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This newsletter is about the causes of neck pain.
Februrary 19, 2012
Neck Pain
Hi ,
Every effect has a cause. It is simply a matter of looking deeper and wider at the sources of neck pain - things you might never think of as a cause of pain.
In general I place the sources of body pain into three general categories: Physical, Chemical, and Psychological. Either individually or more commonly in combination, these sources of imbalance are good sources of pain and dysfunction in our body.
Physical Causes
Physical causes will fall into several categories. The most obvious type is the rapid injury type cause where the stabilizing and movement muscles are overwhelmed and damaged by an injury such as in an automobile accident. Lifting strains, falls, impact injuries like sports, are all examples of rapid injury to joints and muscles that will produce inflammation and pain.
Another very similar mechanism of joint injury is muscle coordination failure. Every movement requires the precise coordination of dozens of muscles right down to the thousandth of a second. Any lag or misfire will cause abnormal motion, joint injury, and resulting inflammation. The coordination nerves are often under performing in the average person simply because of being underused. Without constant use, these nerves degenerate. Any sudden movement can cause a pinch and joint injury results.
Slow injuries to joints and muscles happen in many circumstances. A simple slow strain to the muscle and tendons occurs when you lift too much weight, or lift a moderate weight too many times. Even tiny movements like using the mouse on your computer can cause injury if repeated often enough - the so-called repetitive stress injury. The whole science of workplace ergonomics is based on avoiding this problem.
Another slow injury process is called plastic deformation. What this means is that when you stretch a ligament or tendon by putting the joint into a maximum stretch, the ligament or tendon actually starts to deform by stretching out too much - so much that it can't snap back into its original shape. You can damage a joint as much with this process as you do with an auto accident type injury, yet you won't even feel it while it is happening. This takes place when you are in an awkward position for a long time such as twisting your neck to breathe while sleeping on your stomach.
The last type of slow physical injury I wish to discuss is about posture. This is similar to the plastic deformation problem except here we involve joint compression and joint capsule damage. Posture is all about alignment in relation to gravity. Our body is superbly designed to balance upright in gravity. If we tilt or lean forward our muscles must fight and tense to keep us upright. This tension jams our joints and causes inflammation. When our joints are perfectly aligned with respect to gravity we stay upright with an absolute minimum of muscular effort and tension. Poor posture creates muscular fatigue, joint soreness, and degenerative changes in the joints.
As a wrap up of physical causes for neck pain we must include disease processes that induce pain. Cancer, osteoporosis, degenerative arthritis, goiter, heart disease, gallbladder disease, meningitis, spinal cord tumors, herniated or bulging discs, and so on. The list is long and not much fun. Fortunately I rarely find these types of problems as the cause of most people's neck pain. But they do happen and must be ruled out. Lastly we must consider the unfortunate situation of pain secondary to medical procedures. Although the procedure may have been necessary (such as a spinal fusion), once an area of the body has been changed medically, it will never function the same again - and that usually means some level of chronic pain.
Chemical Causes
A chemical cause of neck pain will involve some sort of inflammatory, neurogenic, or degenerative process that promotes pain. In its simplest form we see chemical pain coming from working out at the gym. The workout involves working the muscles to the point they produce lactic acid and inflammatory cytokines (pain hormones). Your neck muscles might feel pain just because of the chemical changes that take place during your workout.
Another inflammatory based neck pain might be a reaction to a virus or bacteria - a "cold" that settled in your neck. Similarly your body might have a chemical inflammation response to an allergic reaction to some food. Body aches and pains are common reactions to food intolerances. Insect bites and skin reactions can cause the underlying muscle tissues to tighten up and cause neck problems.
A very common problem today that almost no one looks at is the tendency for many medications to produce muscle and joint pain. Even simple drugs like antacids can produce muscle pains by preventing proper mineral absorption from our food. Cholesterol drugs are also famous for producing muscle pains, as are many psych drugs. In this same chemical category are nutritional deficiencies. Not enough calcium, magnesium, potassium, sodium, various vitamins, low iron levels, and so on can all produce muscle spasm and pain in the neck.
A different type of chemical imbalance that produces spontaneous muscle cramping is unbalanced blood sugar levels. When blood sugar drops too low, cells simply do not work right. Muscles will seem to cramp for no reason at all.
Another chemical process that creates pain is autoimmune disorders. In this situation your own body attacks itself. We see this commonly in fibromyalgia and chronic fatigue syndrome. Rheumatoid arthritis is another example of an autoimmune problem that might create chronic neck pain. The most common triggers for autoimmune attacks are grain glutens and dairy foods. These foods trick your body into attacking itself and creating pain if you are sensitive to them. These types of sensitivities are not allergies, but actual genetically programmed reactions. As we are talking about the immune system, it is valuable to understand that the immune system is an extension of the emotional portion of the brain and as such responds heavily to emotional stressors.
Neurogenic pain is a "chemical" inflammation/pain response to nerve inflammation, often from other areas of the body. For example we are all familiar with shingles, which is an infection in the spinal nerve root, but we feel the pain wrapping around other areas of the body. Gall stones will refer pain to the right shoulder and neck; and heart trouble may refer pain to the left shoulder and neck. Headache pain often radiates down into the neck. Digestive trouble loves to send pain signals up into the neck. In fact trouble almost anywhere can refer pain almost anywhere else.
Another whole category of chemical pain is the consequence of exposure to toxic chemicals and drugs causing nerve, muscle, joint, or bone pain. This can be very tricky to diagnose, but when the offending toxin is eliminated from the body, people can enjoy relief they were not able to experience any other way.
Lastly we have to look at the "chemical" imbalances that occur due to an imbalance between the two halves of the nervous system - the sympathetic (flight or fight) system and the parasympathetic (relaxed healing) system. This interaction starts to move us over into the next section on psychological causes of neck pain, but we also get imbalances in these systems due to brain degeneration as in Parkinson's disease. The sympathetic nerves feed primarily the flexion (pull forward) muscles in the front of the body. That is why when we are in fear or anger our body curls up or hunches forward. These two systems are designed to be in balance with each other. Chemical changes that occur with aging cause an imbalance toward increased sympathetic and less parasympathetic activity. That is why old people tend to bend forward.
Similarly brain hemisphere dominance issues (right side verses the left side) produce right/left body imbalances like one side of the neck being tighter than the other. Blood flow issues and brain inflammation might create these problems.
Psychological Causes:
There are many ways in which our mental and emotional states can cause pain. The simplest and most obvious is stress causing muscle tension in the neck (as in "my boss is a pain in the neck"). We carry tension in many different muscles of the body, and neck muscles are one of our favorite spots. Many people tense up in the neck whenever they are faced with an unpleasant task, or when they get nervous or shy.
Beyond simple tension in the big movement muscles is another type of muscle tension pattern that occurs in the smaller stabilizer muscles. These muscles are for posture and gravity alignment primarily. But these muscles are also for communicating our feelings through body language. Throughout the body these muscles tense and produce postural changes that let others know how we feel (even when we ourselves do not know what we are feeling.) Just like the facial expression muscles around our eyes, these muscles are always at work sharing our inner feelings with the world. Just look at the posture of someone who is angry and belligerent compared to someone who is sad or someone who is happy. The more negative the feeling, the more discomfort (pain) the muscles create.
What happens when a person has conflicting feelings? We have many different parts to ourselves because we have many different needs. For example, the need for acceptance may be in direct conflict with the need we have for independence. When both of these feeling states try to express themselves in the body at the same time we can get some serious neurologic and muscle confusion. This creates pain and tension. An important understanding is that these conflicts are often subconscious and hidden in the back of the mind. Interestingly the literal back of the mind is the brain stem where muscle balance is coordinated. I see patients all the time with pain that "came on for no reason" that are showing obvious muscle conflict due to emotional or mental conflicts. Sometimes I will share what I am seeing and suggest a shift in perspective or change of action that resolves the conflict and suddenly the persons pain releases and stays released.
Emotional muscle tension patterns are not random either. Each muscle in the body responds to different specific feeling states. In fact each and every vertebra and spinal nerve in the body reacts to different feeling states. When we are in a state of internal harmony, the muscles and joints are strong and balanced. When we are in internal conflict and disharmony joints become unstable and easily injured. Anyone who does weight lifting or distance running is aware of this reality. Some days we are strong and our endurance is good and other days we can lift half as much or run half as long. Sometimes this is because of what we had for dinner that was not a good choice, but often it is because of feeling conflicts and unresolved issues hiding in the back of the mind.
Many therapeutic techniques exist to release emotional and mental tensions. Everything from psychotherapy to bioenergetics to acupuncture can be effective in releasing the tension buildup that produces symptoms. Even better is to grow spiritually to resolve the beliefs and attitudes that create the conflicts in the first place. This is considerably more difficult as we get very identified with our beliefs and attitudes and our egos greatly resist any such changes. But the essence of spiritual growth is the release of ego and replacement with character virtues.
From a different viewpoint, pain and tension that appears without obvious cause can be used as a personal feedback tool to let us know when we have subconscious conflicts coming to the surface. We are basically invisible to ourselves. We either need other people provide us feedback as to what we are really putting out to the world, or we can use the feelings of tension in our own bodies to get input as to where we are coming from day to day.
Neck pain, like pain anywhere in the body, has many different possible causes. Getting rid of the pain might be as simple as changing the height of your keyboard or as difficult as growing up. The first challenge is finding out what the pain is telling you about its cause. If we are dealing with a physical cause, then physical interventions are needed to resolve it. Chemical causes generally need dietary changes or special nutrition, and psychological causes require supportive feedback and guidance to root out the conflicts and grow to a new place of standing with life. Neck pain is a lot more than just a pain in the neck. I have to consider all these possibilities when I work with a patient. Most of the time there are several different things going on. We are complex creatures, but we are designed to heal and grow.
So if you have neck pain, don't give up hope. Know that there is almost always an answer, but the answer might not be anything you would think of. The answer may involve several different shifts and changes to produce resolution. Healing is a journey - sometimes simple little steps are enough and other times it challenges us to our very core. It is all purposeful. It is all good - even when we don't like the pain.
Take care,
David
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