Neck pain is a super common concern. Physicians estimate that 7 out of 10 of us will suffer from it at some point during our lifetimes. As a licensed massage therapist, neck pain relief is the number one request clients make to me during intake. It’s often coupled with its close relative, shoulder pain — more on that below. Pain medications can help lessen the severity of the symptoms. However, they generally won’t be able to target the root of the problem.
A licensed massage therapist experienced in assessing the causes of neck dysfunction can help you get to the bottom of your pain. In order to address it most effectively during your visit. They can also help you understand some of the reasons why your neck pain started in the first place. And suggest simple lifestyle changes you might need to make in order to prevent it from coming back as a chronic issue.
Like a detective trying to solve a crime, a medical massage therapist will want to know certain details about your symptoms. The more clear and precise you can be, the easier you can make it for your therapist to help. Some of you already know exactly what caused or causes the pain. To others, it’s a mystery. To help unmask the root culprits, we’ll ask a series of questions usually from totally open-ended to narrowing down specifics.
For instance, we might start with open ended questions such as:
How would you describe the pain?
Neck pain can range from dull ache that doesn’t let up to a sharp, stabbing sensation that comes on only during certain positions or movements.
Where exactly is the pain? Does it radiate anywhere else?
Maybe the pain starts just below your right ear and ends up at your shoulder blade. Or the entire back of your neck hurts and all the way down the back of your arm is throbbing, with pins and needles into your ring and pinky fingertips.
How severe is the pain?
If zero is no pain and ten is the worst pain ever, where on that scale would it be? This can go for when you first felt it come on to what you’re feeling right at the time of the visit. And while those numbers are obviously subjective, how you would rate common experiences like hitting your funny bone or delivering a baby can help give your own personal pain scale some context.
How long has the pain been going on?
Three hours ago would make it new and potentially acute; three months ago would make it chronic. It’s also good to know if it’s gotten better or worse since that time.
Depending on your responses to the basic questions, we’ll follow up with more specific questions to help narrow down the specific cause(s). Usually, root causes are activities that have you holding your head and neck out of proper alignment. The abnormal stress on your spinal muscles can cause pain in many different ways.
Here are some questions that may identify seemingly normal things that could have caused your neck pain:
Does anything make it feel better?
There are plenty of palliative strategies exist that can take the edge off of pain, including hot compresses, anti-inflammatories like ibuprofen, topical salves like CBD oil, and rest. These are helpful for us to know what is working for you for neck pain relief. We can also advise on other methods of self-care as well!
How about things that make it feel worse?
Unfortunately, there might be many things that provoke or aggravate your symptoms. For instance, certain yoga poses. Or stress at work. Or something as simple as a very specific movement, i.e. when you turn your head to the right. Sometimes it only feels worse when you poke at it 🙂 This information can also be very helpful in getting you on the path to neck pain relief.
There are many different tools we can use and measures we look for to help us figure out what might be causing your pain.
Palpation means using our fingers to examine different areas of your body for spots that might be tender, warm, or swollen. It’s usually light to medium both to feel what the tissue feels like and to determine how much pressure creates lower levels of your pain.
This means asking you to resist pressure during specific movements (like bringing your ear to your shoulder or having your fingers pulled apart). This helps us determine the strength and function of individual muscles. Dysfunctional neck muscles might be an obvious culprit of neck pain, but did you know that weak or inhibited abdominal muscles can lead to the neck becoming overactive and subsequently painful? And that weakness in muscles as far away from the neck as the fingers can potentially indicate a neck problem?
This means testing to what degree you can move on a given plane, i.e. can you look up at the ceiling and/or bring your chin to your chest? (Ideally we’d like for you to be able to do both.)
We analyze posture and alignment by establishing the location of certain landmarks on your body. For example, where your head is located in relation to your ribcage when you are standing or sitting upright. The position can have major implications for your neck pain. Your cervical spine (your neck) is designed to evenly share the weight of your head through each of the 7 vertebrae. If the load is unevenly placed on a few, the muscle imbalances can pinch nerves.
Observing how you walk can give tons of useful information. For example, did you know that your ribcage needs to be able to rotate with every step you take? If it can’t, your head might start to rotate too much to compensate, and destabilize your cervical spine.
Literally checking how you breathe 🙂 Several key muscles of the neck can also be used to breathe. However, they are really designed to assist breathing and forced exhalation such as coughing or sneezing. As opposed to playing a primary role. Over time, stress can cause you to use these for normal breathing. This can create a host of imbalances, including pain and tension. Especially since all of us take approximately 25,000 breaths every day. We find dysfunctional breathing patterns in almost every single client who complains of neck pain!
Armed with the above information, we can determine what the next course of action would be to address your chief complaint. Assessment and intake time is important because we want to cater our treatment plan to your specific concern. Otherwise, we get stuck rubbing sore spots and hoping it works 🙂
Hint: That might feel good for you but the relief usually doesn’t last more than a day. It might even aggravate the problem. A thorough intake is especially important if we are the first provider you’ve seen and no one has assessed or diagnosed you before.
For example, you might come in with neck pain and stiffness that feels like you slept wrong. During our posture assessment, we notice that your head that tilts to one side while the chin tilts to the other. Then you flinch as we press behind your ear. This is most likely an issue with a deeper neck muscle such as levator scapulae.
Or maybe you could be complaining of pain on one side of your neck that radiates down and all around your shoulder blade. Watching you breathe, we notice your first rib lifting as you inhale. Then when we test your grip, we easily pull apart the fingers of the hand on the same side of the pain. This could be a stenosis of one of your cervical vertebrae causing a nerve impingement with certain movements. Or worse, with every inhale.
We’d address both of these situations in very different ways during our session with you. Not to mention provide you with different follow-up treatment plans. For instance, in the first scenario you’ll probably feel much better immediately. If not, we may recommend a chiropractic visit to realign a vertebrae stuck out of place. In the second scenario, we’d let you know that while you may feel noticeably better after one session, that you’ll need to follow up with a few more sessions with us. And also work with a physical therapist to restabilize the deeper neck muscles.
At Bodyworks DW, we strive to provide you with the highest standard of care, individually catered to your needs. Our therapists continually attend trainings on assessment strategies, both in-house with owner David Weintraub and with other top clinical providers, in order to keep our skills sharp. All of our sessions include intake and assessments to identify postural and movement dysfunctions that might be the root of your specific complaint.
We also work with you to develop a treatment plan that works as much as possible within your schedule and budget. A plan that includes the estimated number and frequency of follow-up sessions we recommend.
In addition, we’ll suggest exercises you can do between sessions, and strategies for lifestyle changes. Such as stress reduction and abdominal strengthening to help set up the conditions to help keep your neck feeling its best. And if we believe that another provider might be able to help you, we have a large team of physicians, physical therapists, acupuncturists, chiropractors, and Pilates teachers with whom we can co-care for you.
Curious about neck pain massage in midtown or the financial district in New York City? Contact Bodyworks DW today or click on the button to book online at either our Financial District or Midtown locations!
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