April 14, 2020
Mechanical neck pain is a blanket term for when there is muscular pain in the neck and shoulders. This means that everything is okay within the cervical spine (neck) in terms of the facet joints, disc and vertebrae but that the muscles that attach to the neck are causing the problem.Usually patients complain of pain and tightness in the muscles in the neck, shoulders and mid back which can refer into the head down the arms or down the shoulder blade. This can be caused by a variety of things; overuse of muscles, poor posture, and structural imbalances such as weakness in other muscles.
Typically, one of the most common problem muscles is the upper traps. The Trapezius is a large muscle that consists of three parts, the upper, middle and lower traps. The upper traps span from the top of the shoulders to the neck and play an important role in elevating or lifting up the shoulders. In addition to this they also help to rotate, extend and tilt your neck. If you work at a desk, driving or in manual labour you may have tendency to elevate the shoulders and find that you constantly have tightness in this muscle. It is common for this muscle to havean increased amount of active trigger points or ‘knots’ which causes pain in the muscle, referred pain and reduced neck movement. The referral pattern for the upper traps is down the shoulder blade and up into the back of the head. In some cases, the upper traps can also be in spasm causing muscle pain, tightness and reduced neck movement.
Another common problem muscle in the neck is the levator scapulae. This muscle extends from the back of the neck to the tip of the shoulder blade and it’s main job is to lift the shoulder blade. It also helps to rotate, extend, flex and tilt your neck. Similar to the upper traps this muscle can become tight and have an increased number of trigger points that can cause local or referred pain and reduced neck movement. The referral pattern for this muscle is most commonly down the shoulder blade.
Putting heat on the tight muscles around the neck will help reduce tension and pain, you can use a hot water bottle or heating pad and leave it on for 20 minutes. Anti inflammatories can help to reduce pain but speak to your Pharmacist before taking any medication. Stretching the upper traps and levator scapulae can help to reduce muscle tightness and pain. Furthermore, massage and dry needling can also help to reduce muscular tightness and trigger points.
Upper Trap Stretch: bring your right ear to your right shoulder and gently pull your head with your right hand while pressing your left arm towards the ground. Repeat on the left side, 30 seconds x 3
Levator Scapulae Stretch: Rotate your head to the right and bend your head down so your noes is towards your armpit. Gently pull head with your right arm and push your left arm towards the ground. Repeat on the left side, 30 seconds x 3
While the above treatment options will help to reduce your pain and give you relief for a while it is important to understand what caused the problem in the first place. Making sure you have correct posture and ergonomics will help to prevent the pain from returning in the long run. Additionally, exercises that work on building up muscles that are typically weaker such as the lower traps can help to bring the shoulder back into a better position and reduce pain in the neck. Pilates is a great way to help build up core strength and improve posture and many of our patients see long term relief from this.