How to self-treat for Neck and Shoulder pain
Anyone who has ever suffered from neck and shoulder pain, which let’s face it, is the majority of the population, will know what a right royal pain in the neck it is. Pun intended! Stiff neck and shoulder pain not only leaves your mobility challenged but can also impact your mental wellbeing. That nagging dull ache that many of us live with daily when suffering from sore neck and shoulders can end up grinding you down both physically and mentally.
Annoyingly for chronic neck and shoulder pain suffers, the root of the pain often goes undiagnosed by medical practitioners. Reliance on painkillers can, unfortunately, become commonplace, creating a stick a plaster over the problem cycle instead of a cure. Many doctors and physios will tell you that bad posture, stress and slumping over a desk are the causes of our neck and shoulder pain. However, there can be so much more at play than these factors alone. Breathing patterns, sleeping habits, exercise and stretching routines (or lack of!), and emotional demeanour can contribute to pain sensitivity in the neck and shoulders.
Interestingly, in many cases of chronic neck and shoulder pain, there is no severe soft tissue damage or injury apparent. And if there was once any damage, the injury itself may be a long time healed. Most physical traumas will heal within 3-6 weeks. What is left thereafter, is a hard-wired neural pain pathway between brain and body. The brain quite literally forgets how to tell your body to let go. This phenomenon is known as central sensitisation: when your central nervous system cranks up the volume of pain in your body, despite the lack of any actual injury. The good news is, this faulty wiring between the spinal cord and the brain can be addressed through; manual soft tissue release techniques, long-held stretches and mobility work. Notably, mindfulness practices, which help you pacify your relationship with your pain, have proven to be highly effective in reducing pain.
You may also be interested in reading Proprioception & Interoception: Making sense of it all!
Another piece of good news is that many troublesome pathologies, such as; migraines, numbness and tingling down the arms, interscapular pain, headaches, and even ringing in the ears, can often be down to issues in your soft tissues that are relatively easy to resolve. Trigger points, traditionally known as knots, commonly refer pain away from the primary point of soft-tissue constriction into secondary trigger points, this, in turn, creates a satellite pain pattern, which may lead you to believe that the source of the pain is originating from somewhere other than the central trigger point itself. So that’s to say, whilst you may be feeling discomfort along the medial border of your scapula, the root of the pain could be originating from an area of tightly contracted muscle in your neck. Therefore, if your treatment only centres around secondary satellite points without pinpointing the main culprit of constriction, then the pain will inevitably return to your problem area.
Working with a manual therapist, who understands the concept of referred pain from trigger points, will increase your chances of getting to the primary source of the pain. If you are in the UK, then any manual therapists trained in Advanced Clinical Massage Therapy from the Jing Massage School will be able to assess where your primary pain sources are likely to be coming from in their highly effective 4-6 week treatment plans.
Of course, it’s not always possible to see a massage therapist, as much as we’d all love to go weekly to get some hands-on action. With that in mind, here are a few simple ideas for neck and shoulder pain home help.
Treating the Suboppcipitals
There is a small group of muscles found at the base of the skull called the Suboccipitals. For such little muscles, these posterior neck muscles can be surprisingly big contributors to headache pain. The Suboccipitals are found under (sub) the central third of your occiput (base of the cranium). Restrictions in this muscle group can manifest as deep-felt headaches, with a pain pattern running in a band from behind your eyes to the back of your head.
To release the suboccipital muscles: lie down on your back with your feet on the floor for support. Place the edge of a yoga block into the ridge at the base of the skull. Allow yourself to sink your body weight into the block whilst gently focusing your attention on some slow and deep belly breaths. Remain focused on your breathing for around ten breaths. Observe where the sensations created from applying pressure to this area radiate from and to.
The insertion of the Sternocleidomastoid (SCM) and Splenius Capitis
Next, roll your right ear to your right shoulder whilst maintaining the pressure of the block along the base of the skull. Here you will encounter the insertion spot for two muscles.
The SCM runs from the front of the neck in the middle of the collarbone to behind the ear. Pain patterns from restrictions in this muscle can extend up the front of the neck and orbit around the eye or across the forehead from one side to the other.
The attachment point of the Splenius Capitis sits deeper to the SCM in this same area. Pain from restrictions in this muscle can refer up to the very crown of the head. Think cap for capitis.
Once you have been in this position for 5-10 breaths, slowly rotate your head back to somewhere between the starting position and behind the ear, again exploring what sensations this creates. Then, bring your head back to the centre and repeat on the other side.
Once you’ve explored both sides, press into your feet and lift up your head to remove the block from underneath you. Take a few moments to connect with the sensation of flow, heat or tingling around your skull and neck before mobilising your neck with some gentle head turns along the floor.
Trigger point work in the SCM
Bring yourself to a comfortable seated position. To find your sternocleidomastoid, rotate your head to the right. You will notice the SCM pop out on the left side of the front of your neck. Grab hold of it between your right finger and thumb before allowing the muscle to slacken again by bringing your head back to the centre.
Next, follow the thick tube-like shape of this muscle up to its attachment behind the ear. Pinch and hold the SCM from the top insertion point down to the inner centre of the collarbone, where it originates from. Another head originates from the medial one-third of the collarbone. Hold any particularly tender spots for around 8-10 seconds. Rest for a moment and then repeat on the other side.
Stretching the Scalenes
The scalene muscle group consist of three muscles the Anterior, Middle and Posterior Scalene. These are located in the side of your neck, between the SCM and the Upper Trapezius. Due to their proximity to the Brachial Plexus, the innervation centre for your arms, restrictions in these muscles can cause phenomena such as numbness or tingling down your arms. They can also be responsible for referred interscapular pain.
To stretch the right scalenes, anchor your right shoulder blade in place by either sitting on your hand or bringing your hand to your lower back with the palm turned out. Now, drop your left ear towards your left shoulder, making sure to keep your nose facing forward. If you would like to deepen the stretch in the side of your neck then bring your left hand to the right side of your head. There is no need to pull here. The weight of your hand with gravity will be enough. When you’re ready to come back up move slowly back to the centre and release the anchor. Sit with a neutral spine for a moment before continuing to the other side.
Trigger points in the Scalenes
If you feel confident about where the scalenes are, then it is possible to treat these muscles yourself for trigger points. Top tip, watching a quick anatomy video will help you make sure you’re hitting the right spot!
Slowly strip along each of the three muscles in this group from top to bottom, looking for any areas of constricted tissues. When you come across any tender or tight areas, apply gently sustained pressure for around 8-10 seconds. To help this process and your fingers, you can rest your elbow into the wall then gradually lean your body weight into your arm and fingers.
Treating the Levator Scapulae with a massage ball
This muscle is said to be the number one muscle for a stiff neck! Originating from the upper backbones of the neck and attaching down on the inner upper border of the shoulder blade, its main job is to elevate the scapulae (clues in the name).
One of the most common trigger points for this muscle is found near its attachment on the medial border of the shoulder blade, or scapula if you call it by its anatomical name. Pain from this trigger point can refer to the side of the neck, down between the shoulder blades, and locally around the area.
To treat this trigger point, take two tennis balls and wrap them in a long sock. Tie the end to secure them in place, leaving a bit of a gap between them. You may need to adjust the gap width once you’ve tried them out.
Lie down on the floor with your feet on the ground and arch your back so that you can pop the sock underneath you. Try to locate the balls around the inner upper border of your shoulder blades. Lower your body weight down onto the balls, taking a prop under your head if you need one for support. If the pressure is too intense, then back off slightly with the amount of bodyweight you’re releasing down onto the balls. You’re in control here!
After a few rounds of breath, slightly shift the balls beneath you into a new position. Repeat this process several times before removing the balls and resting. You can also treat this area with one ball unilaterally.
Releasing the Upper Trapezius
Possibly the first muscle we should look at when suffering from neck and shoulder pain, the Upper Trapezius are a hotbed for trigger point activity. Getting hold of this upper back muscle feels a bit like grabbing a kitten by the scruff of its neck, only without the soft and fluffy pleasantries. Trust me. This muscle lets you know if it’s got restrictions in it! Its referred pain pattern can run up the back of the shoulders and neck to behind the ear, sometimes creating a question mark shape by wrapping around the ear to the corner of the eye.
To treat the upper trapezius, raise your shoulder to your ear to find the muscle. Hook your thumb into the groove that appears at the front base of your neck. Bring your fingers around over the shoulder to pick up the muscle from behind. You should be able to squeeze the muscle belly between the thumb and fingers. Be warned! This may feel quite tender. Relax your shoulder and continue to squeeze this muscle all the way along to its lateral attachment point.
The advice and research for this article have been inspired greatly by the teachings from the Advanced clinical Massage Therapist course that I am undertaking with the Jing massage school. If you are a health practitioner and would like to read more insights from the school itself, then I can highly recommend their book Massage fusion.