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Feldenkrais Method
Neck Pain (cervicalgia)

Cervical Disc Radiculopathy, Cervical Spondylosis, Torticolis, Acute Injury, Chronic Neck Strain, Treatment Strategies

The neck is a fairly vulnerable area of the body mostly because of its considerable freedom and delicate size. Motor and sensory nerves coming from the spinal cord pass through spaces between the neck bones (vertebrae) and supply the arms (See C 1). Hence irritated nerves of the neck and/or pressure on the spinal cord can cause pain, abnormal sensation, and muscle weakness in the shoulders, arms and hands.

Cervical Radiculopathy is the term for a problem that starts in the neck and radiates outward to the shoulder, arm or hand. Abnormal pressure on a cervical nerve or the spinal cord causes pain, sensory changes or muscle weakness in the arm or hand. Pressure on a nerve is usually caused by a bulging disc, herniated disc and/or spurs (abnormal bony build up). (See C 2, 3)

Any irritated neck nerve can cause short-term symptoms whether it is due to a vertebra that is out of alignment or an acute inflammation from ligament/muscle strain. (See C 5) A severe muscle spasm can also be a source of pain and is a protective response to a strain.

Sometimes a cervical radiculopathy is seen following a neck injury like a whiplash, where there may be residual excess movement (hypermobility/subluxation), in one or more neck bones even after the acute injury is resolved. Hypermobility of the ligaments around the vertebra allows it or the disc to easily move out of alignment. Hypermobility issues can be addressed with Prolo (proliferative) Therapy. This involves multiple injections of an irritant into ligaments that help stimulate the formation of new collagen fiber. These injections plus nutritional supplementation helps grow new stronger tissue. A series of injections are generally given about a month apart and may involve 3-6 months of treatment.

See link to Dr. Hauser's web site:

Cervical Spondylosis occurs where there are arthritic changes in the vertebrae. If the discs between the neck bones are healthy and at full height, then the facet joints, which have nice, smooth cartilage on each surface, are under normal pressure. Facet joints are not really meant to sustain much weight, rather they help the neck bones glide. (See C 4) If there is excessive compression in the neck, over time the discs wear and flatten, causing undo pressure on the cartilaginous surfaces of the facet joints, which then wear down.

What remains are rough bony surfaces that grate and grind with movement, this is called Degenerative Joint Disease (DJD), in either the disc and/or facet joints. As a response to long term excess compressive pressure the body responds by building up extra bone (spurring and/or lipping), around the vertebral bodies and or facet joints.

Spurs can cause impingement on the spinal nerves or chord and make movement of the neck painful and stiff. Here Alexander work is imperative to help decompress the neck. Why resort to cervical traction treatments when you can learn to decompress your neck in everyday activity?

Torticolis means twisting and side bending of the neck. Some babies are born with a "wry neck" a true shortening of the sternocleidomastoid muscle, often linked to either in-uterus or birthing strain of the neck. See illustration at:

The rest of us can wake up with torticolis after "sleeping funny" or if we stretch vigorously while our neck is out of alignment. Rotation and sidebending are usually limited in one direction with painful flexion or extension of the neck. The cause can be a vertebra and/or disc out of place. The pain from this may resolve on its own within a few days especially if anti-inflammatories are taken.

If persistent, very gentle positional release techniques help ease the vertebrae into place. Kurashova Tissue Re-education Techniques can also normalize the muscle tension in the neck. It is important to avoid forcing the motion into the direction that is limited and painful.

Acute Neck Strain

If a fair amount of force occurs during an injury, as is the case when there is a blow to the head, fall or whiplash, the first thing on your mind should be a visit to the doctor for x-rays. If a simple strain occurs from a quick or jarring movement, or even forceful coughing, follow the steps above under treatment strategies.

Then if the pain is not resolving with in a few days be sure to consult with your doctor. With cases of whiplash it is best to seek immediate evaluation of injury by a doctor to rule out serious or hidden injury. Often right after a traumatic injury, adrenaline is high causing pain not to be felt till a day or two later so it is better to err on the side of caution.

Chronic neck strain

The number one cause of chronic neck strain is poor posture and poor use of one's spine. Believe it or not, the neck responds to all sorts of imbalances that occur throughout the whole body below it. Most people do not use their spine in a truly supportive way.

Without good bony support, gravity wins, the spine sags creating excess vertebral compression and the head easily shifts forward. Even the most simple habit of crossing one's legs one way all the time causes a chain reaction of shifts that can lead to the tipping of the head in one direction and the lowering of one shoulder. If we are unaware of our habits, they can be our structural downfall over our lifetime. Habits that are either sustained for long periods of time or very frequent have the greatest effects.

Remember, it is how we live and what we do every day that influences our function. Ultimately our function influences our structure.

Muscles and ligaments shorten when placed in shortened positions over time. Bones will wedge under asymmetrical strain as we age. The Alexander work is essential for any chronic strain. Feldenkrais work and stretching exercises can also help maintain more structural balance.

Treatment Strategies:

Once a doctor has ruled out a tumor, fracture, dislocation or disc herniation, the main rule of thumb for any neck pain is to:

1) Reduce the inflammation with either homeopathic or allopathic medicine.

2) Use ice on acute injury, warmth on sub-acute/chronic, as tolerated.

3) Correct mechanical alignment of the cervical vertebrae (I prefer using positional release techniques instead of vigorous manipulation). Having normal alignment of the first cervical vertebra is key. See NUCCA and links (

4) Normalize muscle tone/texture in the neck/shoulders using Kurashova Tissue Re-education Techniques.

5) Balance the whole skeleton and cranium structurally (here I combine craniosacral work with self-balancing pelvis exercises (see On the Level) and a shoe lift if necessary).

6) Avoid stress and strain on the neck by eliminating heavy lifting, carrying briefcases/handbags, use head set telephones rather than holding the phone between ear and shoulder, sleep with the correct amount of pillows (not too high, nor too low but level with your spine).

7) Retrain and improve your posture for maximum decompression of your spine throughout the day using the Alexander Technique.

Learning to use the Alexander Technique in your daily activity empowers you to decompress your own neck in a way is superior to using traction units.

For most spine problems the Alexander Technique "lying on books" is the single most effective home tool, which decompresses the spine, reduces muscle tension, causes a CV4 cranial release and restores the nervous system. This procedure is taught in treatment sessions but may also be found in archive articles.

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MovementWise Christine Inserra P.T.
Certified Teacher of the Alexander Technique & Feldenkrais Method
Physical Therapy serving Chicago and the Greater Chicagoland Area