Neck pain: A Neuromuscular Therapy point of view

Chronic pain, Headaches, Neck pain, Neuromuscular therapy, Shoulder pain / Monday, July 13th, 2009

When a patient presents with neck pain, what are the possible muscular causes and what can help relieve the pain? What was important in the case of Sukie B?

Neuromusclular Therapy teaches that there are 6 factors to consider in discovering the reasons why muscles have become dysfunctional.

The first is Trigger Points that refer pain from hyperactive and hypersensitive muscles to other locations. Sukie reported several instances of Trigger Point referrals to her head, jaw, ear, side of her face, down her arm and into her chest.

The second is ischemic tissue that causes local pain. Ischemia indicates a lack of oxygen, which in the case of muscles means lack of blood since blood carries oxygen. When muscles are chronically tight, blood flow is reduced. The lack of oxygen causes pain just as in an ischemic heart event. Sukie had lots of ischemic tissue both in the short muscles in her neck and the longer ones that go into the shoulder and back. She voiced complaints of burning pain, stiffness and tension.

The third is entrapment which happens when the flow of blood or nerve signals is impeded by the tight muscles around them or by taut bands that are found associated with hyperactive Trigger Point nodules. Symptoms include numbness, tingling, pain and loss of function. Sukie complained of numbness in her arm so entrapment was certainly a factor to be investigated.

Fourth is structural asymmetries. Posture is also considered under this category. Usually causing one-sided symptoms, asymmetries are often overlooked and untreated. Not only can they cause pain, they are common perpetuating factors in chronic pain conditions. Sukie noted that her left hand, foot and breast were all larger on the left side. Her posture at work, at a desk and on the phone, certainly were factors.

Fifth are nutritional and systemic considerations. There are nutrients that are necessary for muscle and nerve health. Factors like allergies, acidic pH levels, or a sub-clinical hypothyroid condition need to be considered especially when pain persists. For Sukie, these considerations were reviewed so she would be aware of eating a diet for health as she dieted for weight loss, drinking enough water, and having some kind of exercise and stretching routine to increase blood and lymph flow.

Sixth is stress. Emotional tension causes muscle tension. Repetitive stress is included here. Stress is well-known in medical circles as a major contributor to all kinds of illnesses. In Sukie’s case, her job was often stressful and there were some family issues. She had this covered already by working hard on reducing stress with the Mindfulness Stress Reduction (MBSR) classes offered at our center.

Having addressed these six factors with Sukie, we started treatment. The next post reviews what we did.