A pain in the neck

Photo courtesy of ABMP

​​It was a cool and rainy day last spring. A woman sat in my office describing her neck pain that had been occurring almost daily for months. Her doctor told her it was probably from a pinched nerve in her back, and some arthritis to boot. She asked if she could continue receiving massage therapy and her doctor agreed that it might be helpful. Besides, the October edition of Consumer Reports listed massage therapy as one helpful treatment for osteoarthritis.
She pointed to a spot on the side of her neck, where her neck meets the top of her shoulders and said that sometimes she feels the pain up the side of her neck, into her jaw, and occasionally a headache that she can feel in her eye.
I placed my flattened fingers over the spot that my client had indicated she felt the pain. Upper trapezius, platysma, scalenes… I would address all three, but figured that most of the pain was coming from the upper traps. There are myofascial trigger points in the upper traps that refer pain to the head and eyes and sometimes into the jaw but one has to be conscientious when treating them since the area may already be exquisitely painful.
The traps’ action on the neck is lateral flexion, side bending, and her son had been telling me about how she naps—sitting upright in her easy chair, with her chin nearly on her chest, sometimes with her right ear toward her right shoulder. I have known administrative professionals with a similar kind of pain from holding a phone in a similar way. So, I decided to treat the upper trapezius first.
Paying careful attention to the “V” of the shoulder, the area in between the clavicle and the top of the shoulder blade, the muscle was treated. When I heard “Oooh that’s it,” I hung out on that spot until she said the pain was going away. Then I dug in a little more, but she quickly said that pain was subsiding, too. We repeated the releases one more time.
The upper traps also attach on the head at the superior nuchal line of the occipital bone at the back of the skull. After bringing fresh blood, oxygen and nutrients to the part of the upper traps at the V, the attachment on the occiput was treated. Having the head cradled and fascia manually rubbed and stretched is an experience that most people like. A lot. I found that to be true once again.
The traps are a big muscle, and when I was satisfied that I had left no stone unturned with her upper traps, I sifted through some of the muscles on the front of her neck that could be contributing. We did a myofascial release on the platysma, creating a little space between the chin and the shoulders. I scooted her sternocleidomastoid muscle (the scm) over a little bit to treat the scalenes all the way down to the connection on the first and second ribs. When we finished she sat up, moved her head all around, and said “THAT feels really good.”
If you suspect that your neck pain is from spending a lot of time with your ear toward your shoulder, you might enjoy some myofascial pinning and stretching, too. Try bending your ear toward your shoulder and using your firmly planted palm to pin the muscles alongside the neck. Then slowly unbend your neck and enjoy the stretch of the fascia under your palm. Feels great!

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