Anxiety & Neck Pain

There’s a huge link between anxiety and neck pain. In this article, we’re going to explore how this works, and what you can do relieve pain, reduct stress, and regain comfort.

We’ll start off with a precise definition of chronic neck pain. Neck pain is defined as pain that arises from the base of your skull down to the seventh vertebra, which is where the neck joins into your shoulders. And chronic means the pain has lasted longer than three months.

Common Chronic Neck Pain Causes

It turns out the neck is the second most common place in your body to feel chronic pain. The commonest is lower back, then neck, then everywhere else.

Neck pain can then radiate up into your head or down into your shoulders, thoracic spine, arms or chest.

If you think about the millions of people with neck pain, the question is why? Why should this be?

When you start to think of the function of the neck, the answer starts to become clearer. What is the neck’s primary job?

It holds your head up, and your head is where four of your five senses are based. Your vision, smell, hearing, and taste all reside in the head.

Now, the head weighs 14 pounds – a lot of weight. And the neck needs to constantly hold it up and swivel it to see, hear, smell and taste better. It’s an incredibly important job and takes a lot of energy every day.

The shape of the neck varies hugely in individuals. It varies from a long, slim, elegant neck to a short, broad squat, solid muscular neck. If you think about the job that the neck has to do, which is to hold up this 14 pound weight, constantly working against gravity then it’s clear that a short muscular neck will do the job much better.

That’s the first reason for neck pain: a genetic issue. People with longer necks have an increased risk of chronic neck pain.

The next major issue is people balance their head in different ways. This turns out to be amazingly important.

There are two main ways you can balance your head on your neck. The first is good, the second is not (but it feels a little easier, so people do this more when they’re tired.)

Your head has a point of balance where, if you dropped a vertical line from the top of my head down through my body, my head would be balanced right on the top vertebrae of my neck,

The line of force runs straight through my neck, there’s minimal work for me to do. Everything is stacked beautifully on everything else. This is optimal.

The second way of balancing is to slump. You’re still keeping your head level. The point of balance is still over the neck. But now your neck has a curve in it and your back is slumped. This posture will also hold your head up, but everything has changed. You’ve moved out of the optimum posture, and holding this position for a long time will cause neck pain.

Slumping neck posture has become increasingly common over the last 30 years. I have a friend who is a physiotherapist in New Zealand and he calls it the I-hunch.

Neck Pain and the I-hunch

The I-hunch is something that occurs due to laptops and handheld screens, which people use all the time. With laptops, the screen is lower, than optimal. Nobody holds a tablet or phone up at eye-height when they use it.

They hold their device down at tummy or chest level and usually slump down to view it. If you do this for many hours of the day (and studies show this is what happens,) then this slumping posture shortens your neck, and in time causes muscle fatigue and grumpy neck facet joints.

If we look at the structure of the neck, what you have is a series of vertebrae, which stack on each other. There are a series of very small discs in between each vertebra. The most important structure in the neck, which does a lot of the holding (at least 50 to 60% of the weight) are the facet joints.

If you have upright, lovely posture, then your neck is long and the facet joints are freely able to move. This posture will ensure that the stackers are sitting nicely over each other and that the joints are free to move.

If you slump and then curve your neck back, all these facet joints get jammed up. The pressure doesn’t go directly through the stackers. It goes at an angle that doesn’t allow the facet joints to move freely.

Over time, this causes the joints to become worn and your ability to turn your head and move is significantly changed.

The second problem with slumped posture occurs in the muscles around the vertebrae. These muscles are of three kinds. The first kind are posture muscles. These are small muscles that are there just to balance the vertebrae stackers, so they can do their job against gravity. They have a lot of work to do to constantly keep things balanced.

The second group contains larger muscles, like the trapezius. These muscles will move your neck from side to side and rotate your head. They are bigger and stronger muscles.

There’s a third function which only turns on at certain times. There is a group of muscles which largely are postural muscles, and are turned on when you are under huge stress. They turn on when your brain says: “I’ve got to escape from here.”

These are called the accessory muscles of respiration. They are turned on when you move into stress breathing, or fight and flight breathing.

As with all the muscles in your neck, they have an optimum range where they work nicely, they’re given them time to rest, they do the job and are not grumpy at all. If your posture is suboptimal, (for instance if you constantly slump,) then the posture muscles have to work too hard.

They’re working harder than they were designed for, and they become grumpy. This turns on trigger points. You end up with pain not only from the joints being jammed up but also from trigger points in the muscles that are trying to support your neck.


Anxiety & Neck Pain, and the Big Picture

What we’ve looked at so far are the biomechanical factors that predispose people to have neck pain. If you have a long slim neck and sub-optimal posture, then you are more likely to end up with chronic neck pain.

If you’ve had some kind of significant injury, you are also more likely to develop chronic neck pain.

The big question is, are there any other factors that increase your risk of chronic neck pain?

What differentiates the person with the slim, neck who slumps, and has pain, from the person who doesn’t have pain?

To answer this, we’ll look at some of the large population studies on neck pain that have been done to discover causes of chronic neck pain. These studies have used multivariate analysis, which is when you take all the variables and you put it into a pot and work out which factors are significant, and which aren’t.

In these studies, one factor comes up above all others. It’s what the people who’ve study neck pain call inner tension or inner stress.

Inner tension is the single most important factor that will increase your risk of getting chronic neck pain. Inner tension means that you carry your stress in your neck.

It’s interesting because this is different from lower back pain or shoulder pain. Inner tension is specific to chronic neck pain.

There are other factors which somewhat surprising. Here they are:

  • Women have more chronic neck pain than men. Part of this could be that women tend to have slimmer necks. Part of it has to do with inner tension.
  • If the person has had less than eight years of education. The reason for that is that if you have less education, you end up in one of two kinds of jobs. The first kind of job is in a recurrent job, for instance in a factory.
    The second is you’re working in agriculture where you’re lifting and twisting and putting stress daily on your neck and back.
    These two kinds of jobs also tend to have less autonomy, which can add to inner tension as they have less control over the intensity or hours of work.

Overarching all of these factors though, is this idea of inner stress, where you carry your tension in your neck.

Once you have set off chronic neck pain, this starts a vicious cycle. The pain causes stress, and the stress causes more pain in your neck, which will cause more stress. So it creates this incredible vicious cycle, which you then have to somehow live with and manage.


Structural Causes of Chronic Neck Pain

When you look at chronic neck pain, there are a number of sources the pain can come from. The first source is the facet joints. They may become damaged in an accident or suffer from slow attrition – wear and tear from a slumped posture. Gradually over time becoming more and more grumpy. So the facet joints are a very significant cause.

To a lesser extent, the disc may be a cause of chronic neck pain, but it is less likely, as it bears less weight.

The third source of pain is the neck muscles. In particular, you can get trigger points that arise in the postural muscles or power muscles.

Neck Pain & Stress Breathing

Trigger points usually reside in the muscles that are used for stress breathing. The reason I say this very confidently is that stress breathing is one of the primary drivers of chronic neck pain.

You can be virtually guaranteed that people with chronic neck pain, will not practice lovely, relaxed, diaphragmatic breathing. They’ll be stress breathing. And when they do this, they’re using their neck muscles for a role that should only happen in extreme circumstances. (Like when you’re being chased by a lion.) However, people with chronic pain are living in a stressful environment, and this tends to turn on stress breathing.

And the manifestation of that stress is their neck pain, which makes the stress worse, so they’re living in this vicious cycle.

Chronic Neck Pain and Sensitisation

The final factor is that no matter from which source your pain comes, (the disc, fact joints, or muscles,) all of these structures will send messages from your neck up to your brain.

On the way, these pain messages will pass through certain points where they can be amplified. If you’re in pain for months, your pain system will start to become sensitized.

This means pain messages will become amplified. Over time, this means you’ll feel more pain, even if your neck is healing. This occurs with everybody who has chronic pain.

Managing Chronic Neck Pain, Stress & Anxiety

The question is then how do you manage what’s happening? How do you reduce the impact of the pain on your life and improve the quality of your life?

There are a number of different ways. The first is to acquire knowledge. Knowledge is power.

The first thing is to understand that there are structural causes of neck pain (like a grumpy joint.) There are also causes where emotions like anxiety/inner tension are added to the mix. Muscle trigger points are a significant cause of chronic neck pain, and this has a lot to do with stress, anxiety, and stress breathing.

The last is thing to understand is how your pain system then winds up and increases pain by amplifying pain messages.

These three things dance together: the physical, the emotional and the pain system. To improve your pain, you need to work on all three.

#1 Breathing

The first thing is to become aware of your breathing. Retraining your breathing takes time and practice, but it’s well worth it. It can give you a whole new sense of well being, stress relief, control and relaxation.

If you have chronic neck pain, you are guaranteed that quite a lot of the time you will be breathing in your chest, rather than your diaphragm. This means you’re using the accessory muscles of respiration, and what you need to do is learn how to get this area to relax and engage your diaphragm. for breathing

When you use your abdomen muscles to breathe comfortably and efficiently, you turn down the amount of tension that you have in your neck muscles.

#2 Posture

Number two is to improve your posture. Change from a slumped posture to upright, comfortable, easy posture. There are people with an upright stance who still hold a lot of tension in their bodies.

Instead, you want to be able to find the point of effortless balance where your head is held up using the minimum necessary strength from your muscles.

We are designed to hold our heads this way. We’ve just moved out of optimum design so that we could use the new technology which takes us away from good posture.

#3 Trigger Points

The third is to do is to learn how to treat the trigger points in your neck muscles. These trigger points are being turned on by abnormal posture and tension. So you can learn to treat those in a painless and a very efficient way.

#4 Facet Joint Release

The fourth is that you can learn how to release the facet joints of your neck vertebrae. These are small but very important joints in the back of your neck. Releasing these is something that you can do for yourself.

If you look at practitioners who help neck pain, osteopaths as a group are very skilled at mobilising and freeing up neck joints.

The problem of putting your body in somebody else’s hands is that you only get treated when you go and see them. However, it’s possible for you to learn how to release your neck facet joins. You can get them to glide and increase your range of movement.

These four things are all important for relieving chronic neck pain.

#5 Reprogram your Pain System

The last thing to do is to learn how to down the amplifiers in your pain system.

Once you’ve learned these things, you’re self-reliant. You become the captain of your own ship. You can change your neck from a slumped tight, painful, grumpy neck to a beautiful, upright, mobile, and hopefully pain-free neck.

For those who have neck pain, this will change your life.