To find the cause of the problem, we would first note all the details about how the symptoms came about, what it feels like, timing, daily pattern, and any aggravating or relieving factors. We also ask about associated headaches or other symptoms, any issues with other joints, your health in general, and any significant events in the past such as accidents or surgery.
We then observe your back, neck and shoulders, and assess movement in all directions – making note of any restrictions or pain. We may also perform special tests to assess the condition of nerves, joints, muscles and ligaments.
Once we have established our working diagnosis we will always take time to explain to you what we found and let you know how we can help, and whether we need to make any referrals.
Our treatment approach is aimed at improving freedom of movement where it is restricted. We use specific massage, mobilisation, manipulation and stretching techniques to improve the flexibility in joints and muscles, relieve tension, and ensure good circulation for effective recovery.
During the session, we will also provide advice on exercise, posture and other techniques to aid fast recovery and maintain treatment results.
Exercise and Advice
These are some of the most common techniques and exercises we prescribe for neck and upper back pain:
Diagonal neck stretch
Main muscle: Trapezius
Sit on a chair with your feet comfortably on the floor.
To stretch the right side, hold on to the side of the chair with your right hand, slightly back towards the backrest.
Look away and down, just beyond your left knee. Assist this movement of the neck by gently pulling the head with your left hand. Hold for 20 seconds on each side.
Tip: If you can see your left elbow in front of you as you pull, then this is the perfect angle for the stretch.
Side neck stretch
Main muscle group: Scalenes
Sit on a chair with your feet comfortably on the floor.
To stretch the right side, hold on to the side of the chair with your right hand. Look straight ahead, and use your left hand to assist a side stretch of the neck by gently pulling the head to the left. Hold for 20 seconds on each side.
Target area: base of head, upper neck
Main muscle group: Suboccipitals
Lie on your back, with a small pillow or no pillow under your head (a small Pilates ball can also be used).
Tuck your chin in, as if to give yourself a double-chin, and think about pulling the back of your head down and away from your neck. Hold for 5 seconds and repeat at least 5 times.
Make sure your neck is relaxed and your head is not lifting away from the pillow.
Tip: This stretch can also be done sitting, ensure you start with a good neutral posture and straight back.
Main aim: Safely improve stability and strength in the neck
Sit comfortably with good posture, and find the most neutral position for your neck, looking straight ahead.
Create resistance by pushing with your hand against your head, but without moving your head from its neutral position.
Push with your hand against your head at these 6 points: front, back, sides, and above each eyebrow.
This will respectively challenge and strengthen the muscles responsible for movement in these directions: forwards, backwards, side-bend, and rotation.
Hold each point for 2 seconds and repeat at least 5 times.
Child’s pose (Also known as prayer pose)
Middle and lower back stretch
Start on all fours (this might not be one for the office…)
Keeping your arms stretched ahead on the floor and sit back towards your heels.
To add side-bend: Rest one hand on top of the other, creating a stretch on one side, and sit back towards your heels again. To increase the stretch, move both hands further out to the side.
To add rotation: Thread one arm under the other, then follow it with the shoulder and neck, creating a twist through the spine.
Improving posture to protect the shoulders, neck and back
You can do this exercise anywhere, sitting or standing, while waiting for the train or at home while watching TV.
Start with your shoulders as relaxed as possible in a neutral position.
Then bring your shoulder blades back and down, as if to make them meet behind your back, or slip into your trousers’ back pockets.
Hold for only a second or two, then relax and start again. Repeat 10-20 times.
Tips: You can start by standing sideways in front of a mirror as you do it, and observe the dramatic change in your posture. As this exercise is designed to change the habitual ’round-shouldered’ or ‘slouchy’ posture, the more frequently it is done the better.
How does it work?
By bringing the shoulders back to their neutral place, beside our chest and not in front of it, we are improving the arms’ ability to move freely in all directions, thus reducing the potential for strains and injuries at the end of their range of movement.
This posture is also better for the back and neck, as it creates better alignment through the spine and reduces demand on its muscles.
Improving freedom of movement through the upper body
Windmills are essentially the upright version of front-crawl and backstroke swimming.
Standing or walking, start with your shoulders relaxed, and swing your outstretched arms in turn to create circles beside you in the air.
Follow each arm with your gaze as they move, to engage the neck and upper back in the movement as well.
Repeat 10 times forward and 10 times back.
If your shoulders won’t allow you to do this exercise comfortably, you can try bending at the elbows and creating circles with the elbows instead, or just rolling the shoulders with your arms relaxed beside you, still following the movement with your head and neck for maximum effect to the spine.