare practitioner. 

 Each case of neck pain is unique, and no two sufferers will require the exact same treatment. However, as a general rule, I find it effective to change lifestyle habits first (computer screen height, for instance), treat fascia restriction next, then strengthen your muscles once the joints and tissues are working correctly. For most, this is a successful formula to ease that “pain in the neck” and achieve the lasting relief you need.   

Dr. Eric Winder has 25 years in practice with a focus on relieving pain and restoring alignment and motion through fascia release therapies. For more information, visit https://gentlebay.com/