We’ve all had niggly pain in our necks from time to time, but often meeting up with friends, going to the gym or for a walk is enough for much of that pain to go away.
However, the ‘occasional niggle’ can often turn into constant and debilitating discomfort, with the neck and shoulders feeling like a solid block after just a few hours of working at your desk. Sometimes with one seemingly innocuous movement of the neck leaving you stuck in pain, unable to turn your head any further. "The straw that broke the camel’s back" so to speak.
If this rings a bell, read on as we will try and clarify why neck pain has become even more common since early 2020. There’ll even be a few tips at the end, on what you can do to manage and prevent this from happening in the future.
A complex issue
You’ve tried most stretches, you’ve been rolling your head throughout the day to get some movement. This probably helped relieve some tension, but not for long.
Once again at the laptop the pain starts, your concentration loosens, frustration mounts and more stress adds on to perpetuate this vicious cycle.
Stretches, regular movement and posture fixing however are only part of the answer when they are applied in isolation. We need to also take into account the bigger picture of the biopsychosocial model of pain.
This model simply includes all the other factors that are responsible for causing and maintaining neck pain (the psychological and social) that go way beyond simply the tension in your neck muscles or the pressure on your discs (the biological / anatomical bit). If we want to find long-lasting, sustainable solutions we need to start understanding the role of these factors in our homes, routines and habits, and accordingly make the necessary lifestyle adjustments.
Sitting at our laptops
But let's start with the obvious physical causes of neck pain. We have not evolved to sit in front of a screen for hours on end. We evolved to generally move… to hunt, work the land, run from predators, mate, rest...
From an anatomical perspective, a long-term sitting position often drives our shoulders and head forward (as the head makes up 20% of our entire body weight), due to the position of our keyboards, mouses and screens. So combine that with the unrelenting force of gravity, which produces a constant forward and downward pull, we then compensate by naturally tilt our heads upwards, extending the neck for long periods of time, in order to keep our eyes on the screen.
The result in a much increased work load of the small muscles below the skull (the sub-occipital muscles), as well as the muscles running at the back and front of your neck, and an increase in the natural curve of the neck (cervical lordosis). These muscles tend to store more tension and tire faster, whilst the small facet joints (the little joints wither side of your neck) can become compressed, causing discomfort.
Our natural response to this discomfort is to move to try and avoid discomfort so that, in normal conditions, our body repairs and adapts itself, and in a few days the pain is gone. However with the pressure of more home working and less moving around the office the pain does not always go.
In essence, research advises that frequent breaks, moving around and changes of position and having a variety of work set-ups, different postures, angles and stimuli for your body.
The Role of Stress
Stress and anxiety increase muscle tension and drive the perception of pain.
Contrary to common belief, stress isn’t just about feeling mentally drained. Stress is our response to anything that challenges the healthy mental and physical balance. Some stress is a good thing. It’s there to make us perform efficiently, bring us back to balance and dissipate once the job is done.
However, in our modern lives, stress invades every aspect of our daily routine and we've come to associate it with feeling restless, anxious and awful. We have to deal with never ending work commitments, kids, partners, taxes all whilst trying to meet everyone’s expectations of us. For some people there is that inner drive to be perfect or to please others. All of this can set up stress. Simultaneously, our body is handling the strain from lack of regular movement, loss of sleep, over-snacking and staring at computer screens and so muscular tension builds and builds.
The Effect of the Pandemic
We learn to live with stress and to adapt so that it remains within manageable levels. Prior to the pandemic, coffee or tea breaks at the office were the perfect excuse to satisfy some physical and social needs. The commute to the office was the way to progressively detach from home-life, readying ourselves for the workday, whilst the journey back gave us the chance to ease ourselves into home again; each space maintained its own set of rules and symbols within our life.
Now, even though we are in an endemic phase, for many most of those small but essential routines either no longer exist of do not hold the same value. Coffee breaks have little meaning without social contact; home and work have blended into the same space; it is hard to motivate ourselves to exercise and social outlets are hardly present. We are lacking de-stressors and distractors. Thus, our focus is placed almost permanently on our aches and pains, which become more real and intense, muscles do not have their chance to relax and so the following week this “vicious cycle” will repeat.
So, why is the pain still here?
Let us put a little perspective on this… feeling some pain is fine. Actually, it is good for you! Pain is telling you to change position, to stretch, get active, do all of those things that are healthy for you. Basically, pain is there to protect you. But sometimes it hangs around longer than it needs to, and long after anything needs to be protected. But why is this?
We need to understand that pain is an experience that your brain decides to make you feel when it is 'under threat'. It is a response to possible tissue damage to make you protect yourself. Your tight neck muscles or strained joints may send signals notifying your brain that things are not as great as they could be and ultimately it is your brain that decides whether these signals are relevant enough to have pain. Nine times out of ten, the same pain you are feeling now would only be a fraction of its intensity if you were sat on a beach googling ‘things to do on your holiday’ rather than being stuck at your desk, in mid-winter.
So what’s the point of this…?
Of the many factors that account for our experience of pain, we need to ask ourselves: How anxious am I about it? How are my general stress levels? How is my general physical and mental wellbeing?
All this can have a profound impact in defining whether, and how intensely, you will feel pain.
We learn pain
Interestingly, our brain can also learn to experience pain simply by associating it with a particular activity or experience. When you feel the same pain over and over again, at the same desk, or during the same particular job, physical activity or stressful situation, then your brain learns that these environments are a threat and begins to predict pain in advance of it actually happening.
This then leads to increased tissue sensitivity, muscles tightening, altered breathing - all the physiological events that happen during pain - but prior to any actual physical load on your body. This prediction of pain is real pain. There is no difference between this pain and actual ‘physical’ pain because all pain is real and all pain is an output of the brain not something happening in the tissues.
Think about it, you can have discomfort in your neck for months, and a two-week warm holiday is all it takes to make it go away. You even survived a 6-hour flight without moving and… without pain. Then on the flight home, as you start planning your work tasks, before you know it the same neck discomfort is back. Your brain is predicting how it will feel in a few days time and adapting accordingly, by making your tissues more sensitive and better able to detect the ensuing threat that not moving at your desk and being stressed out will bring.
To get out of this, we could just book the next flight back out to holiday-ville. Or we could actively unlearn pain: pre-empting the pain by getting up and moving before it starts hurting, making our next working position unpredictable, changing our desks around to remove any visual cues or memories of the last few weeks of pain, distracting ourselves from the pain but also understanding that our joints and muscles are generally healthy and not the only factor causing the pain.
If you’d like to learn more about how you can reduce your neck pain give us a call, or book an online appointment to see one of our Osteopaths or our Alexander Technique teacher.