Got a pain in the neck? I feel you.
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I’m getting ready to move. So, of course, mine is killing me. You know that knot you get under the shoulder blade that causes excruciating pain up the side of your neck? Of course you do.
I think mine has been coming and going for about 12 years now.
Not all discomfort at the top of your spine is stress-related, but lots of it is, so get checked out.
It’ll probably turn out that your mind-body connection needs some sorting out. When it comes to spine pain, say the folks who know, the emotions trump.
What the experts say
“Stress, conscious or unconscious, causes an increase in muscle tension, which then causes pain. Psychological factors play a role in virtually all spinal disorders. If you take 100 patients with no back pain problems, 40 per cent of them will show abnormal spine MRIs. Stress can manifest itself as pain, and as it progresses, doctors treat it as a purely physical symptom. Patients get started on pain medication, which, taken long-term, can cause depression. Sleep gets disrupted, there’s daytime fatigue, and what started out as a stress-related pain problem can turn into full-blown chronic pain syndrome. Among people experiencing chronic pain, there’s a much higher incidence of personality disorders.”
WILLIAM DEARDORFF, clinical health psychologist, Beverly Hills, California
“Pain can be caused by a structural problem such as a fracture, tumour or true nerve impingement, but mechanical and structural issues are often less important with chronic pain. People who hold stress, tension, anger or grief inside generate signals via the autonomic nervous system (fight, flight, freeze) that cause the muscles and tissues to tense up. This produces true physical pain, but the cause is emotional. X-rays, MRIs or CT scans can rule out structural conditions as long as one takes into account how common minor disc bulges are in the population. People who are perfectionists and people-pleasers are more likely to suffer from a condition that I call ‘distraction pain syndrome.’ It’s a way of drawing your attention away from the things in your life you don’t want to focus upon.”
DAVID SCHECHTER, physician, expert in sports medicine, Beverly Hills, California
“Almost half of people who don’t have depression before whiplash injury have depressive symptoms afterwards. Most of these tend to go away during the first year, but in about 20 per cent [of cases] they are persistent. Depressive symptoms can prolong recovery. There’s usually no single cause of neck pain. What works best is staying active and reducing psychological stress. Over-the-counter pain relievers can help, as can mobilization, manipulation, acupuncture, massage therapy. If you have an injury, you need to be screened, but [serious injuries] are rare, and diagnostic tests, CT imaging and X-rays are usually unhelpful.”
LINDA CARROLL, professor, School of Public Health, University of Alberta, scientific secretary, Neck Pain Task Force, Edmonton
“A lot of neck pain is caused by postural issues and is work-related. The computer needs to be right in front of you, the top of the monitor at eye level, your shoulder blades back, not stooped and flexed forward, your chin tucked in. Your elbows should be bent 90 degrees. Trauma can be caused by a motor vehicle accident or contact sport. Do keep your neck moving. Don’t overload your backpack, and use one that has a strap for the waist. This takes some of the load off the spine and moves it to the hips. Avoid putting it on one shoulder, because that will strain the muscles. Exercises to strengthen your mid-thoracic spine are a good preventive measure.”
LEIGH DAVIS, physiotherapist, On the Mark.it Physiotherapy, Toronto
“There were some case reports of people experiencing a rare type of stroke after seeing chiropractors. But in the vast majority of these patients the stroke was due to an abnormality in an artery in the neck that causes pain and headaches before the stroke. It appears that chiropractic care has caused the stroke, when it is actually coincidental. If someone develops an explosive headache, is dizzy and starts to feel numbness and weakness, he or she should go to the hospital emergency department right away. Neck pain may be caused by arthritis, infections or a tumour, but these are all very rare. We see a big association between neck pain and depression, and people with neck pain also have a lot of headaches and gastrointestinal complaints.”
DAVID CASSIDY, research director, Rehabilitation Solutions, Musculoskeletal Health and Arthritis Program, Toronto Western Hospital
