Daily neck pain affects almost all the people that I see, at some point in their life. This type of pain is one of the following: its already there upon waking and gets better through the day, or has arisen gradually over time, or is the result of an old injury in the past and not completely healed. If your pain is the result of a recent injury within months of an event, or ongoing pain related to vertebrae fusion, hardware, nerve damage and other diagnoses, please continue seeing your PCP for care and referral. This article is not meant to treat or diagnose neck issues, but rather give an overview of common causes, and exacerbating habits that we as a culture have accumulated.
However, I have homework for you if daily neck pain (not from serious Dx) is affecting your quality of life. Let's do it.
We need to evaluate if your neck pain is related to your pillow. If your neck pain is present upon waking, you likely need a new pillow solution. Your pillow should support your neck through the night to allow your neck to feel pretty good first thing in the morning.
The bigger the pillow is, the worse it could be making your pain.
What we want is for your sleeping posture is for the back of the head to be somewhat flush and horizontal. When the back of the head is propped up by a large pillow, it's held in a head-forward posture, meaning that your head is pushed forward and away from in-line with the spine.
The principle of efficiency: the body will hold whatever positions we are in the most, whether we are aware of it or not. Its also referred to as body memory. Our oldest, strongest habits and postures are the default, underlying pattern and they are present in some way, even when we are "trying to sit up more." The other side of this coin is, if we train our bodies, little by little, more and more, we can create better default patterns that are good for us and we won't have to think about them.
Your body will hold the default pattern, strongly and unconsciously. And that's amazing in the countless times a day it helps us - unless of course the default pattern causes muscle imbalances, then, uh-oh. That's why we need to address how we sleep because we do that a third of our life.
The pillow should support you in the nape of the neck, not the back of the head. When you rest, note if your head is held further forward than your chest. If so, your sleeping posture is holding you in a neck-forward, or "front-loading" posture that you are likely to repeat throughout the day, because of that principal mentioned earlier. We want a sleeping posture where the nape of the neck is fully supported, allowing the back of the head to be flush with the bed, in line with the whole back.
It is too bad that those pillows by Posturepedic or the one you bought from your chiropractor did not help. It is. I know. The size of the form that sits under the nape of the neck, or its density is probably not appropriate for you. They come fit one, fit all... but for many of us, they don't help. Until you can find a better pillow, you can get the smallest pillow in your house, and curl the edge up under your neck. That's a start.
Here is a list of pillows I recommend trying, and they are not too expensive
Back sleeping: fantastic.
Side-sleeping: Please keep your spine and neck straight and either support your upper arm with a pillow or have the top arm resting at your hip. We want to get out of the curled-up fetal position into a position where the chest is open and the neck is long.
Stomach-sleeping: No amount of massage, chiropractic, physical therapy, or other homework can help if your sleeping posture undoes the work every night. I'm really sorry, that's how the neck is. I want you to be pain-free. Here are some suggestions about coming out of this habit.
Getting out of bed
Please roll gently to one side and push up with your arms. Sitting up straight from laying on the back will immediately tighten the front neck muscles. Its also a nice way to set the intention early in the day to notice and care for the neck. Little changes like these go a long way. We are starting a gradual process of exchanging neck-forward postures and movements to more balanced ones.
Massage Therapy, Craniosacral Therapy
Regular bodywork of some kind for a distinct window of time should be helpful in reducing distressing symptoms. Under this category is also physical therapy, acupuncture...The list starts there. The higher in severity the symptoms the more often you can go, such as once a week for a month or two if necessary.
For long-standing neck pain, please also see Chronic Pain Recovery in Six Steps.
Neck-forward posture, or front-loading
Observe yourself in the mirror so that you can see yourself at profile in a posture that is normal for you. Are the ears stacked in a line above the shoulders? Is the chin in front of the chest? Most of us will have our heads in front of our chest. However, for our spine, nerves, head and neck to function well, ultimately we need to work on getting our chest, or sternum, or heart to be in front of our chins, our heads. One step at a time.
As you observe yourself in profile, notice the muscles in the back of the neck - they may likely be on overstretch as your 9lb head is being tilted forward and often, down. The muscles on the front of the body: the ones that move our arms especially, overpower the muscles that stabilize the neck and back muscles. And this is natural: our eyes, our arms, our work is in front of us, however without a variety of movements and demands to compensate, our bodies get used to being forward and next thing you know, gravity starts holding us there.
The front and back muscles need balance to function; balance as both are at their proper length, keeping us steady ever straight upward like a tree. When a muscle group is overpowered and forced to do its balancing job on overstretch...those muscles, the ones in back, eventually get cranky.
Re-train the neck with this gentle exercise and your neck will change.
Our body responds to the demands on it. In order to re-program the demand, we need to enlist frequency and dosage (dosage in this case means length of time).
Twice a day, lay on your bed so that your head is leaning off the edge of the bed. Have it be a gentle stretch, not so severe that you can't stand it. Its really important to come out of the stretch very carefully - gently scooching down toward your feet with the neck relaxed and supported. Then roll to the side as in #3 Getting out of bed.
If you are experiencing pain, lessen the angle of the stretch. Baby steps preferred over leaps of flexibility.
Start at 2-5 minutes at a time for a week. Move up to 5 minutes, twice a day for a week or two and then move up to 10 minutes twice a day. The muscles in the front of your neck will change. They have to. This will allow the neck a gradual but persistant change. Consistent effort is key. If you forget or drop-off, just pick up again with full effort, no worries. Allow for 6 weeks of this exercise.
Heart-first alignment, physical and emotional
The rest of this article looks at the larger journey of coming out of head-first posture, as it is a major contributor to neck pain. Let's let it be a slow, gradual journey, which is easier to commit to, and has best results in my opinion.
Remember, the head and neck will need to stack onto a solid core.
Do you have that?
If not, don't worry.
Click on the image to learn a gentle core training.
Neck pain, and also back pain, affect so many people because of the sitting culture in which our developing bodies sit in chairs most of the day, most of our lives. Posture that creates misalignment is not an individual failing but a societal blind spot, until recently.
Our optimal functioning is literally de-conditioned by sitting in chairs.
For most of us, there is also slouching forward in the upper and lower body that lets our postural muscles go lax and weak, having little left to support us as they are intended.
The head is at least 9lbs and was meant to float on top of the cervical vertebra. This can only happen when the cervical vertebra is floating on top of an upwardly rotating ribcage, which is held up by healthy abdominal muscles, which are cued into their position, or muscle tone, by a healthily toned pelvic floor, which is informed by healthy hips, and legs, and low back.
This also includes a de-conditioning of an important energy center that gets occluded in this posture: the heart. Instead of describing this, you may want to experience it for yourself in the next section.
Holistic Re-Training: from Head First to Heart First
note: please do not ascribe time limits to the steps
Notice where your head is, in relation to your chest, sternum, or heart. Be grateful for a functioning body and for the curiosity you have to allow you to search for and implement healthy possibilities. That is a ton of great stuff working for us right there, without a doubt.
Sit on your "sits" bones, whether its in a chair, or on the floor. Notice your breathing. What of your chest or abdomen moves. What doesn't move. Or when standing, notice your feet on the ground, on the Earth as it pulls you to it and also holds you up.
Notice and engage the pelvic floor while you breathe. Engage the abdominals.
Allow your ribcage and heart to hinge upward from the bottom of the ribcage. Allow your head to float above the collarbones....with the heart, sternum, chest, ribcage forward.
Notice your heart is now in front of your head. Its a different placement, a different composition. It enacts a new set of responses, and perhaps sensations. What does this feel like to you initially?
Couple this exercise with Sitting Butterfly to allow your body to adjust, and how it feels will continue to evolve, and continue to get easier.
Notice and inquire why its challenging to be "heart-first" in this world. Notice and inquire what comes up for you with the prospect of living "heart-first." Honor this lovingly. If you wish, notice and inquire what life would be like with more "heart-firsters" in the world.
Be aware of the potential of your availability for physical-mental-emotional-spiritual healing to support whole-person openings in the heart, and learning energetic boundaries that protect your "heart-first" way of being. Seek and you will find.
I have a special treatment for the Four Chambers of the Heart that many have found very helpful to revive one's own inner resources in the heart.
More heart-first resources here at HeartMath Institute. They also offer free, monthly, 30-minute trainings in heart resonance designed by Ph.D.'s, to "power-up our intentions to add more heart to our world and incorporate heart intelligence into your day-to-day experiences and interactions." Sign-up for Heart Calls here.
Whether its to relieve your daily neck pain or to develop a heart-first posture or way of being, you will benefit from beginning the journey, along the journey, and when your being has adjusted to the new way of holding yourself. Your physiology will then hold you up, and support your higher well being, including your goals, purpose and joy in life.
That's what health is. To meet the dynamics of life, connected to our inner support and resources.
Today let's begin again. May you be happy.