How To Fix Neck Pain

Without Drugs or Surgery Neck and Upper Back Pain, Muscle Tightness,

Shoulder Pain, Rotator Cuff, Nerve Compression © Jolie Bookspan, MEd, PhD, FAWM

Named "St. Jude of the Joints" by Harvard School of Medicine clinicians

Fix Your Neck Pain! This article to Fix Neck and Upper Body Pain is one page on my large no-charge web site DrBookspan.com. I am a research scientist and clinician in human physiology and performance in extreme environments. I study why common training techniques and rehab methods don't work and what works better, and makes your life stronger, faster, smarter, healthier, and sometimes funnier. I make my web site available for a better world. On This Page: How to understand and stop several major musculo-skeletal causes of neck and upper body pain, and learn healthy ways to move so that you do not get the pain in the first place. That is different than doing stretches or exercises to stop symptoms, then returning to the same bad movement that causes or continues the pain. You can enjoy your favorite activities instead of giving them up. This Get Started Right Now summary covers main causes of: Neck Pain, Upper Back Pain, Shoulder Pain, Bad Cervical (Neck) Discs, Nerve Impingement, Pain Down the Arm. Reduced (or Increased) Cervical Lordosis, Forward Head, Poor Posture, Round Shoulders, Rhomboid Pain, Upper Crossed Syndrome, Cervical Spondylolisthesis, Muscular Pain, Rotator Cuff Tears, Numb Fingers, Repetitive Strain, "Stress" Pain, Upper Back and Neck Tightness. Read my books for more. Hope I will get to meet you in my CLASSES or over a personal online consult, maybe in a rare in-person Private Appointment. If you want more about me, check my page of Adventure Medicine. Have fun. SITE MAP. At the bottom of this page (and every page) are main navigation links, plus buttons to SHARE , TWEET, and LIKE. Now let's go fix your neck!

Answers In A Nutshell My work is not alternative medicine. This is evidence-based, tested, sports medicine techniques, applied to real life - where you actually need it. Many call it innovative. I call it simple standard-of-care. Neck pain and upper back pain, rotator cuff tears, and most pain in the upper body and shoulder area, are not a disease or condition or something that once you have, you have it for life. It can be an injury like a sprained ankle, that with a little common sense and information, can heal and you can be better than before. You do not need to have surgery or extended medical treatments or rest to relieve neck and upper body pain, or most disc or rotator cuff tears. You do not need to give up impact activities like running or martial arts, give up weights or heavy occupational work, or activities you love. Many common exercises and well known stretches, even rehab stretches cause (or don't fix) neck pain because they are not healthy movement. They are found in gyms, yoga, Pilates, and many popular fitness books and videos. They are done out of tradition, and like smoking they may "work" but are not healthy. By changing movement and body habits to healthy ones, you will get the built-in exercise you need for health while you prevent causes of much neck, shoulder, and upper back pain and injury. For people with injuries from accidents, poor movement habits can make the areas hurt worse and prevent healing, leading to unnecessary treatments, instead of identifying and stopping the movement habits that make it continue to hurt - long after an injury would ordinarily heal. You do not need to give up computer or other desk and sitting work to stop neck and upper body pain. Sitting and working in unhealthy ways can be easily changed to healthful habits. This article will give you the concepts. After understanding them first, use the separate free Sitting Healthy article. This is different from doing sets and reps of exercises, then going back to injurious daily habits. It is not true that reaching overhead must impinge the shoulder, or that you need to give up overhead activities, even repetitive overhead activities. The problem most often comes from reaching overhead in faulty positioning. This article covers fixing neck and upper body position to be healthy so that reaching, which is a needed part of real life becomes pain-free, plus a built in stretch. Muscle pain, disc, or joint injury are not causes of the problem - they are RESULTs of what you are doing to hurt your neck - things you can fix yourself. Even when inflammation or immune response are identified, they are results, not causes. This article will show you how to understand and fix causes instead of using drugs and surgery for the results. This means you do not fix pain with a bunch of exercises and stretches. We fix the injurious movement habits that cause the problem. You may have several causes of pain. If you fix only some of them, you will fix only some of your pain. The answer is not to continue on, missing the rest, saying "it just takes time." Don't allow the other damaging causes to continue. Check for other causes you may have missed and fix them all. Then you will stop all pain, and instead of alternating feeling better from fixing one thing and hurting from other causes, wondering why you have intermittent results, you fix all and heal all and go on stronger and better than before. Not all neck pain is from what may show on an x-ray or other test or scan. You are not doomed by scan results. Many common medicines and prescription drugs can cause pain. Un-needed treatments and surgeries are done - causing more pain and reduction in physical ability. Easy changes can stop the need for harmful medicines. Study of posture rules, exercises, and devices has shown they have made as much or more pain and damage as slouching, and do not create healthy movement. They are also no fun. First, healthy lengths during movement needs to be learned. Then all daily movement builds-in healthy comfortable fun habit. Not All Exercise is Healthy Medicine. Much cost, time, and worry currently spent in medical treatments are unnecessary, and often unhealthful. I show you how to change daily movement and exercise into Healthy Medicine. It's not health care if it's not healthy. Welcome to my Health Care Reform School™ - I call it Fixa U™ . This article explains all the above. Make sure you understand the concepts (many highlighted in green) . The end of this article (where it says "More fun...") gives many helpful links to pages on this site for more help. Also see the bottom of every page on my web site for main navigation links.

1. Bad Cervical (Neck) Discs

Years of poor sitting, standing, and bending habits is enough to injure your neck as badly as from an accident. Rounding the upper back and slouching the neck forward unevenly presses on discs. Over time, they start to bulge (herniate). The disc, and the swelling and immune response of the body trying to heal the area, can press nerves, sending pain or numbness down your arm ( sometimes around your torso, depending which nerves). This is not old age, but bad habits that you can quickly stop. The same forward head can also be coming from rounding the upper back, then trying to straighten from the neck, resulting in craning the neck. See below how to easily stop this.

Tightness from years of poor positioning - both slouching the neck forward AND also pulling the neck and head inward thinking that is "standing up straight" can both press the same nerves mimicking nerve impingement and disc pain.

A degenerating disc is not a disease, but a simple, mechanical injury that can heal, if you stop grinding it, shearing your neck bones, and physically pushing the disc out of place with unhealthy habits.



Left drawing above - side view of normal disc between two vertebrae. Right - disc pushed out (herniated) from bad bending habits.

Lift and bend properly to avoid damaging your discs. Sitting, standing, and living with your neck and head forward

can eventually shear the cervical (neck) discs on the bone making small tears, and push them out of place Why Strengthening Does Not Work To Stop This Kind Of Neck Pain It is not a matter of strengthening muscles to stop pain. Strength does not make you sit or move in healthy ways. Strength does not make you stop bad movement habits. You can strengthen and become a stronger person who still slouches and does injurious exercises. No special chairs or devices make you sit right (although many encourage worse sitting. See Healthy Sitting.) Sitting, standing, moving, and living your life with healthy movement mechanics is up to you. Instead of doing artificial rehab exercises, using stiff, uncomfortable posture drills, then going back to damaging daily life movement, try living and moving with healthy movement mechanics. Here is how:

2. Muscular Pain from The Forward Head, Reduced Cervical Lordosis, Upper Crossed Syndrome





The forward head (#1 left) commonly results in sore shoulder, neck, and upper back.

Straining and forcing to pull to "straight" position is as unhealthy and painful as slouching. Use the info on this page to make healthy upright position (#2 right) comfortable . Tilting your head, neck, and upper body forward is called a forward head. A forward head is the source of much neck, upper back, and shoulder pain. It makes a classic "tension" pain across the shoulders, in a diamond pattern down the middle of the upper back, in the neck, up the neck to the head, and sometimes down the arm. Sufferers are often told they have a condition or disease, or problem that is inherited that they need to live with, and take months of treatments and medicines even surgery. However it is a simple slouch, often made to feel normal by tightness. The pull and strain of the weight of a forward head is like the weight of a bowling ball yanking forward on your upper back muscles . A forward head can eventually damage neck and upper back structures, over years of moving and rubbing at angles they were not built for. Chronically holding neck muscles in an overstretched position weakens them. The forward head creates shortened, contracted muscles in front, and a stretched, weakened back. Cervical (neck) discs are pressured posteriorly. This creates a cycle of forward positioning that herniates discs and makes sore aching muscles, and the tightness and habits that keep you tilting forward. The result is that the average person has upper body pain from the poor positioning and at the same time, the chronic poor positioning makes them too tight to stand up straight. Forward head is a common source of headache. Yet, after mechanically pressuring their neck all day, people call it stress and do not fix the very forward posture that would give them relief and stop the injury process. The ways to fix it are straightforward and can be quick, depending how much you understand and apply.



Check Yourself For Forward Head You may be surprised to find that you do much of your standing, sitting, activity, and exercise with a forward head. No wonder you have pain. Look in any fitness magazine and see all the photos of people doing exercise with their neck tilted forward and chin jutting forward. Look at how people jut their chin and neck forward when they eat. See how they often tilt the neck forward and pinch the back of the neck at a sharp angle when they drink. Instead, get the range of motion from your upper back by gently unrounding the upper back and keeping the neck more neutral. Look how people carry backpacks and bags - neck tilting forward against the load instead of using muscles to hold the spine in upright healthy position? Then they do shoulder stands in yoga, which overstretches the posterior ligament, pushes discs outward, and creates forces that generate bone spurs. The average person overstretches and unequally stretches their neck and upper body so much, it is no mystery that they hurt - it is a mystery that they dont hurt more. Upper Crossed Syndrome The pain and other problems of the forward head are sometimes referred to as Upper Crossed Syndrome. It is not a disease or "condition" or structural problem, or something to live with. It is mechanical pain from bad posture - slouching. It is easily fixed. Don't "do exercises" for your pain then go back to the forward head . Methods follow below. Don't Force The Neck and Head Rearward, Tighten, Or Retract Using the "Double-Chin" or "Dorsal Glide" Exercise or Posture It is common to hear you must pull the head and neck back, or pinch shoulder blades back, and other strains to "stand up straight." Posture rules like this cause as much or more pain than the slouched forward head. This common cause of pain are covered below in #4 below. From Twitter:

3. Hidden Source of Shoulder Pain and Rotator Cuff Tears - Poor Upper Body Positioning

The forward head and rounded shoulders are a surprising hidden source of shoulder and rotator cuff pain and impingement. With the head held forward, and/or shoulders rounded, the upper shoulder rotates forward which gets in the way of normal motion when you raise your arm. The upper arm bone squashes the soft structures of the shoulder capsule against the shoulder bones (where the scapula meets the clavicle). This can cause pain, squashing (impingement) and rotator cuff injury. How often does this happen? Every time you wash and comb your hair, pull off a shirt, put away groceries, scratch your head, brush your teeth, and reach for anything you can be causing mechanical injury to the area and / or cutting into rotator cuff tendons a tiny bit at a time, until they fray and eventually tear. In short, a forward head and rounded shoulders can cause shoulder and upper back and neck pain through many dozens of injurious movement mechanics a day. Injury adds up over time. It is not true that reaching overhead must impinge the shoulder, or that you need to give up overhead activities. When you use healthy position of the upper body and shoulder, there is no more impinging. You will be able to go back to many aspects of daily life that require reaching. Healthy reaching is also a built-in stretch that the shoulder needs for good function. A small number of people have a damaged or structurally changed shape to the shoulder bones that can, in some instances, rub during arm motion. Good positioning also helps in these instances. In severe cases, for example, dead bone, infection, or a large acromial hook that pierces surrounding tissue, the area needs more medical evaluation and possible surgical repair. Doing standard shoulder exercises does not fix poor positioning. Often people do their shoulder and neck exercises in the same unhealthy position that damaged it in the first place.

4. Pain from Forcing to Stand and Sit Straight - Craning, Overcompensating, Yanking Chin Inward (Double Chin Position), Retracting At the Neck, and Forcing Stretches. Also A Hidden Cause of Headache

Check yourself - when you try to stand or sit "straight" or "pull back your shoulders" - do you do it by jutting your chin up (craning the neck), yanking the chin inward (double-chin), tensing the neck muscles, trying to pinch the shoulder blades back? No wonder you hurt. Craning the Neck Craning the neck is surprisingly common, and a major source of neck, disc, facet (spine joint), and shoulder pain. "Craning" the neck means folding or pinching the neck backwards, with the chin and face lifted. Craning may be confused for, even the cause of spondylolisthesis in the neck - a sliding of the vertebrae. Check to see if you crane your neck to look up, to drink, eat, to reach overhead, to try to stand straight, to read, to dress yourself, and wash in the shower. Check yourself to see if you jut your chin forward so often in daily life, continuing injurious habits and pain. People are often told to stand up straight by bringing "ears over shoulders" or "pulling their shoulders back." One common result is to tip head back and crane the neck instead of getting the point - which was to straighten upper body positioning (posture), not make it worse. See the drawing of Backman!™ below demonstrating craning. To stand and sit straighter, don't tip your head back, yank your ear over your shoulder, or merely bring shoulders back, leaving the neck still tilted forward. Get the concept of unrounding the upper spine instead of forcing the neck back to make comfortable healthier upright position.

Are you so tight that you crane your neck to look up, or to try to stand straight?

The forced, pinched neck position hurts and can even create a sliding of vertebrae on the one below it, called Spondylolisthesis (in general, the top or bottom bone sliding more changes the name to retrolisthesis or anterolisthesis - covered separately on this web site). No surgery or pills needed - Use the two stretches below to become comfortable holding upright position instead of craning your neck. Tensing or Effort to Hold Straight Some people keep their head and neck tightly tensely straight. That hurts, obviously. Forced "straight" position is not healthy and not right either. Relaxed upright position means not tightening the muscles so much they hurt. Overcompensating hurts right at the back of the neck. Pulling the chin in too hard usually hurts at the corners of the side of the neck. Another specific and common place pain will start from doing this wrong is at the back of the head and neck People susceptible to headaches will get pain, and sometimes enough for nausea from tensing the chin inward and backward too tightly and too much as a way of sitting and standing. Many people are mistakenly told to do" the double chin exercise" which misses the whole point of what makes healthy normal positioning. It does not teach healthy relaxed position. Strengthening the muscles is not at all what is needed. Tensing these very muscles like that causes plenty of pain. More about this below.



5. Making New Pain in the Upper Back - Forcing Backward Too Much and Too Far

More bad advice includes "pinching the shoulder blades back." There is no need to pinch anything. Pinching brings more pain and tightness. Often it is not the shoulders that need bringing back, it is the upper spine that is too rounded or forward. What is needed is to unround (straighten, extend) the upper spine and leave the shoulders out of it. Other times, the shoulders were fine, but the person applied a party line "fix" of "pinch shoulders back" which moved them back too far (since they weren't wrong in the first place). Blindly trying to do exercises or therapy moves, and never checking cause and effect, wastes time and health.

6. Hidden Cause of Lower Back Pain - Increasing the Inward Curve of Your Lower Back (Causing Swayback) When You Think You Are "Bringing Shoulders Back"

Another common result of the common instruction to "bring your shoulders back" is that people lean their upper body backward instead of unrounding the shoulders. Leaning backward creates hyperlordosis (swayback) which is a large hidden cause of lower back ache. The shoulders and upper back may even stay rounded forward, meaning you caused a new problem (swayback) as well as kept the old problem of rounded upper spine. Photo example below shows leaning backward instead of straighteneing slouched and rounded upper body. Make sure you are doing what you think you are doing when you think you are straightening. Straighten more from the upper spine, and notice what you are doing with the rest of you. Don't lean back. Your lower back and your shoulders are two different body parts. Pay attention. More on fixing the bad habit of swayback is on the summary page of Fixing Lower Back Pain With Standing. This photo example above shows leaning the upper body backward. The shoulders and upper body are rounded.

WALL TEST

Try This Wall Test To See If You Need to Fix Upper Back Pain and Poor Positioning. This is a diagnostic test, not an exercise: Stand near a wall, with your back close to, but not touching the wall. Back up toward the wall. See what touches first, and how it feels most habitual for you to stand. If your heels, backside, upper back, and back of your head all can easily and comfortably touch the wall (Figure # 5), without trying or straining , then it's a good probability that you can stand healthfully upright and straight. That is the goal. Do you like to, or feel most comfortable to stand with only your behind touching, as in figure # 1 in the drawing below? You may stand flexed (bent forward) at the hip. Do you like to, or feel most comfortable to stand with your upper back leaning back to touch the wall with the rest of your body forward of the wall (figure # 2)? You may stand with upper body slouched backward. Does it feel most "normal" to keep your head forward? Figure # 3 Do you need to arch your lower back or crane your neck back to line up - figure # 4? Tight, painful, and needs fixing. Do this wall test, described above,

to TEST if you have the healthy positioning needed to avoid neck and upper back pain.

This is a test to tell what is the problem and see if your two stretches below worked, not an exercise to fix positioning or pain. If you are too tight to comfortably stand as straight as in figure # 5, then you are too tight to stand up straight. Pain can result from the bad positioning (slouching) your tightness creates all day, every day. Pain also comes from tightly trying to force "straight" position. That is not the point of standing straight. My work shows you how to make healthy positioning comfortable and relaxed. (Note to big people: Do not try to push your head back to touch the wall - if you have a big back, you'd have to have a jug sized head to reach the wall without leaning back or forcing. In that case, no need to touch your head to the wall to check positioning. Check if you can comfortably hold in line with midline of the body). On Mar 20, 2017, Michael M wrote:

"This is a Game Changer! I completely get it now! You are right I have been doing it habitually as an exercise not as a tool to assess and give me feedback. Like you said, I am so used to other methods that say to wait for 6 months to see results. I have established I have forward head from the wall test now I need to MOVE ON!"



Being too tight to stand comfortably upright is common and no mystery. Here is what to do:

Two Retraining Stretches Before you do any stretches, see the above to see if you even need them. Stretches do not fix pain. Exercises do not stop sources of pain. They are tools to correct sources of the pain which you are supposed to identify first, then apply the new positioning, as below. For each stretch to make standing well comfortable and possible, understand and do two things - where do you feel it, and does it hurt or help: a) Instead of "doing" a stretch, move and adjust until you feel the stretch in the intended place , b) It does not hurt at all but makes you feel better.If it hurts, you ARE doing it wrong. Use each stretch to identify what you are doing wrong and change what is wrong. These are not conventional stretches. I designed them to give you instant feedback of what is wrong and what you need to fix. 1. Tight pectoral (chest and front of shoulder) muscles rotate your arms inward. To see if you do this, put your arms at your sides, look in the mirror and note direction of your thumbs. Do they face inward  toward each other? To restore the entire front chest area to functional resting length do these two stretches, then *use* the new straight positioning for all you do . It is not the stretches that fix the problem, but the purpose of the stretches - to allow you to hold healthy position the rest of the day: Chest Stretch (also called Pectoral Stretch, even though it includes other muscles and structures in the chest and shoulder) Face a wall, left-hand photo below. Lift one hand up, elbow bent out to the side. Shoulder down and relaxed.

Turn away from the wall, using the wall to gently brace your elbow back as you turn away, shown in the middle and right-hand photos, below. Hold only a few seconds - 3-6 should be enough

. Instead of "doing" a stretch, get the purpose - to feel the stretch in the front of your chest on that side. Then you move accordingly, instead of doing strange rules that you can't feel or understand.

If you don't feel the stretch in the front chest, you are not doing this stretch right. See if you arm is behind you or merely out to the side. Remember, understand what you want to feel, then you will know how to move.

Don't ruin the posture of all your other segments. Don't let your lower back arch or your chin jut forward. Stay upright and relaxed without straining any other areas out of line

If anything hurts, you are doing it wrong. If your fingers or arm goes numb, you are pushing too hard.

Hold properly only a few seconds, then switch arms.

Keep good positioning Avoid the three mistakes shown in the photo below . Students of my Wilderness Medical Society Snowmass 2004 Stretch Workshop each demonstrate one thing to avoid. Avoid hyperlordosis by flexed hip (left), forward head (center), and hyperlordosis by thoracic lean (right).



Drop your arms and look at your thumbs again. Thumbs should face forward now.

Try the Wall Test again. It should be easy to stand straight now. If not, see if you have done this stretch correctly. 2. Next - The Top of Upper Back Neck and Shoulder Stretch (Name of this stretch is shortened to Trapezius Stretch, even though it includes Levator Scapulae and MANY other muscles and structures, of course.) This is not a "neck tilt." Do not use hands to pull the head downward. I do not recommend neck rolls either. Use the following for the intended, which means read and understand first. Don't merely"do" it with no understanding. Stretches can't fix you. Use these special movements that I developed to make healthy position comfortable. Stand against a wall, with your back and the back of your head against the wall, gently Put one hand behind you, as if in an opposite pocket, photo above.

Breathe in. While breathing out, slide your other hand down the side of your body toward your knee, photo at right.

Tilt your head downward to that same side, gently. Keep it as much against the wall as you comfortably can.

Don't round or hunch forward, or drop or raise your chin.

Feel a nice stretch along your entire side.

Hold a second or two while breathing. Switch sides.

If your lower back hurts or pinches to do this trapezius stretch, you may be increasing the arch in your lower back. If you don't know how to tuck your hip to reduce overarch, see the free article on hyperlordosis to fix this. Try the Wall Test again. It should be easy to stand straight now. If not, see if you have done this stretch correctly. Repeat correctly until your Wall Test shows you have fixed the problem. Your wall test should become straighter starting the first day you use this two-stretch method correctly. Your head does not need to touch the wall for your body to be healthy and upright.

How These Two Stretches "Fix" You

Do not do these two retraining methods "as stretches" then go back to forward head. They do not fix the forward head. They fix ability to be comfortable without a forward head - standing straight. Do both stretches many times a day to allow you to stand and move the rest of the day without the forward position that injures and brings on pain . Use the Wall Test to check if you are straight. If not, do the two stretches above (pectoral and trapezius) again, then check if you have accomplished the purpose of the stretches with the Wall Test again until you have corrected the problem right then and there Do not walk away with a tight, forward neck. That would be silly. There is a third stretch in this series that I teach in my books, classes, and private appointments. More good stretches are also in the Stretching Article on this web site. On Mar 21, 2017, Michael M wrote:

"As I was walking, my left shoulder started to hurt. I figured it was from playing with my kids (which I can do now thanks to your work). But as I was walking, I noticed my right thumb was pointed forward and my left was pointing inward. My left shoulder was rounded inward! I stopped by a street light pole and stretched it out. It began to immediately release the pain."

Exercises to Strengthen Will Not Retrain Position or Posture

Neck pain exercises are misunderstood. Do you injure your neck all day then hope to fix it with a few exercises? It will not work if you "do exercises" then walk away with no use of the positioning or strength you just practiced. It is like eating butter and sugar all day, then doing 10 minutes of exercises and wondering why it doesn't "work." When you stop sitting, standing, and bending wrong and injuring your upper back and neck many dozens of times each day, it can heal . The key is what you do all day. Try these retraining drills slowly. See how you feel the next day, then increase. Use these movements, not as exercises to do 10 times, but to retrain how to stand, sit and move with straighter healthier positioning all day .

Holding Healthful Upright Position is Upper Body Exercise

One of many conventional exercises often misused and misunderstood is the "double chin" (also called "dorsal glide"). It In this not-so-helpful exercise, people are told to pull the chin in 10 times (or 15 or 20...). Often people do this in stiff, painful ways. Then they go back to walking and sitting all day with their head forward, wondering why their neck still hurts. Or they force their chin in, causing more pain. Don't do that . This "exercise" can not strengthen or change posture or pain. Even people who have never had neck pain, can hurt when they do this uncomfortable not-so-helpful exercise.

Instead, understand that "the double chin" exercise is not something to "do 10 times" then stop. It is something you use in relaxed way to learn the concept of not holding a forward head . Then you can use it to keep healthful relaxed but upright head position all the time . In other words, you do this concept one time . Also you use it to see if you are too tight to stand comfortably straight. You fix that first, then go on to use the straighter positioning. Don't overcorrect - not all pain is "Forward Head." Often it is "Tense Head." People who think they must keep the chin pulled in stiffly or the head back with effort often notice pain at the bottom of the neck where it joins the shoulder, back of the head, and/ or pain behind the ears. Keep chin from jutting forward, not stiffly or so tightly that it hurts. Change the bad "double chin exercise" into a more useful, functional way of standing simply, upright, comfortably, and healthfully.

When you try to "straighten up" make sure you can tell if you are straightening from your upper back, not by increasing the inward curve of your lower back, or leaning your upper body backward, or "pulling shoulders back." The move comes from lessening a too-large curve in your upper spine. Test your position with your back against a wall often during the day, to see if the back of your head touches, without pain, strain, craning your neck, or arching your lower back (described previously). If it is not comfortable, do the two easy stretches (described previously) to restore ability to stand upright - comfortably - and then use that ability all the time, in intelligently applied, relaxed, healthy way . The idea is to make it possible do this without strain, not to cause it. Don't force to pull back or make a "double-chin" - that will hurt as much as the original problem.

The Point of Exercises

Strengthening and stretching are important, but do not change posture or lifting habits , and so, do not cure neck pain or posture problems. Use this new Dr. Bookspan method of using your brain and voluntary healthy movement habits to stop the source of pain . I have redesigned back exercises to be used to retrain you how you hold your body all the time. Doing neck exercise is not like getting a shot of penicillin or going to confession. It does not fix bad habits the rest of the time. Neck exercise is supposed to retrain your thinking and habits *all the time* not merely something to "do 10 times." Strengthening has no effect on posture if you dont apply the strength the rest of the day to control joint angles for all activities. Neck pain has a large component of bad movement mechanics, not weak muscles. Strength does not make you stand or move in healthy ways. Many people do strengthening exercises and become stronger people who still crane their neck, look upward constantly pinching back from one neck vertebra instead of unrounding their upper back, and slouch their neck and head forward. "Core" exercises are especially misunderstood and repeated and prescribed without any understanding that stronger abdominal muscles have little to do with the most common causes of back pain. Moreover, most conventional core training exercises are done in bent forward ways that reinforce the same bad mechanics you started with. For the research and interesting story on what abdominal muscles really have to do with back pain, see my article on Abdominal Muscles - what they do may surprise you. Bending, standing, moving, and living your life with healthy movement mechanics is up to you. The rest of this article tells more on how. Where strengthening helps - Someone may use good body mechanics all day, yet ache with fatigue at the end of the day. That is not a back injury or true back pain that needs treatments, and should not be addressed with medications. Another instance is someone who really is so weak that they can't hold up their own body weight or the weight of their shoulder bags and instead, shifts it onto their joints, which wear with time and grind under the weight (slouching). A little strengthening allows you to do more before fatigue pain sets in, and to be more able to use good mechanics instead of slouching. Strengthening will not keep you from slouching, and don't fall prey to unhealthful exercise programs claiming to cure back pain. Almost any movement can make you feel better for the moment. Over the long run, it's better not to use injurious movement techniques for your health. Use good mechanics for all you do and healthier ways to exercise explained in this article, other free articles on this site and the books with more.

Do You Exercise in Ways that Damage Your Neck, Shoulder, and Upper Back?

Neck Pain FROM Your Exercises

If you hurt from excessive forward bending all day over their desk, steering wheel, work, and TV, the last thing you need is more upper back and shoulder rounding. Many exercises, ironically even those commonly (but mistakenly) prescribed for back and neck pain, involve more forward bending - toe touches, knee to chest, crunches, and shoulder stands like "the plow" and "the frog" (lying backward, raising legs over head so that body weight presses your upper back and neck into flexion). .

You already are good at rounding your shoulders. Don't add to your round shoulders with more stretching in back.

Rounded posterior shoulders are part of the problem. Instead, stretch the front, shown earlier in this article.



Why add to a forward head or "base of the neck pain" with these?

Adding body weight to a stretched-forward neck accelerates disc degeneration, gradually pushes discs outward to the back (herniate), and can eventually make the bone protect itself by growing a bone spur.

I did studies that found no relation between hamstring flexibility and lower back pain (except for all the people hurting their back by DOING hamstring stretches) - click to see why it is so often mistakenly prescribed for back pain.

Is Your Drinking Hurting Your Neck?

Academy student Jessica Lattouf demonstrates fixing neck and upper back position for healthier drinking and eating: 1. Craning the neck and lifting the chin with a rounded upper back (upper left). At upper right: correcting to healthier position. 2. Lower left shows forward head and rounded upper back, fixed to relaxed, healthier neck and upper body (lower right) when eating from plates low on a table: Healthier body position does not mean to rigidly hold straight and never bend the spine. It means to be aware if you habitually slump your weight on a rounded or angulated spine and use muscular control for healthier mobile positions that move as needed throughout healthy range. Check if you jut your chin forward to eat and drink. Pushing the neck forward while lifting the head (chin forward and up) creates severe forces on the discs, presses the joints together in back, and in general produces unnecessary pain and injury. Instead, keep chin in. When eating and drinking, get more of the lift from your upper back, "unrounding" and straightening the forward curve of the upper back, instead of only pinching back from one spot in the neck. Easy, fun Neck Saver reminders for drinking and sitting click items.

Neck Discs Can Heal

Disc injury is not a life sentence. Disc degeneration or slippage (herniation) can heal - if you let it, no differently than a sprained ankle. Stop damaging your discs with bad bending, standing, and sitting habits and the discs can heal. It takes years to herniate a disc, and only days to weeks to heal it by stopping bad habits.

Muscles Can Heal

When you over-tighten muscles with hunching and bad habits, they can remain too shortened to let you stand properly. Or they stay tightened in knots or spasm. This changes their muscle chemistry. When you slouch, you keep some muscles overly shortened and others overly stretched, which weakens and strains them. Massage does not stop the cause. Are you paying good money gimmicks and medical devices and massages and treatments and adjustments then go right back to causes? Stop bad movement habits and you will stop causes, and muscle knots and triggers and sore spots will quickly heal.

Pain When Your X-Ray is Normal

You may be in great pain from simple damaging mechanics or holding your body tightly. Your X-rays and scans are normal. You may be told nothing is wrong, or that it is "stress" or to give up favorite activities. Your pain persists from bad postural habits. This is no mystery. Change the bad habits to change the pain. You will be able to keep your active life and do more than before.

When Pain Is Not From What's On Your X-Ray

Other times, the scans show some minor problem like arthritis, herniated disc, or degenerating structures. Like car tires that are mid-life, but perfectly good, some wear may show on exam  but this is unrelated to performance or pain. Pain is falsely ascribed to the arthritis or to the disc. Patients feel doomed, and are often told to give up activities. Pain (even the herniation itself) may mostly result from poor mechanics. This is no mystery. Change the bad habits to change the pain. Keep your active life - it's important for your health.



Sometimes, the scans show some major problem, and major surgery is performed to correct it (taking out away from healthy outdoor fun and indoors, sick, eating institutional food, away from fresh air and sunshine - that's not health). When the original problem was from the bad positioning, often pain persists or returns because you never corrected the mechanics that caused it. The defect itself may return from uncorrected mechanics. Surgery can be avoided. Fix the source of the problem and the results of the problem can heal without surgery. Instead of being forced into reduced health and activity, you can do more and have a fun active life.



Pain From Your Medicines

Common prescription medicines cause much joint and muscle pain. The pain is not a rare effect as previously thought. It is common. Are you on medicines for lowering cholesterol? Sleeping medicines? Drugs for depression and anxiety? Irritable bowel drugs, stomach acid drugs (a contributor to osteoporosis and thinning bones, too) drugs to help you concentrate, to help wake up, to calm you, for allergies. Increasing numbers of drugs are found to have pain as side effect, even, drugs for pain. Stretches and exercises will not fix this kind of pain. People with existing pain are often put on new medicines that cause more pain in an expensive, unhealthy cycle of pills, payments and pain, all needless. In an ever worsening cycle, side effects are "treated" with yet more drugs with effects that lessen and degrade your health. That is not "side effects" and that is not health care. Many of these drugs are not needed. Some, like stomach acid drugs, are associated with rebound and increased symptoms. A top health priority is to stop the need for these drugs so that you can lessen, then stop the need to take them. If you are in pain and don't exercise or move much because of that, then get cholesterol and other health problems from not moving, can't sleep, then take cholesterol and sleeping medicines that cause dependence and more pain, INSTEAD, start with the healthy principles in my free summary articles and all my books so that you can move again, and be healthfully tired at the end of the day and sleep well at night. Not all exercise is good medicine. Healthy exercise as healthy medicine will stop much pain and need for medicines that cause more problems. ----- “Doctors are men who prescribe medicines of which they know little,

to cure diseases of which they know less, in human beings of whom they know nothing”

Voltaire (1694–1778), French writer and leading figure of the Enlightenment -----

Pain From Your Expensive Ergonomic Pillows, Beds, and Devices

Check for large pillows, hard (too firm) pillows, and beds that press or curve you into specific positions. They are a common source of neck and upper body pain and headache. Often they are designed for people with unhealthy tightness to hold them in that same unhealthful position. Save your money and get free preventive medicine and relief - use healthful stretches and movement in the day time so you can straighten out more comfortably while sleeping. If you are too tight to lie down comfortably on your back without with a pillow under your legs and head then it is no mystery that you are too tight to sleep comfortably without being held in shortened tight positions by props and special pillows. Stop the need for them, then you will stop the pain.

How Long Does It Take To Fix Neck Pain?

Using everything presented above, you should feel the difference as soon as you stop the causes of pain every day, reposition your head and neck during all you do, and use the two easy stretches, as intended, to make healthy position more comfortable. If you're not feeling better right away, check what you are doing compared to what you have learned above and in the other free articles, for example, are you still sitting badly right now reading this? Check what you are doing compared to what you THINK you are doing (are you are doing it wrong?) .

Are you doing bad exercises from other sources? It is common to do a few movements from my work, but continue or add injurious moves from other sources that slow recovery and re-injure.

Are you tightening or clenching any muscles to move? "Tightening" is a common instruction for PT and exercise, however it is not a good instruction. Tight muscles can hurt and impede healthy movement.

Are you overcompensating? Are you making new bad movement habits that seem opposite of original unhealthy movement thinking that will "undo" or fix?

Are you going back to bad movement habits during the day? Check my free article on Bad Exercises, this one on bad stretches, and this one showing better health and understanding of healthier ways to sit at a desk and computer and other long sitting.

Make sure your pain is not from medical conditions (vascular, infection, shingles, Lyme disease, Sickle Cell, allergies and food sensitivities, other) or from many medicines known to have body pain as side effects It takes years to hurt a disc, or neck muscles, and only days for it to start healing once you no longer are injuring yourself. Make sure there is not something else contributing to your pain. It is almost always quick and easy to start getting your life back and start feeling better right now. Don't wait.

When you look upward and reach upward for all your daily activities, don't pinch your neck back at an angle. Instead, "unround" your upper body, which is a great stretch that you need anyway.

----- On Mar 20, 2017, Michael M wrote:

"On page 72 (Healthier Stretching), you have an upper back stretch where I unround my upper back. I did it last night and it felt great. I did it nice and soft and moved my head slightly to the right and BINGO I felt a stretch on the one spot I am complaining about. I felt it from the back of my head down to the exact spot in my upper back I was complaining about. Its not pain, it felt like a good stretch. I am using the stretch to not only unround but to also release the tension in that area." -----

What To Do Every Day To Prevent Neck Pain - Restore Muscle Length to Allow Healthy Positioning All The Time

Count how many times you let your head tilt or hang forward each day. Imagine the injury to your neck by doing that many times each day. Check if you're overcompensating and yanking, or tensing to be straight. That's just as painful.

During the day, check if your positioning is straight with the Wall Test - described above. The wall stand does not fix the posture - it is a test to tell you what you need and where.

If standing straight with the Wall Test is not comfortable, use the Pectoral (pec) muscle stretch and Trapezius stretch - described above.

To look downward for reading and working, simply keep chin comfortably in, and neck straight and upright, not forward. Tip your head down instead of hanging the weight of your head forward on your upper spine and muscles.

First thing in the morning, don't sit on the bed. Instead of sitting and rounding your back first thing, turn over and lie face down. Prop gently on elbows, but not so high that it strains. It should feel good and help you straighten out first thing. Get out of bed without sitting.

Don't droop and hang your head forward when standing, sitting, and other movement. Remember that posture and body positioning is voluntary. This is the whole key to stopping upper back and neck pain when standing, sitting, exercising.

Lie on your back on the floor (diagnostic for tightness and repositioning). Can you lie on your back without needing a pillow under your head? If not, your forward head has become dangerously tight. Do everything above to relieve it. Be careful and use your brain not to do unhealthy things that hurt.

Sit without rounding your shoulders and upper back too far forward. Sit without pulling head, neck, or shoulder back too stiffly backward, or overarching lower spine. Sitting article.

When sitting, i t is not important "to keep feet on floor" or keep flat thighs - parallel to the ground. That is often repeated as advice to prevent pain, but it does not change injurious mechanics . Focus on the main issue, not the trivia.

See if you habitually look upward by tilting the chin up (pinching the neck back at one folded point), or if you understand how to get range and a good stretch at the same time by "unrounding" and extending all along the upper back. Neck stays more neutral.

If you habitually hold your head forward, don't merely pull your chin in to" fix" your posture, - unround more from the upper body where the leaning forward is coming from.

When you think you are stopping pushing your chin forward, and bringing your chin in to" fix" your posture, don't do it by arching your lower back - or leaning the upper body backward. The postural change needs to come from your upper body, not by creating another strain on another body part .

Don't think you have to live your life "on eggshells" constantly holding yourself rigidly straight. Restricting your movement to limit pain is not how to live, isn't healthy, and isn't fun. Get more active. Learn the principles and apply them, instead of memorizing "rules" and buying expensive ergonomic chairs and beds .

Summary - Fixing Your Own Neck Pain

Neck, upper body, and much shoulder pain is not a mysterious "condition." People spend their day sitting, working, walking, and driving with their upper body rounded forward, they lift and bend with rounded forward bad positioning all day, then exercise rounded forward, physically pressing discs outward and overstretching muscles in back. They do yoga and Pilates moves with their head forward or pinched and craned backward, then do shoulder stands, plows, and other stretches that forcibly push discs outward. They take anti-inflammatory medications for mechanical pain that is not inflammatory, try remedies that do not address the cause of the problem while they continue doing the causes, do physical therapy in bent forward ways that exacerbate the original problem, give up favorite activities, have surgery and then return to previous bent forward habits. After all this obvious cause of pain, everyone is astonished that they "tried everything and nothing seemed to work." It's like overeating all day, waving your hands in the air for five minutes, then saying "I don't understand why I don't lose weight; I do my exercises." Using muscles to hold healthful positioning would stop the pain at the same time that you burn calories, strengthen, and be a free workout: Use healthy positioning to stop the cause of pain and damage. Then no need for pills or surgery, and the injury can heal.

Pain can be avoided by no longer damaging body structures with poor mechanics.

It's simple - Dont memorize complicated rules. Simply use muscles easily to reposition for daily life. How is your neck and body positioning right now? Rounded, bent forward to read this? The whole point of exercise and therapy is missed when you dont learn to consciously use your muscles the rest of the day for standing, sitting, bending, and all you do in daily life. Use your muscles to stand and bend in healthy ways for all daily tasks. Bonus: It burns calories, strengthens, and is a free workout. Watch other peoples posture, gait, and movement habits. It will remind you to straighten up.

Notice injurious "fitness and health" moves featured in fitness and yoga magazines and books.

Please don't combine other people's injurious stretches and exercises then come back to me and say my work isn't fixing that.

Make sure your pain is not from medical conditions (vascular, infection, shingles, other) or from many medicines known to have body pain as side effects.

Send me your success stories and photos showing the principles in action. Prizes for best ones

Please do not e-mail me saying you are "doing the exercises 10 times" and want me to "tell you how to fix your pain from the forward head, or from straining to do exercise." Here is the answer now: Stop slouching your head and neck forward or forcing and yanking to straighten, and the source of pain can stop. It is not the exercises that fix things, it's you.

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Don't Change These Concepts and Methods Back To "What You Know" - These Methods Work Only As Written and Intended

Henry Louis Mencken said, "Any man who afflicts the human race with ideas must be prepared to see them misunderstood" Even so, please don't change my work back into what you know, or what others say, or what you learned somewhere else, or "doing exercises." Check the concepts in this article again in green type (and let me know if green type doesn't show up on your device). To paraphrase Bertrand Russell, "An untrained man's report of what a knowledgeable man says is never accurate because he unconsciously translates what he hears into something he can understand." My work is primary source, and often, not what we learned in school and the gym. Remember, that is good.

Success Story from Julie Ballenger

Julie Ballenger had breast cancer, 2 mastectomies, more surgeries to fix complications, infections etc, then a serious car accident that resulted in whiplash, occipital neuralgia, migraines, and scarring. Many years of neck, jaw, head, and upper body pain followed that would not resolve. For years, she saw dentists, oral surgeons, neurologists, chiropractors, myofascial therapists, and others for many expensive and repeated treatments, but, "could not find anyone who has any solutions, options, help other than drugs to mask the pain." She worked full time, had two young children, and wrote me in 2013, "I drag myself through the days with this constant pain. I found your work online by accident and have become a great fan of your books and am very inspired by your personal history. Thank you for being out there. This has been a very lonely journey. Your books were a lifeline to me and I find you amazing. " We worked together over mail, then she came to see me for a personal appointment in Philadelphia in 2013. Photo below is the result Here is her 2015 follow-up "I was told in 2000 upon my first breast cancer diagnosis, by a man who was certain he could tell the future, that I would not see 50.



Well- here I remain. Thank you for the Happy Birthday wishes (and remembering) I did indeed have a birthday—49, and planning on 50.



I am doing pretty well. I sometimes still battle neck pain and behind the shoulder blade pain. So- I pull out my very dog-eared Dr Jolie books and my notes from my visit, remind myself, reevaluate, get back to doing some of the stretches and movement I’ve neglected to do for a bit, figure it out and it works. I seem to get amnesia every once in a while and need a gentle Jolie kick in the proverbial pants. You always work, J.



My kids are 13 and 11 now. We are doing a lot of activities as a family this summer—biking, pool, summer evening walks. The job requires computer work, but I do get up and about as much as I can.



You are welcome to post/publish this. I remain one of your biggest fans." You Dont Have To Live With Pain I hope you were able to get a quick and easy introduction with this article. My books tell more.

Thank You

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