There are two main causes of neck and shoulder pain: structural stress and compression. Virtually all types of conditions and injuries that lead to neck and shoulder pain will have structural stress or compression as main components.

Structural Stress The most common characteristic of structural stress or poor posture is chronic slouching which causes what is known as a forward head. Slouching forces the head forward in relation to the ribcage, causing the small muscles of the neck to have to constantly hold up the ten pound weight of your head so it doesn’t roll forward and off your shoulders. Imagine how difficult that becomes after a long day at work! Now, repeat that over and over for weeks on end. No wonder your poor neck and shoulders are in pain! Structural stress can affect how far you can turn your head. To illustrate this, sit in an intentional slouch and turn your head to look to the right and then to the left. Notice how far you can turn in each direction. Now, sit up nice and straight and again turn your head to the left and right. Do you notice a difference in how far you can turn? Most people do. Did you also notice that turning in each direction while sitting up straight is more comfortable? This is because when sitting up straight, all the muscles and bones in the neck and upper back have room to move and do not get in each other’s way. Thousands of people suffer from pain at the area where the neck and the upper back meet. Chronic, and usually unconscious, raising of the shoulders causes the structural stress in this area and leads to a pretty surprising level of pain that travels from the upper back just above the shoulder blades and up the neck to the base of the skull. The muscle usually involved in this discomfort is known as the Levator Scapulae, the muscle which elevates the scapula, or shoulder blade. Pain is usually felt when the head is turned, or if slouching is chronic. Slouchers will find that they unintentionally raise their shoulders just a little bit as they sit in an attempt to relieve the pain in the area. Alas, this never works and actually adds to the pain level over time. Artificial means that raise the shoulders can also help to create this pain. Sitting with arms resting on armrests or on a table or desk can cause pain in the levator scapulae. So, too, can holding the phone between the shoulder and the ear. Find other ways to sit at your desk, workbench, or kitchen table and start using a headset or speakerphone to talk on the phone!

Compression The bones of the neck are stacked on top of one another, like a stack of children’s building blocks. The muscles of the neck are like two strong, wide elastic bands on either side of the neck holding the bones in a stack. The discs between the bones form a cushioning and shock absorbing layer that protects the spinal cord and the base of the brain. Discs can be illustrated by imagining marshmallows between the stacked building blocks. If the elastic bands, or muscles, are balanced and in good condition, there is ample space between the bones of the neck to avoid squeezing of the disc spaces. If, on the other hand, the elastic muscles along the sides of the neck are too tight, then the disc spaces are squeezed, squashing the discs (or marshmallows in our example), leading to bulging discs. In severe compression, the walls of the discs break down and lead to herniation of the discs. Pain is the result. Compression forces the irregular shape of the bones of the neck to come closer to one another. In this state, they tend to get in the way of one another and make it more difficult to turn the head. Often, people will begin to try to unconsciously correct this situation by shifting the head even more forward, or by raising the shoulders to create slack in the muscles at the side of the neck. More pain is the result.

Massage provides relief The antidote is the relaxation response.  During the relaxation response, your endocrine and nervous systems activate changes to slow your heart rate, improve your circulation and digestion, and relax your muscles—in direct counteraction to the stress response.  There are many activities that can trigger the relaxation response such as exercise, deep breathing, meditation or listening to soothing music.  One of the best methods to combat stress is therapeutic massage. 

When you are overtaxed and running on empty, massage can help you recharge and restore the energy and creativity you need to successfully meet your challenges in a number of ways:

Release of muscle tension: During massage your tight muscles tend to relax, relieving painful muscle tension that can sap your energy.  Though the effects of a single session may be temporary, a well spaced series can actually reverse chronic muscle contraction.  Massage also stimulates the release of endorphins, your body’s natural pain killers, giving you a “pain break” and creating a sense of well-being. 

Increased circulation: Massage increases circulation, clearing out accumulated stress hormones and waste products that can make you feel tired and sore, and bathing your cells with nutrients vital for tissue repair.  A short-term increase in oxygen to your brain can reduce mental fatigue and improve your ability to concentrate and attend to your problems.  As your tissues are cleansed and flooded with nutrients, you may even experience relief from emotional symptoms such as anxiety or depression, along with a renewed sense of optimism which can last for days. 

Improved sleep: The quality of restful sleep usually improves in the days following a massage.  This gives your body a chance to further repair and restore your energy levels.

  Psychological support: Finally, massage gives you a measure of control, just knowing there is something you can do to take care of yourself when you need it, massage helps you feel less at the mercy of external events. A program of regular massage will put you in touch with your body, teaching you to monitor its signals and needs so you’ll know when you should take time out from the things that worry you.  In this way, you can avoid the damaging effects of chronic stress and gain some control over your sense of well-being.  

Self Care  Neck and shoulder pain responds very well to slow and gentle stretching of all the muscles involved in supporting the head, neck and upper back. This means that a good overall stretching program should include stretches for the front, sides and back of the neck, the chest and the upper back and shoulders. Remember that the armpits are part of the shoulder girdle and the muscles that pass through the armpits often play a big role along with chronically tight neck and shoulder muscles. It is really important to stretch all the muscles equally as they are all dependent on the condition of each other as they support the weight of the head. When stretching the neck muscles, it’s important to remember that the relatively small muscles of the neck have a really big job to do. That is, they are responsible for holding up the ten pound weight of your head for the entire day, no matter what position you put your head in. And, some of these positions can be very stressful indeed! If the muscles in your neck are in pain, avoid adding stress to them by supporting the weight of your head while you are stretching for the safest and fastest results. Drinking plenty of water is always important with any muscle or soft tissue imbalance. Adequate hydration is important for restoring the normal sliding and gliding characteristics of connective tissue. Keep drinking lots and lots of water! Neck and shoulder pain often develops as a result of poor posture. Correcting your posture is one of the most helpful things you can do to avoid neck and shoulder pain in the future. Trying to remember to sit up straight, avoiding the unnecessary raising of your shoulders and keeping your head situated squarely over your shoulders is a challenge to be sure. But, the payoff is huge in terms of pain reduction and relief.  


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