Two new pillows, a stand that raises the screen to eye level, getting up every afternoon to roll the shoulders a few times. Many people with long-standing neck and shoulder pain have tried all of these before coming to the clinic, yet the back of the neck still feels heavy. At the visit, after listening, the doctor asks about something completely different: what time you usually eat dinner, whether you feel bloated or burp after eating, whether you often wake up in the middle of the night. People who are pointing to the back of their neck are often surprised.
The muscle you squeeze at the back of your neck
When the neck feels tired, people tend to reach back and squeeze the band of muscle that runs from the hairline at the nape down to the edge of the shoulder. That is the upper part of the trapezius, the muscle that lifts the shoulder and helps the head tilt and turn. It tightens when you look down at your phone for a long time or brace your shoulders when you are anxious, and it is the spot patients point to most often. Sitting at a screen all day, eye strain that brings on neck pain (Vietnamese) follows the same path: the head gradually juts forward, and this band of muscle has to brace for hours.
Applied Kinesiology has a system that pairs each muscle with an internal organ or a meridian, gathered by Walther in the foundational AK textbooks from 1981. At the clinic, we often find the upper trapezius weakened in people whose stomach is overworked: late dinners, rushed meals, frequent bloating, sour belching after meals. This link is one direction to check, and quite a few people with neck pain have a perfectly healthy stomach.
Ear toward the shoulder, hold still for a few seconds
After a few questions about dinner and your stomach, Dr. Dinh Ngoc Duc (MD, MSc in Traditional Medicine) also asks when in the day the pain is worst, right after waking up or in the late afternoon and evening. Then the doctor asks you to bend your head forward and back and turn it to each side, and checks sensation and reflexes in both arms to see whether any cervical nerve root is irritated.
For the muscle testing part, you sit up straight, tilt your head to bring your ear toward your shoulder, turn your face slightly to the other side, and at the same time shrug that shoulder up to meet the ear. The doctor places one hand on the side of your head and the other on top of your shoulder, then slowly draws the two apart over a few seconds. All you do is hold still. The doctor watches whether the gap between ear and shoulder opens up even though you are trying to hold it, and which side holds less well.
On the side that holds less well, the doctor may ask you to place your palm on the upper abdomen, just below the tip of the breastbone: if the weak muscle firms up while your hand rests there, your eating habits need closer questioning.
The neck is treated, yet a week later it feels heavy again
The muscles and vertebrae of the neck are always checked first, because problems there are common and can be tested right away. For some people, treating the neck alone is enough: the neck turns much more easily and the trapezius holds firm within the same session. For others, neck pain spreading to the shoulder has its root in the pelvic area (Vietnamese): work on the neck clears only half of it, and the rest eases only once the pelvis is treated.
More telling are the people who come back after a week with the neck as heavy as before and the trapezius weak on the same side. If the neck has been treated and the pain still returns, something elsewhere is probably weakening that muscle day after day. The doctor goes on to look at the stomach and at eating, sleep, stress and micronutrients, so that muscle testing can show which direction weighs most on you right now.
Sleep is the factor most often missed. A review of 14 longitudinal studies by Manderlier and colleagues (2022) found moderate evidence that sleep problems in women predict chronic neck pain, and strong evidence for higher body weight in women, although the effects were small in both cases.
Long-term stress, anxiety, depression and a lack of support from the people around you are all among the important risk factors for neck pain, according to the global epidemiological review by Kazeminasab and colleagues (2022). In 2019, about 27 out of every 1,000 people were living with neck pain. Stress is also checked with muscle testing, while you think about what is worrying you.
People who often get cramps or muscle twitches at night are also checked for magnesium (Vietnamese). And when a muscle stays tight long after an old injury, the doctor considers that the nervous system may still be holding a protective pattern.
The person who blamed their sitting posture
One patient had long-lasting neck and shoulder pain and was convinced it came from sitting badly at work. Through muscle testing, the doctor found that the pain was tied to an overworked stomach. After receiving support to bring digestion back into balance, this person found the neck much lighter. One case is not enough to conclude that everyone with neck pain should look to the stomach.
Treatment follows the direction that was found
A section of the neck that is not moving properly is mobilized by the doctor with gentle force, sometimes together with work on the neck proprioceptors. These are gentle examination and correction techniques within an Applied Kinesiology session. When the stomach stands out clearly, the doctor prescribes an herbal decoction to harmonize the Stomach (“harmonizing the Stomach”, 和胃, hé wèi), matched to your pattern, and talks with you about your dinner time and how you eat. People who sleep fitfully and whose neck has been stiff for many months may receive acupuncture at the back of the neck together with points that help sleep come more easily.
Neck pain with fever, chest tightness or black stools
With a few kinds of neck pain, the first place to go is the hospital:
- A stiff neck with fever, or a severe headache that comes on suddenly: go to the emergency department right away;
- Pain spreading up the neck and down the left shoulder when climbing stairs or exerting yourself, with any of chest tightness, shortness of breath or sweating: call for emergency heart care;
- Numbness or weakness in the arm that gets worse week by week: see a neurologist;
- A dull ache above the navel lasting several weeks: have a digestive check-up;
- Black stools or vomiting blood: go to hospital right away.
Worth keeping
- For one week, note when your neck feels heavier: on waking, after dinner, or after a poor night’s sleep;
- Try eating dinner one hour earlier than usual for seven days, and see whether your neck feels lighter in the morning;
- Count how many times you wake up each night, so you can tell the doctor;
- Each time you squeeze the back of your neck, notice which side is stiffer and mention it at your visit;
- Note the nights you get cramps or muscle twitches, so the doctor can consider checking your magnesium.
References
- Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM et al. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord 23(1):26. https://doi.org/10.1186/s12891-021-04957-4
- Manderlier A, de Fooz M, Patris S, Berquin A (2022). Modifiable lifestyle-related prognostic factors for the onset of chronic spinal pain: A systematic review of longitudinal studies. Ann Phys Rehabil Med 65(6):101660. https://doi.org/10.1016/j.rehab.2022.101660
- Walther DS (1981). Applied Kinesiology, Volume I – Basic Procedures and Muscle Testing. Pueblo: Systems DC.
