Fixing Upper Back and Neck Pain
Monday, October 16, 2006
Healthline
The post Breasts Causing Upper Back Pain is a Myth explained that a tilted-forward position of the head and neck, called a forward head, is not the normal tilt to the neck. It is an avoidable slouch that causes much upper back, neck, and shoulder pain, and pressures the discs of the upper spine. Do you have a forward head? If you can't put your back against a wall and comfortably touch the back of your head to the wall too without overarching your back or raising your chin, that usually indicates that the muscles in front of your chest are so tight that they restrict normal standing. The resulting bent-forward position of your neck creates large forces on the muscles and joints of your upper spine as it strains to hold the weight of your head forward of the supporting spine instead of above it.
Being too tight to stand and sit upright instead of slouching forward is common, even among people who stretch regularly. The reason is that they usually practice stretching forward, rarely stretching the front muscles by stretching back. In turn, holding your body bent forward instead of upright perpetuates tightness. To get the stretch in the front chest (pectoral) muscles that you need to stop the slouching-tightness cycle, use the photo above left for reference and try this:
- Stand facing a wall. Bend one elbow out to the side and put the inside surface of that arm against the wall, as in the left-hand photo.
- Turn your whole body and feet away from the wall, letting the wall brace your bent arm behind you, as in the right-hand photo.
- If you are doing this stretch right, you will feel a nice stretch in the front of your chest.
- Keep your shoulders down and relaxed. Breathe. Smile.
- Hold a few seconds, breathe in, change arms, and breathe out while stretching the other side for a few seconds.
- Now drop both arms and turn to stand with your back against the wall again. If you did this pectoral stretch right, standing straight with the back of your head touching the wall should now feel more natural and comfortable and no longer a strain.
- When you walk away from the wall don't slouch forward again out of habit. Hold the easy new healthy positioning for everything you do.
This pectoral stretch is one of two techniques to stop upper body tightness that prevents standing and moving in healthy ways. I will cover the second soon. Remember that head and body position is voluntary. Hold your head up and shoulders back softly. By not letting your head hang forward all day, you will no longer need constant pills, adjustments, or treatments for pain. You will stop the cause.
Thank you to photo subject Paul Plevakas, shown from the book Fix Your Own Pain Without Drugs or Surgery - What to do to fix many sources of pain and injury, step-by-step.
Post with helpful info to get the purpose of this pectoral stretch - Pectoral (Chest) Stretch - The Most Common Mistake in the Best Shoulder Stretch
Even more information is in the replies to the many reader comments below this post. Before asking more questions, see if your answers are already here.
Click the labels under this post for all Fitness Fixer posts about that topic, for example, for posts about neck pain, click "neck," for healthy sitting, click the label "sitting." For all posts explaining discs or fixing pain, click those labels.
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Labels: chest, disc, fix pain, neck, posture, shoulder, sitting, stretch, upper back
31 Comments:
At Tuesday, October 17, 2006 8:38:00 AM,
KathyB said…
I learned this exercise a few years ago, when I WAS in the habit of slouching. It really works! If you do it every morning you really loosen up the tightness and train your muscles to hold you more upright.
At Monday, January 29, 2007 10:06:00 PM,
Mim said…
After only a couple of shots with this my head was touching the wall when standing with my back to the wall. After only a day or so of this and the neck stretching exercise, my back is getting so straight and the most comfortable and restful lying position is flat on my back, legs straight, toes pointed up, arms by my side with thumbs facing up - and all without any pillows at all. Hope I'm doing this properly - it certainly feels so much better.
No more round shoulders or forward head, and with my pelvis tucked no more sway back - wonderful. (Yes, I was a postural mess, LOL)
At Sunday, April 08, 2007 1:58:00 PM,
Jolie Bookspan, M.Ed, PhD said…
The second stretch that I mentioned is now posted:
Nice Neck Stretch.
It is the second of two techniques to use together to quickly reset resting muscle length, and stop the upper body tightness that prevents standing and moving in healthy comfortable ways.
At Monday, April 09, 2007 4:28:00 PM,
Anonymous said…
I hear the heart beat at my back head position i went to neurologist he did scan and said its everything is normal but i am suffering the same from past one year.
At Tuesday, April 10, 2007 1:08:00 PM,
Jolie Bookspan, M.Ed, PhD said…
Good that you got it checked.
See if you are pulling back too hard. It presses blood vessels. Also makes the muscles hurt at the angle of the neck.
The idea of the two stretches is to make restoring healthy position feel normal and comfortable - not pulling, yanking, and pinching off of blood vessels to force straightness.
Do I understand that you felt this before trying the "back head position" you mention? When else? What happens when you try the wall stand?
At Friday, August 03, 2007 12:27:00 AM,
Paul said…
i have a problem with my upper back what this problem is seems to be a mystery, i have consulted numerous medical practitioners and each one has a different opinion of the problem. they have all given me exercise's or treatment with little or no success. the problem has been on going for around seven months now and i am feeling really drained by it, to a point where i physically want to curl up in bed and just stay there.
the problem been pain in my upper back between the shoulder blades and central, this is usually fine during the day however after going to sleep for around 3 to 4 hours i wake with the pain, staying in bed, moving into different positions does not help, pain killers seem to do nothing only make me feel drousey. but i still cannot sleep as the pain keeps me awake, so i take myself downstairs and sit infront of the tv. the pain subsides in anything between half an hour to 2 hours, i can then go back to bed and get another 3 to 4 hours before i am woken again. i have been diagnosed with a herniated thoratic disc, inflamation, posture problems, and even told that it is all in my head( i wish, i could do something about it) most of the treatments i have received have had an initial inpact making me believe they are working, only for the symptoms to then come back a few days later. the only thing that has worked for a significant amount of time was medication for inflamation (dicloflex) although i ended up with annemia as a side effect. since then i have seen a surgeon, who said it was postural without taking an x-ray or mri scan. a physio for the so called posture problem, who then later said it was a disc problem with treatment and exercise routine having little o no effect. i have even tried traditional chinese accupuncture which has not been preductive so far. what can i do? or whom can i see about this? kind regards paul, eyorks
At Thursday, August 09, 2007 11:15:00 AM,
Jolie Bookspan, M.Ed, PhD said…
Paul, sorry you're gong through all this. Doing a few exercises and stretches then going back to body mechanics that causes pain sets you up to perpetuate the pain.
What things should you check for?
1. Specific common medicines (and herbs) make surprising body pain. Some (like stomach acid medicines) are given for side effects of other medicines, and add more pain. Let's look into stopping mechanical source of the pain so no medicines are needed.
2. Stop exercises that contribute to the cycle you describe like crunches, leg lifts, and toe touches. Don't sit rounded at desk, TV, or exercise.
3. If the pain is caused by "posture," it is easy to tell and fix:
- Try the wall stand test in the first paragraph of this same post (that you replied to) Fixing Upper Back and Neck Pain and let me know the result. Is your head forward of the wall when you stand normally? Is it uncomfortable to stand with the back of your head touching the wall when you also touch your heels, backside, and upper back?
- When you stand normally, do your thumbs roll inward, explained in the post Thumbs Can Show Tightness That Leads to Upper Back Pain.
- What happens when you do the pectoral stretch in this post (that you replied to above)Fixing Upper Back and Neck Pain? Can you then stand comfortably straight right away? That is the purpose of the stretch. Then you keep healthful positioning for all you do after that and don't go back to the tightness and mal-positioning that causes upper body injury.
- What happens when you do the Nice Neck Stretch - it should feel better, and make the wall stand test work more easily, right away.
4. If the pain is from an upper back disc, that is also easy to tell (MRI or other test) and is often easy to resolve quickly:
- The post Disc Pain - Not a Mystery, Easy to Fix shows how discs are physically pushed backward by daily habits. It is easy to stop sitting and bending wrong- shown in the post The Cause of Disc and Back Pain. Then the disc can heal. Takes about a week. Don't worry.
5. How does the Quick, Feel-Good Upper Back and Chest Stretch feel? It is good to help restore problems from both posture and disc.
At Wednesday, August 15, 2007 11:59:00 PM,
cwalker3 said…
Thanks because I have had trouble with lower back. It really can take away from my workouts.
Fitness website
At Tuesday, August 21, 2007 11:29:00 AM,
Jolie Bookspan, M.Ed, PhD said…
Cwalker3, trouble with the lower back with workouts is frequently from common exercises. The exercises "work" to give exercise but are damaging, in the way that cigarettes "work" to calm nerves and help weight loss but have unhealthful side effects.
Some exercise examples are posted in Common Exercises Teach Bad Bending. A main concept of bad stretches is in Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch. The mechanism of how this kind of bad bending affects discs and surrounding structures is in Disc Pain - Not a Mystery, Easy to Fix.
A different kind of lower back pain than the injury from bad bending above is chronic achyness after long sitting and standing - Fixing the Commonest Source of Mystery Lower Back Pain and other posts under the labels neutral spine and facet joints. The exercises associated with this kind of injury are in Prevent Back Surgery. Use the functional exercise throughout this blog and my website (www.DrBookspan.com) instead.
At Sunday, February 17, 2008 1:34:00 AM,
Travis said…
Hi Jolie. When I do this chest stretch, I feel a pulling deep in my back/shoulder blade. What would cause that? For example, my neck and shoulders are pathetically weak and rounded. If I try doing shoulder shrugs properly, I feel a burning along the top back of my shoulders.
At Friday, February 29, 2008 4:35:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Hi Travis, don't strain or push hard on the stretch. If you don't feel a good, helpful stretch in the front chest (pec) muscles, you are doing it wrong. The second stretch to do with this one is Nice Neck Stretch. The idea is to check your positioning with the wall test, then do the two stretches, then check using the wall test that they worked. If you don't immediately feel it is easier and more natural to stand straight against the wall, you have not done the stretches right. The point of the stretches is to restore functional muscle resting length. The point is not to "do" a stretch, whether it hurts or not. Get the purpose of the stretch.
I don't know what shrugs "properly" means to you, or what you are actually doing when you do shrugs, but an easy question is if the burning just means you feel exertion in the muscles, which is what you want.
More important, the two stretches are supposed to be used to fix your rounded shoulders then and there. You are not supposed to leave them rounded. Doing shrugs (and just about any other movement) with rounded shoulders is nasty for the shoulder joints and perpetuates problems.
For the pec stretch- Keep your elbow about ear height and keep your shoulder down and back. Make sure it feels wonderful.
For the trapezius stretch (Nice Neck Stretch) do it with your back against a wall. If your lower back hurts when you lean to the side, press the lower back space closer toward the wall - lower back pain us usually from overarching this small inward space.
At Sunday, March 02, 2008 2:19:00 PM,
Travis said…
Putting my elbow at ear height made the difference! I was trying it at shoulder height before and it didn't work. Thanks!
The "proper" shoulder shrugs was about not doing them with rounded shoulders (the burning was from exertion). I don't have that problem anymore (the extreme weakness in my upper back/shoulders - fixed by arm circles) and my postural habits are improving.
At Monday, April 21, 2008 10:48:00 PM,
Sandra said…
I was surprised to see "leg lifts" listed as an exercise to avoid - is this the one where you lie on your side and lift the leg about 45 degrees and then bring it back down (outer thigh exercise)? If so, would that warning also include the inner-thigh leg lift?
At Tuesday, April 22, 2008 1:14:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Sandra, I think your question is referring to the reply to reader Paul who was having pain from a body tight from a lifestyle of forward bending and sitting: "2. Stop exercises that contribute to the cycle you describe like crunches, leg lifts, and toe touches." These would be leg lists of lying on the back and bending the hip (forward) to raise the leg.
It is more important to understand the reason and purpose of any "exercise" you do. Exercises by themselves do not fix pain or posture. Many contribute to the cycle of bad positioning and continuous forward bending, for example. This post was to show the problems of keeping the upper body rounded forward and to break that cycle. The upper body chest stretch given in this post does not fix things, but you use it to lengthen the muscles so that it becomes comfortable to hold straight, healthful position, but you have to hold it and use it during daily life.
As mentioned in my reply above, "Doing a few exercises and stretches then going back to body mechanics that causes pain sets you up to perpetuate the pain."
For side-lying leg lifts, just examine what you are doing them for. They are not damaging, but they are not functional - nothing in real life moves like that. You are not preparing your body for anything it needs. Side lifts, barely strengthen, and what little they strengthen is not the way you move anyway. They also will not remove fat from that particular area. If you want to strengthen the thigh, better ways would be in the ways you move while standing. My work is to educate that just "doing exercises" is not the key, but training your muscles to move in healthy and functional ways.
My new book Health&Fitness THIRD edition - How to be Healthy Happy and Fit for the Rest of Your Life has several chapters on all of this.
At Saturday, May 03, 2008 3:46:00 PM,
Anonymous said…
I have terrible posture and really tight muscles (which I am trying to correct now by doing these stretches). Does chest/upper back muscle tension/tightness affect speech in any way? I find that when my back and chest muscles are really tight, I tend to stutter and find it hard to force out words. Wheras when my muscles are loose (after a massage or long stretches) I don't have this problem.
At Tuesday, May 06, 2008 12:27:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Anonymous, if you don't have the problem after what you are doing, keep up the good work and keep us posted.
Remember that the stretches themselves do not fix posture - done right, they restore the resting length you need to comfortably stand right, then you use it. Don't do the stretches then return to "terrible posture."
At Sunday, September 21, 2008 11:54:00 AM,
farioreo said…
Jolie thanks for all the good advice.I was told that I have upper back postural pain.I have for the last 13 months donde scapular sqeezes,row exercises,stretching on the door way with very lttle imnprovement and perhaps at times worsening by adding new ligamnet pain ?On the 2 stretch exrecises you recommned,how many reps a day are adequate?are there any otehr exercises that are helpful?like swimming?Are upper back strength exercises bad or worse ,such as scapular squeezes?rowing?Is there a book out there that will be helpful?Thanks a lot ,Alberto.
At Sunday, September 21, 2008 12:00:00 PM,
farioreo said…
Hello jolie.How many reps per exercise do you recommned of the two strteches?I have tried stretcing on the door way,scapular squeezes and rowing machine or resistance band and still have upper back postural pain.Should I just try your two stretching exercises?are the ones I mentioned bad for upper back postural pain?are there any good exercises?do you have a book out?thanks a lot,Alberto.
At Monday, September 29, 2008 7:35:00 AM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Alberto (farioreo), Don't worry, it's not "sets" and "reps" of any exercise that fixes, but stopping the cause of the pain. If you have pain from slouching the upper body, you will stop the source of the pain by no longer injuring the area with the slouching. Doing exercises then going back to slouching doesn't fix the cause and won't help, no matter how many "sets and reps" you do.
The message (I hope) of this post is that, "Being too tight to stand and sit upright instead of slouching forward is common" and that the two stretches mentioned in this post make it possible for you to comfortably straighten out. Then you voluntarily straighten out and use that new healthier position for all you do.
See if you are doing exercises that are counterproductive and add to the problem you started with. Check if you spend time bent forward - standing, sitting, bending -
Are You Making Your Exercise Unhealthy? and Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch and Common Exercises Teach Bad Bending.
If you use the two stretches properly one time, it should improve the wall test - being comfortable to stand straight That is how you tell if you have done it right. Doing artificial squeezes and exercises does not address the cause of the pain.
Check some of the comments and my replies to them in this post. I reminded Paul and Sandra " Doing a few exercises and stretches then going back to body mechanics that causes pain sets you up to perpetuate the pain."
The book if you have neck and back pain and also want to move, live, exercise, and eat in healthy ways, is "Health & Fitness in Plain English THIRD edition" (not earlier editions). If you only have pain then the book "Fix Your Own Pain" should be enough. See more about them on my web site books page www.DrBookspan.com/books.
It should not take 13 months. The pain should lessen as soon as you stop the slouching that causes it, and use good movement instead. Then you can go back to fun things you enjoy, and do them in healthy positioning. Have fun getting better.
At Thursday, October 02, 2008 11:17:00 PM,
ness said…
I am very large breasted and have always been. It's a very difficult thing to find a comfortable bra. For the past few months, I've been having upper back pain. I felt like I needed to "crack." Every night I complain, and nothing works!
Except this. haha, you have NO IDEA how pleased I am that this "fixing upper back and neck pain" stretch works.
Now, I'm not going to pretend that I think I'm perfect now because I've been sitting straight for about 10 mins and it is starting to get a little tiring.
But, I don't feel ANY pain.
I'm amazed.
Was that it?? Really my DDDs have nothing to do with it???
At Friday, October 10, 2008 2:06:00 PM,
Ravi said…
My father has a problem . he is sufering from pain in back part of neck.pain is in top part of shouler also.He often feel his hands become tight and a vibration like postion in his both the hands.. sometimes He feel that his both the palms became tight and hard to close the palm in punch kike position.He feels tough in writing something or doing any work.we have consulted few doctors & undergone their tratement also but the the problem still persists.Please guide. This problem was arise since last 2 months when he had pick up a heavy thing
At Sunday, November 23, 2008 9:59:00 AM,
farioreo said…
Jolie,thanks for the answers.I just read them.Must be a good sign and it is,because ever since I incorporated your stretching exercises to my scapular squeezes etc,I have been better.Not at 100%,and it must be due,as you pointed out,from going back to poor posture after the exercises.We must be aware of keeping our shoulders and head back.I will order the fix your pain book.Again ,thnanks for all your info.Sincerely,Alberto.
At Thursday, December 18, 2008 1:32:00 PM,
Anonymous said…
Dr. Bookspan,
I have been following your blog for the last couple years and I have bought your book recently. I have on-off upper back pain for almost 10 years. Sometimes it is excruciating (such as today). I have started to practice these two main stretches. Though I am having quite a bit difficulty with the second one, because of the pain. I am hoping to be able to write you one day that I am pain free. (or even a few months between the episodes would do it).
Hope you and your family have nice Holidays,
Beste
At Wednesday, December 31, 2008 12:24:00 AM,
Anonymous said…
I CANNOT do this correctly
i CANNOT feel the stretch in my chest.
At Saturday, February 07, 2009 1:06:00 AM,
Mike said…
"I CANNOT do this correctly
i CANNOT feel the stretch in my chest."
(This was a December post. I hope he/she is still checking)
The idea is to bring the elbow back. While keeping your body straight, bring your elbow up and to the side. Do not stretch the shoulder joint. Feel the stretch in the chest muscle. Look at the photo closely and notice which parts move and which parts are aligned or angled to each other.
I have a friend who used Dr. Bookspan's techniques and was mostly pain-free in about a week after 7 years of back and shoulder pain and weekly chiropractor adjustments. Now he doesn't need a chiropractor and he can play golf pain-free. He will contribute a post here soon with details about his application and success with the techniques.
At Monday, March 09, 2009 7:44:00 PM,
Ruth said…
Jolie - What a great website and so much good information. I have ordered two of your books. My question is that I am 63 years old and x-rays show that I have "degenerative spondylosis from T5 through T10. There are small anterior and anterolateral osteophytes arising from the vertebral bodies. No compression fracture." Can you comment on this at all? Is it too late for your exercises to help me? I also have lumbar and neck problems, but
I'll save that for my next blog.
Thank you very much for your help.
Ruth
At Monday, March 09, 2009 8:26:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Ruth, it's not too late. Start getting your upper back mobile again. Sooner is better than later. Much of the stiffness usually turns out to be functional - lack of use rather than from x-ray findings. Check how much you sit and stand and bend over and go about all your daily activities with rounded upper back. Then feel how good it would be to use more comfortable straighter positioning for your regular activities all day. Use the many links I provided in the many replies above, to this same post, and my books for ideas on changing to healthier positioning so that the upper back is not subject to those degenerating forces and can begin to heal and regain mobility - safely. Don't worry. Keep your spirits and keep me posted.
At Tuesday, March 17, 2009 11:15:00 AM,
lisa said…
I have had the feeling of stress in my shoulders, neck and head for months. I was t boned in a car wreck, but did not get injured in October. I then had a close friend in the hospital that I visited daily for hours. While there I read several books. That is when it started. I have taken muscle relaxers, went to a chiropractor, received acupuncture, and am undergoing treatment from a psychologist( for different reasons.) However, this returning DAILY stress feeling that can turn into a head ache has now been happening almost daily for 2 or 3 months. I am going crazy. I am starting to think something is wrong with me. I toss and turn while sleeping as my shoulder and neck wake me up. I was and still am pretty active. I practice yoga, surfing, weight training, running, swimming. But since this has been happening I am not doing as much because some things like running make me tense up then I am in pain that day. I am at the point that if someone wants to talk about anything that is stressful it makes me tense my shoulders and bring pain. How can I break this cycle with out having to turn to anti anxiety drugs? The chiropractor said that my head is leaving my body probably from the reading and poor posture. The 2nd chiropractor said it was my shoulder. The psychologist said it is a combination of everything. I do not think I was injured from the wreck because the pain did not come until a moth later. I have been working on my posture more. Could that make me tense bu forcing my shoulders back. Your blog is giving me hope. I have been doing the neck and wall stretch and checking my thumbs. Any advise? Thank you, Lisa
At Monday, March 23, 2009 9:17:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Lisa, hello don't worry. I think you left a similar question on the post The Cause of Disc and Back Pain. See my reply there with many things for you to try. Drugs are not needed.
In addition to all I wrote for you in the answers of the other post, check your yoga. Several standard moves push the neck and head forward and make the scenario you describe worse. Omit shoulder stands and plow, rabbit, turtle, and others that bring chin to chest. Check the post Gaze Perseid Meteors Without Neck Pain and Getting the Right Yoga Medicine. You can be fine, so don't hunch shoulders or worry. Breathe, smile, we care.
*********
At Saturday, March 28, 2009 3:12:00 PM,
lisa said…
Jolie, I had a MRI and found out I have a 2 degenerated discs and the 3rd is herniating. What exercises and stretches can I do? I am really upset with my results. I am wondering if they will get better with out surgery? I will have a second opinion when I get back to the states. Lisa
At Tuesday, May 26, 2009 10:12:00 PM,
Jason said…
my upper back is extremly tigh in the morning when i wake up, i've tried streching and icy hot, but nothing works. As the goes on my back loosens up but in the morning it hurts, i cant even put my chin to chest. What can i do fix this problem? HELP!!!
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