If you are looking for practical information you can use right now to help your neck and shoulder pain, you have come to the right place. This free guide will cover the causes of neck and shoulder pain, the home remedies that really work, and the professional options for treatment if that is necessary.
A QUICK INTRODUCTION TO CITY ACUPUNCTURE
Between our three New York City locations, City Acupuncture performs over 25,000 acupuncture sessions a year. Pain in the neck and shoulders is the single most common complaint that we treat. With all that experience we have become real experts in this problem, and now we are happy to share that expertise with you - we hope it helps!
SO WHY DO MY NECK AND SHOULDERS HURT SO MUCH?
When talking about neck and shoulder pain (or really any muscle pain for that matter), it’s important to recognize that your body is made up of a series of muscles, tendons, ligaments and bones that are connected in specific ways. For example, looking at the slightly creepy picture to the left, you can see that the trapezius muscle (highlighted in yellow) runs from the base of the skull over to the shoulder, and then from the shoulder down to the lower spine. By nature anything that effects the shoulder will also effect the base of the skull and the lower back, by way of the trapezius.
Now picture yourself sitting at a computer. Notice the way that your head is pitched forward as you look down at the keyboard. Or picture yourself looking at your phone; visualize where your head sits in relation to your neck and shoulders as you scroll through Facebook or whatever. Imagine the way the trapezius has to stretch in order for your head to pitch forward like that.
Now consider this: Your head by itself weighs about 10 lbs. In order for your head to stay upright, the muscles of your neck have to be able to bear those 10 lbs. Part of how the neck muscles accomplish this is by distributing that weight equally amongst themselves so no one muscle has to carry too much.
The problem comes in with the pitch forward. For every 10 degrees forward your head is tilted, the force of gravity effectively adds another 10 lbs of weight to your head. That's another 10 lbs. that the poor, stretched trapezius has to bear. At some point the weight becomes too much to bear. Your neck muscles are simply not set up to work like that - at least not for hours at a time, day after day.
So eventually, the muscles of the neck have had enough and they start to hurt. We could go more in depth into the chemistry of how that happens, but for the purposes of this guide it’s enough to know two things:
- When muscles are overworked they form knots.
- Knotted muscles can’t bear as much weight, so the body starts to engage the muscles next to the neck to help out. This, plus the nature of the trapezius going from the neck to the shoulders, is the reason that neck pain so often spreads to the shoulders.
DO I HAVE A PINCHED NERVE?
This is a common question. Although very often people do have pinched nerves, it’s important to think through exactly what that means before getting too depressed about it. The fact is that pinched nerves are almost always caused by muscle knots, and they are totally fixable because of that fact.
HOW DO MUSCLES AFFECT NERVES?
The spinal cord is basically a bundle of wires that are running through a tube. The only thing to keep in mind is that this tube is broken in segments called vertebrae, rather than just being one long tube.
Between each vertebrae, nerves leave the bundle in the spine and run out into the body. Forget about the words in the picture to the right, just look at the yellow nerves bundled together in the spinal column, and then exiting the spine and going out into the body in between vertebrae. This is the main way your body communicates with your brain - through electric signals sent via the nervous system. So for example, when you reach down to pet your doggy, the nerve endings on your hand are stimulated, and an electric signal is sent from the hand touching the dog, up the nerve, into the spinal cord, and from there into your brain. Your brain processes the signal, decides what to do (ie pet the dog) and sends that signal back the same pathway to the nerve endings in your hand, which responds by opening your palm and petting the dog. All of this is happening so fast that you are not conscious of it, yet it is absolutely essential to your ability to operate in the world.
Meanwhile, many muscles are attached to the vertebrae as well (look back at the first picture for an illustration). These muscles help keep the spine upright, and also to twist and turn the way your brain wants your spine (and other bones) to move.
Here is the rub: when there are knots (also called trigger points) in those muscles, they can pull the vertebrae of your spine a little bit out of alignment. Remember there are nerves poking out of the space between vertebrae, so when a vertebrae is pulled out of alignment, it can touch one of the nerves. When that happens, you get shooting pains, numbness, tingling, and all the other things people are talking about when they talk about a “pinched nerve.”
In this picture to the left you see a green circle around a "slipped disc" causing the spine to impact the red nerve. The healthy nerves above and below are yellow. The condition pictured probably resulted from a car accident or some other physical trauma to the spine, but the effect is replicated by trigger points without damage to the spine.
So… Get rid of the trigger points in the muscles and they will stop pulling the spine out of alignment, and the vertebrae will stop touching the nerve and the pain will stop. Simple, right?
OK, SO WHAT CAN I DO ABOUT IT?
First, the simple stuff you can do at home:
- Rest. I know, this is not always very practical. The hard fact of the matter is that most of us are not independently wealthy and we can’t just quit our jobs (or take extended sick leave) because our neck and shoulders hurt. That said, it is important to rest those muscles as often as possible, to allow them to unknot so that they can keep working for you with minimal pain.
- Ice or Heat. Ice is very often used to calm inflammation and stop pain, and that’s well and good. HOWEVER, it is important to note that using ice repeatedly over a long period - or using ice for more than 10 minutes at a time - can seriously slow down your overall recovery time. Ice is a vasoconstrictor, meaning it makes your blood vessels smaller (that’s why your neck feels numb after icing it for a couple of minutes - there is very little blood getting to the nerve endings). That numbness is good for stopping pain, but it is bad for allowing your bodies natural healing process to function. For a more thorough overview of this part read this post. It's about knee pain but the principle is exactly the same for neck and shoulder pain as well.
- Stretching. This one is basically a necessity. Even if you decide to pursue professional treatment for your pain, it is a guarantee that your treatment plan will include stretching at home or at work. If you go to a health provider who says you don’t need to stretch the muscles of your neck and shoulders, do yourself a favor and find a different provider.
City Acupuncture has created short videos for a couple of the most important stretches for neck and shoulder pain. Here is the first one, for more go to our youtube channel or just google "neck and shoulders stretch."
If you want to look for other stretches beside those on our channel, just keep in mind it is super important that you are stretching at least the following muscles, so be sure to include them in your search terms:
- The trapezius muscles.
- The rhomboid muscles.
- The levator scapulae muscles.
There are plenty of others that will be helpful (the teres minor, the splenius and the pectoralis muscles all come to mind), but the three listed above should be considered mandatory for a stretch routine. Plan on stretching each muscle for 60 seconds (30 seconds a side), and then use that to determine how many muscles you can stretch at a sitting. If you are at work and can’t take a real break, you may want to stick to the 3 major ones (that’s 3 minutes total). But if you have a little more time, it’s better to stretch as many as you can, as often as you can.
- Self-Hypnosis. OK, this one may seem a little more out there. But, consider this: Pain is caused by a signal from the affected muscle to your brain. Through self hypnosis, you can direct your brain to pay attention to something other than the pain. In this simple self hypnosis exercise, courtesy of Dr. Brooke Donatone, LCSW you are training your brain to focus on your hands instead of your aching neck and shoulders:
Set a timer for 2 minutes and simply tell yourself that at the end of the 2 minutes your pain will be reduced. This may be awkward at first but once you see how effective it is, you will get over your initial skepticism. Now sit straight and put your hands on your lap, palms up. Close your eyes, take a deep breath, and then let it go. Continue to focus on both hands. If your mind wanders, go back to focusing on both hands. Continue until the timer is up.
The trick is that your mind can't concentrate on both hands and the pain in your neck at the same time, it has to choose. Through this exercise, you are consciously choosing to focus on your hands instead of the pain. It isn’t a cure, but at least it may get you through that last report you were supposed to file (or that last Facebook update you had to post) until you can take a real break and let the muscles relax.
- Change Your Posture. Remember that whole “head weighs 10 lbs.” thing from the opener? The great part of recognizing that fact is that you can opt to change your posture and take a lot of the burden off those neck and shoulder muscles.
First off, try to keep your ears level with your shoulders. If you are not sure how to do that, look at yourself in a mirror and adjust your head until you can see that your ears are directly parallel to your upper trapezius muscles. That is proper alignment, and it will immediately take some pressure off those aching muscles.
Another option for checking and correcting your posture: stand up against a wall with your shoulder blades flat against the wall - is the back of your head touching the wall as well? if not, you got problems. Gently push your chin in until the back of your head rests against the wall. that is correct posture, now just try to maintain it.
What to Do When Those Aren’t Enough
Remember that pain works on a spectrum. At one end of the spectrum are the minor aches and pains that will just go away with no intervention, on the other side of the spectrum is a real trauma that requires immediate hospitalization.
Most likely, your problem falls somewhere in between. If your neck and shoulder pain is more than the simple home remedies above can handle, you most likely need one or more of the following in order to recover:
- Adjustment of the vertebrae to put it back in alignment.
- Relaxation of the surrounding muscles (trigger point release).
- A targeted stretch/exercise routine to prevent the problem from coming back.
In our experience, acupuncture is remarkably effective at achieving all three of these objectives. A good acupuncturist provides a safe and effective treatment for both acute and chronic pain without surgery or drugs. Using very thin needles in place of a therapist’s hands allows an acupuncturist to more fully resolve muscle knots in less time that physical therapy. Modern acupuncturists are well versed in both traditional and contemporary views of the body, which allow them to see problems from multiple perspectives. This flexibility allows acupuncturists to treat very complex problems that other therapies cannot. Lastly, acupuncture is able to relieve pain in one part of the body by putting thin needles in a very different part. A good example of this is that there are excellent points for neck pain on your achilles tendons near your feet. So if your neck is very sensitive and you can’t bear to have someone touch it, an acupuncturist is still able to help you, when nobody else really can.
If you are thinking of trying acupuncture and you live in the New York metro area, City Acupuncture offers a first time special for new clients at any of our 3 locations around the city. Returning patients pay $39 on average per session. Check it out or leave a comment below!