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Neck pain has become more prevalent over the last decade probably as a result of increased computer usage, especially hand-held devices and tablets. Anybody that has had chronic neck pain knows how un-fun it can be. In fact, for some, neck pain along with its oft-associated shoulder pain, arm pain, or numbness/tingling can be unnerving, and enough to drive one slowly insane (I know, I speak from experience). So the following are the ten steps necessary to beat neck pain:

The first is to go see a chiropractor. Don’t delay—the longer you wait, the harder your neck pain becomes to treat, and the longer you can count on its sticking around. Neck pain can be stiffness, achiness, sharp or shooting pain, or severe pain on movement. If you have neurological symptoms—like numbness and tingling—in a limb, you really can’t afford to wait. Don’t lose limb function—get to your chiropractor (or medical doctor) right away.

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So you’ve beaten neck pain this time, and I am sure you don’t want to go through that battle again, so the best thing you can do to avoid a rematch is to be conscious of your posture and biomechanics when you exercise. Biomechanics is the way the body moves, and doing so properly will be the difference between looking and feeling good, or breaking down structurally. That’s right—poor biomechanics will lead to increased joint degeneration, tight muscles, sprains, strains and other injuries. So remember to keep your shoulders retracted when you workout, whether lifting weights, dancing or doing yoga.

Retracted shoulders are the proper biomechanical position for upper body movements, so always keep that in mind when working out. This should keep your neck and shoulders operating smoothly throughout your lifetime. Neck pain is no fun—I speak from experience—so the best defense is a good offense: attack future neck pain by creating the best environment for you neck, shoulders, and upper back to function. You won’t have to suffer or find yourself under the surgeon’s knife one day if you listen to me now. Whether you are trying to beat neck pain now, or prevent it from happening in the future, follow these ten steps and you can’t go wrong.

56569871 (Copy)When it comes to beating neck pain, and preventing it from rearing its ugly head in the future, posture must be addressed. Good posture has so many benefits that not correcting yours now is a huge mistake, but if you have been having neck pain, then you’ll need to do it now anyway, or you just won’t feel better for very long. My absolute favorite exercise to get the good posture ball rolling is the Brugger Relief Position—it’s called a relief position because once your postural muscles become used to the movement, this pose should feel great. Watch the video below to see the proper way to do the Brugger Relief Position:

This position conditions the postural muscles which hold us upright when we sit or stand. It has some similarities to the chest raises, but you do not have to squeeze hard in this one—just light enough to feel the contraction should do. The combined moves in the Brugger are some of the fundamentals of good posture, so practice liberally—five times per day is perfect, and just come back to it periodically throughout your life. Simple. Finally, let’s talk biomechanics:

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Once inflammation has been diminished, muscle spasms reduced, and muscle tissue decontracted it is time for lengthening the muscles of the neck themselves. Although a number of neck muscles could use stretching, the upper trapezius and levator scapula are two of the most common muscles involved in neck pain. Further, due to stress or simply poor posture, both these scapular elevators get short and tight over time. Watch the video below to see the best stretches for the upper trapezius and levator scapula to help beat neck pain:

It is important with these two stretches to do the steps in order; if you miss a step or combine them, you will not feel the stretch, so if you mess up a step, start over from the beginning. Avoid the temptation to pull on your head to help get a better stretch; what I show in the video should be enough. Now let’s talk about posture:

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Schroeder-Piano (Copy)One important factor in beating neck pain is to strengthen and stabilize weak areas such as the upper back and shoulders. Since we spend so much time in activities which have us flexing our upper torsos (think Schroeder playing the piano), it is no surprise that the upper back muscles get weak or inactive as a result. Strengthening this region, then, is of the utmost importance. My favorite exercise to carry out this task is the chest raise—simple and effective…no bells, whistles, benches, cables, kettlebells or five-finger shoes needed. Watch the video below to see how simple the chest raise is to do; but don’t mistake its simplicity for easy—this exercise is tough, especially if your upper back extensors are deconditioned.

People will often ask me if they should do this exercise with weight. The answer is NO! Gravity will provide the resistance. Weights will simply have you recruiting muscles you are not attempting to strengthen. If not challenged by this movement, then you may not be deconditioned. This is a rehab exercise, not a gains exercise. Stick to your tried and true for muscle growth. But like any other contraction, muscle tissue is being micro-torn, which will then repair, so giving a minimum of one day rest between sessions is imperative. Drink lots of water too (two liters), always. And get ready for the next stretch: the neck stretch…

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Once you have had your neck pain spasms and hyper-contractions addressed, you can now start stretching. While a number of neck and shoulder muscles will need to be stretched for a comprehensive recovery from your neck injury; one of the most fundamental—one which I give to every one of my patients that has neck or shoulder pain—is the pec stretch. The pectoralis major and minor are the two muscles that make up the chest. Although both will need stretching, the pec minor in particular can be problematic when short and tight. Because of its insertion point on the scapula (shoulder blade), a tight pec minor will roll the shoulders forward and the chin forward and out (anterior head carriage), which creates quite a strain on the neck.

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Watch the video below to see the best pec stretch to relieve neck pain.

The pec major will also need stretching. Watch this video here (don’t be fooled by the title) to learn the best pectoralis major stretch to relieve neck pain.

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Two things happen to muscle tissue: One is they get short and tight, and two is they can remain in contracted state. Shortened muscles are your typical “tight” muscles, which you can stretch to provide lengthening. Contracted muscle on the other hand can be stretched til the cows come home, and they will not de-contract. Muscle spasms are an extreme example of this hyper-contraction. Try to stretch a spasm and all you will do is make it worse, because the muscle will reflexively oppose the lengthening (that’s why they have spasmed to begin with—the incredible Innate Intelligence of the body). Decontraction is best carried out with a technique called post-isometric relaxation (PIR). As the name implies, it involves relaxations (decontraction) after a light contraction. The idea is we need to contract to relax. Watch the video below for a demonstration on this enormously effective relaxation technique:

PIR is so effective, and hyper-contracted muscle so painful, that this technique alone can be the answer for your chronic neck pain–you know the kind: the one that has sent you to a multitude of doctors, chiropractors, therapists and acupuncturists, none providing the complete relief of that painful neck that you’ve just wanted…to…stretch…out, but it never seems to help. That is usually a hyper-contracted muscle and you need PIR.

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Once the inflammation connected to your neck pain has diminished, you can start to receive muscle work. Muscle work, in this context, can refer to anything from massage, to trigger point therapy, to post-isometric relaxation (PIR). Although it is imperative for inflammation to be reduced, a practitioner can work around any inflamed area, so therapy for the upper back, for instance, can be very helpful to the person suffering from neck pain. Muscle spasm, a common reflexive guarding response to many neck injuries, can also be reduced with electric muscle stimulation. Watch the video to see a demonstration of this type of therapy.

Because the muscles can be such a large component of neck pain, wisdom is in addressing the muscle tissue to return blood flow, break up scar tissue formation, and realign the connective tissue fibers being laid down by repair cells so that this soft tissue can heal properly, and with least potential for creating an environment of chronicity (scar tissue, poor blood supply, trigger points). Once the neck pain muscle spasms have been reduced, those hyper-contracted muscles need to be relaxed.

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Neck pain - Palm Desert chiropractorIf you are dealing with an acute injury—ligament sprain, muscle strain or herniated disk—you will need to ice the area. The best way to tell if ice is necessary is to poke around the painful area. If the painful points are easily found and are tender to the touch, that is a good indication you need to ice the region. Icing is a very specific activity, which can make or break your healing, so following the proper icing rules is essential. Watch the video below for the proper way to ice an acute neck injury.

Ice breaks inflammation—that vital part of the healing process that can act destructively when allowed to sit around for too long. Inflammation has an interesting characteristic, whereby it causes a diffuse pain (wide area, difficult to pinpoint). As inflammation decreases, pain becomes more localized. These are a few more signs that tell you the need for ice. People often ask about using anti-inflammatories, like Motrin, instead of ice…I wrote a piece on it here, and will leave it to you to read up. Once inflammation has been reduced sufficiently, you can move onto the next step

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Neck pain - Indio chiropractorA good chiropractor will give you a full evaluation—physical, orthopedic and neurological. Most neck pain has a complex of factors, from spinal, to muscular, to fascial, to disk, and each one needs addressing. Some factors you can take care of yourself, but others just need professional care.

If you have fixated spinal joints (subluxation), you will need a chiropractor to release them. No rest, stretching, exercising, heat, ice, or Advil is going to take that pain away. Only a chiropractic adjustment will do that–by opening the joint and restoring movement. Don’t underestimate this crucial step—it is why so many neck pain cases never fully resolve. Get your neck pain evaluated by a chiropractor for the most comprehensive approach to neck pain relief.

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