©2019 Portland Pain Institute LLC

Essential self-care: resting the neck

When the neck tightens due to stress or injury, its muscles are exerting more effort than required to hold the head upright. Overworked muscles grow tired prematurely. Like tired legs, a tired neck needs to rest. Diligent neck rest is absolutely essential for the fastest, most complete recovery from neck injuries, and can prevent spasm and pain for those without injuries.

The neck is peculiar in that its tired muscles seldom actually feel tired, unlike the legs or feet. When the legs and feet are tired, one simply sits to rest, removing body weight from the limbs below. In contrast, the poor neck is expected to continue, without respite, its work of holding the head upright. Instead of providing a helpful sensation of tiredness, a tired neck will feel tight, irritated, and/or painful, prompting most people to squeeze or stretch the neck for momentary, symptomatic relief. Neck discomfort sometimes indicates a need to be moved again, after a stationary period, but most often signals a need to rest.

Given the demands placed upon it, plus its delicate construction, the neck is especially vulnerable to what I have termed chronic exhaustion. Chronic exhaustion of the neck is a distinct condition that warrants specialized intervention. A defining characteristic is the fact that the subject cannot rest the neck adequately at home, either with sleep or conscious effort. The condition requires guided relaxation, which permits thorough rest and the unmistakable reversal of exhaustion. In fact, one must experience facilitated rest in order to fully appreciate the impact of chronic exhaustion—for the before-and-after comparison.

Like any discomfort, exhaustion provokes a stress response. While all discomforts trigger essentially the same stress response, specific remedies are required to relax it; the remedy must match the problem. Hence, when neck exhaustion is not recognized by either the subject or practitioners, adequate rest may never be obtained. Typically, treatment will consist of symptomatic relief of spasm and misalignment. In contrast, rest is more than mere symptomatic relief for an exhausted neck. It is both cure and preventive.

Muscle strength is gained by exertion plus rest. If rest is inadequate, exertion leads to weakness instead of strength. If proper rest is not obtained soon enough and regularly, a tight neck loses strength insidiously, growing increasingly prone to exhaustion and degeneration. The progression from neck tension to tissue degeneration can be generalized as follows:

1. Due to various stressors, the neck is tighter than usual for a period of days or weeks.

2. The tense neck is deprived of rest during waking hours; the stress response is compounded. When tension is severe, the neck can no longer relax or rest adequately during nightly sleep. It will be tense even after the body sleeps, and more susceptible to exhaustion.

3. Daily neck exertion continues, without rest. The subject does not notice or suspect neck exhaustion, but suffers from mounting discomfort. The subject seeks common pain relief methods, complaining of head, neck, shoulder, arm, and/or upper back discomfort. Despite symptomatic relief, deep exhaustion persists.

4. Due to prolonged exhaustion, the neck muscles grow weaker and lose mass—an atrophy process similar to that resulting from lack of exercise. Caught in a downward spiral, the weaker neck is even more prone to exhaustion, spasm, spinal misalignment, and pain. Neck pain becomes chronic or recurrent.

5. Over time, local tissue stasis induces degenerative spinal conditions, such as disc compression, straightening of normal spine curvature, osteoarthritis, narrowing of nerve passages, etc.

Not every chronic neck pain case will appear to follow this sequence, as noticeable atrophy does not occur in all subjects. Or, due to injury, some subjects will quickly progress to the fourth stage. Regardless, where excessive tension persists, one can assume that some degree of exhaustion exists. Therefore, exhaustion is inseparable from the development of chronic pain and degeneration.

The causes of neck tension that can lead to chronic exhaustion include emotional stress, inadequate sleep, long work hours, biochemically induced fatigue (e.g. hypothyroid symptoms), poor body mechanics or posture, and various injuries. Also, injuries in surrounding areas can spread tension to the neck. Many whiplash victims, even those receiving chiropractic and massage, will heal the neck injury tissue damage normally in a few months, only to complain later of discomforts in the head, neck, and nearby areas. After the injury damage has healed, there are two reasons for the ongoing stress response and pain: 1) injury memory discharged during an Arneson Method session, and 2) the neck exhaustion sequence.

Injury memory (local, residual stress response) cannot be removed entirely without activating the sympathetic nervous system’s discharge mechanism. Thus, many whiplash victims experience pain and pathology for years or decades after a single injury. Injury memory adds to the neck’s workload and inhibits proper rest. In perhaps all cases of neck exhaustion, pain discharge will be experienced with the Arneson Method. However, immediately before and for weeks following discharge, the neck requires thorough and consistent rest; discharge is not the only remedy needed.

Naturally, rest is by far the best remedy for exhaustion, which is not eliminated by symptomatic treatment of neck tension and pain. Standard remedies for chronic or intermittent neck pain entail exertion, stretching, soothing (e.g. hot packs, gentle massage), or the various forms of manipulation, to the glaring exclusion of comprehensive rest. In the 1990s, chiropractors were taught to prescribe neck strengthening exercises for chronic neck pain. This is logical, as stronger muscles are less prone to exhaustion and pain. However, the process of strengthening a chronically exhausted neck is unnecessarily long, arduous, and may not actually help the problem.

Some physicians do recommend rest, but the subject is instructed to rest the neck at home. Since physicians are unaware of the chronic exhaustion condition per se, they are unaware of the inadequacy of independent rest. Rest is commonly recommended for acute neck pain (even to excess), which is more sensible. Acute neck pain—due to recent traumatic injury—is not yet accompanied by chronic exhaustion. Likewise, pain flareup in the midst of chronic pain will also benefit from rest at home, but such rest will not eliminate the underlying condition. Since starting to look for them in 1994, I have not heard mention of chronic neck exhaustion or the facilitated rest remedy outside my own practice.

Both chronic neck exhaustion and injury memory can be eliminated in a single Arneson Method session. The logic and process are straightforward. The exhausted neck requires thorough rest, which happens only when the neck is deeply relaxed. However, the neck is usually the last area of the body to relax, even when not injured. The method entails systemic relaxation first, of the whole body, which invites the neck to follow suit. (In contrast, manipulation methods ignore systemic relaxation in their symptomatic treatment of neck tension.) After a few minutes of total comfort, the neck releases its excess tension, perhaps for the first time in years. It can finally rest adequately. Clients often doze at this point, while the neck rests and reenergizes. Auto-adjustment of the cervical spine during the resting stage has been a consistent observation. When the neck is sufficiently rested, the discharge process begins automatically. The neck muscles contract involuntarily with momentary pain, followed by complete relaxation.

After the neck discharges injury memory, it is either pain-free or nearly so. An atrophied neck will be instantly stronger and tangibly fuller due to the surge of circulation through expanded blood vessels. However, even after discharge, a weakened neck must still regain strength and muscle mass in order to avoid the danger of the exhaustion sequence. The client must rest the neck several times each day, for two or three weeks, until clearly stronger. During this period, resolution of secondary symptoms in surrounding areas has been demonstrated consistently. In almost all neck cases that receive an Arneson Method session, diligent rest permits independence and resolution after a single session.

Resting the neck at home is a simple, enjoyable operation. One lies flat or places the head on a table—any comfortable position that removes the head’s weight from the neck. Then, for ten to twenty minutes, one consciously lets go of tension in the neck and back. For best results, the neck should be rested on a schedule, at regular intervals, but also as soon as possible if any discomfort is felt in the head, neck, or shoulders. Since tight neck muscles often “refer” pain to the head, one should interpret any head discomfort as a cue to rest the neck. Recovering clients should do nothing else while resting their necks—e.g. reading or conversing—that could tense neck muscles inadvertently and cancel the rest benefits. While driving, in a pinch, the neck can be rested by leaning the head back against the fingertips of one hand. Readers with neck trouble could try resting their necks right now, as they will almost certainly notice some relief.

After the rest/discharge session, the neck is instantly stronger and better prepared for neck exercise. However, neck exercises taught by practitioners are overkill for a neck that is suddenly relaxed after being tense and weak for months or years. The weight of the head alone, alternating with rest, is sufficient for regaining strength and mass in the first few weeks of recovery. Moreover, neck clients who receive massage therapy should avoid all massage procedures on the neck until the problem is completely resolved. Muscle tension should be allowed to come and go until it eventually balances to the body’s specifications. During this period, rest is the treatment of choice for any neck irritation. After normal muscle mass and strength return, clients would likely benefit from more rigorous neck strengthening exercises; stronger is better than weaker.

In some cases, there is a tendency towards neck spasm and subluxation due to unresolved emotional trauma, in addition to injury memory. Typically, such symptoms are identified as “stress-related,” as the actual trauma memory is inaccessible to the subject. Hence, after injury memory and exhaustion are eliminated, the subject may still suffer from “stress-related” pain. For such cases, removal of injury memory has provided permanent relief of symptoms stemming specifically from the physical trauma component, while leaving the emotional component intact. Clients were able to remedy occasional “stress-related” tension with rest and relaxation exercises. Elimination of the injury memory component greatly simplified their conditions.