help with neck pain

Aarif Ameen

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i could use some advice. i'm still a student, so please be gentle with me ;)

my neighbor called me up this evening begging for help. she was complaining of a "pinched nerve" in her neck that was causing pain in her neck, back, shoulder and almost down into her chest. her new job involves her sitting at a desk with a keyboard that sits way too high for her and she drives an SUV - so her shoulders are up to her ears all day. i found trigger points all over her neck, shoulders and back. the worst ones were in the levator scapulae (one side was far worse than the other) and rhomboids minor. her traps were tight from top to bottom and her scalenes were like guitar strings. when i felt like i did all i could - i was afraid to do any more. i took my time warming her up and addressed each muscle individually and slowly. it was still pretty deep and painful for her and i didn't want to over do it. anyway, her pain was significantly reduced and her ROM was far better. except for one thing. turning her head away from the side with the most pain was done with ease at the end of the massage (something she could barely do when we first started). but when she turned her head into the pain her movement was restricted by pain, although she said not as bad as before. but still, it was not something i liked seeing. i'll admit that i'm still a bit gun shy when it comes to the anterior (and especially medial) side of the SCM. is this what i missed? or do you think it was something else entirely?

i told her to drink lots of water and be very conscious of the way she holds her shoulders for the next two days. after two days of rest i'd be willing to work on her some more. aside from hitting the usual suspects again, i'm not sure what more to do. specifically for her not being able to turn her head into the side with pain. i mean, aside from referring her out - which i already tried to do, but she's grateful for the relief she got tonight and is willing to let me continue to work on her for my educational benefit :) what else... :smt017

thank you guys for your help!!
 
help with neck pain

Sounds like you're doing great, just keep doing the same work and adjust as she has more pain free days. Massage can be really helpful in pain relief, but it doesn't usually happen in just one session (sometimes it can, but those are few and far between)! If she doesn't change what she was doing to create the pain in the first place, she will always be having those types of issues. Don't let the fact there was still some pain discourage you, you'll find the longer your in this field that will be the general norm. The fact that there was some improvement is good. When my clients don't notice a bit of relief by the second or third session then I change what I'm doing or refer them out.

One suggestion that seems to work for clients who hold tension in their bodies without realizing it that I demonstrate is have them do this exercise while laying in bed, maybe when they bed down for the night or just anytime they have about ten or fifteen minutes. While laying down, starting with their jaws -- clench the muscles hard for about five seconds, take a deep breath and then relax after repeating a couple times, move to the neck, the shoulders, the forearms, the hands, the buttocks, the thighs, etc until they reach their feet. After a few days (or maybe the first time) of doing this ex, they will be more aware of when they are clenching up during the day and that will help them end that habit.

Usually pain that occurs in the neck while turning head is in the superior traps of the side the head is turned towards (in my practice). Again, the fact there was some improvement is good enough, here is where you'll find massage is best when used on a regular basis along with changes the client makes in their daily postural habits.
 
help with neck pain

Anytime I have folks complain of severe pain & find their bodies to be extremely tight, I often suggest icing the regions involved. Generally speaking whether they use real ice, ice packs, or frozen packs of veggies (this works very well by the way!) make sure they first of all have at least a towel between their skin & the cold therapy pack of their choice. They should leave it in place for 15 to 20 minutes max & then off for about 45 minutes to an hour & back on again. This will usually cut down on the pain & any muscle spasms. Drinking fluids - especially water & also taking a good powdered Magnesium supplement
(I really like Peter Gilham;s Magnesium Calm) can all help.

It sounds like the work you did really helped your friend - though she should continue to get more work done by you or someone else & she will need to focus more on both stretching & working to release her body to avoid a repeat episodes. She should check her posture & body mechanics, as well as taking breaks from her computer work as well. If the keyboard is to high for her - suggest that she put a chair pad or other cushion on top of the desk chair she is using until something can be done about the desk or keyboard setup. That may help to balance out the problem at least somewhat!

Keep up the good work - it sounds like you are getting some good experience under your belt already! :D
 
help with neck pain

From your description, SCM isn't the problem, though it will be part of the overall picture. As kathryn noted, it is more likely to be upper traps, or levator scap, or both. Serratus posterior superior is a good possibility too, but good luck getting to it! ;) This person will need pec work too, especially pec minor. If you don't know how to do it yet - DON'T. Consider referring this person to a working professional instead.
 
help with neck pain

One way to think about this is to consider the muscles involved in turning the head into the painful side. If the side she is turning into hurts, then think about the muscles on that side that are being stretched by that movement. Lev. scap., subocc., and so on.
 
help with neck pain

thank you so much for your help! even though i get nervous about "causing" pain - i knew i was doing what i was taught. i just felt so unsure of myself after i got home. i really appreciate the encouragement and the reminders that i can't fix it all in one hour (although i'd be willing to bet some of you can :altwink: ). i was very careful to warm her up and work slowly, causing the least amount of pain as i can. overall, i'm proud of the work i did.

i did talk to her about using ice, ibuprofen and lots of water. we talked about how she can pay attention to her posture and changes she could make in her activities to prevent this from happening again. i checked on her yesterday and she was very sore. i encouraged her to stretch like i had shown her the night before, and she nodded and said "ok", but the look on her face said "yeah right". her ROM and stiffness was still better than it was before our session, but i would have liked to see her looser. she said she expected the soreness - comparing it to working out. but i couldn't help but get the feeling she blamed me for it. maybe that's just my own issue. she still didn't want a referral and insisted on scheduling another session when the soreness subsides, so maybe i'm just projecting my own guilt. which is totally off topic.... (i'm extremely eager to learn gentler and less invasive techniques - classes i can't even register for until i'm certified.)

her sup. traps didn't really have any distinguishable TPs. they were more like solid hard muscle. when i finished working on them they were still tight but since i had already spent so much time on them i wanted to give them a breather. i'm relieved that at least the pain (turning her head into the side with pain) is being caused by a "work in progress" and not something completely overlooked.

pec minors. i have been taught and we have practiced in clinic. i really don't like working on them because of how tender they are. and i didn't even think to check them but now that you've mentioned it, it's suddenly obvious. thank you!

~~crossing my fingers and hoping she feels some relief today~~

and i am soooo grateful to have this forum in my "toolbox". thank you guys so much!!
 
help with neck pain

I know what you mean about the tenderness of pects. I've found that using hot stones on the pects really helps relax those muscles in a kinder way. I love my stones. I joke with the clients when they oooh and ahhh about how good they feel that hot stones turn 'mad muscles' into happy ones.
 
help with neck pain

Sounds like you are doing great! One additional thing I would do it work on the scalp. It is amazing how much ROM you can regain by really working this area!

Come in close to the scalp and grab hair, it is important to start close to the scalp. Pull outwards for 10-15 seconds, then rotate your hand, with the hair counter clockwise, then rotate clockwise. Go all around the head, paying special attention near the base of the skull. It may be tender to boardline painful, so go slow and communicate.

This is really good in a chair massage too if they will allow it! LOL
 
help with neck pain

Talenyn said:
Sounds like you are doing great! One additional thing I would do it work on the scalp. It is amazing how much ROM you can regain by really working this area!

Come in close to the scalp and grab hair, it is important to start close to the scalp. Pull outwards for 10-15 seconds, then rotate your hand, with the hair counter clockwise, then rotate clockwise. Go all around the head, paying special attention near the base of the skull. It may be tender to boardline painful, so go slow and communicate.

This is really good in a chair massage too if they will allow it! LOL

Oh yeah.. that's one of those techniques that while you are doing it you are sitting there thinking, "Man! I wish someone was doing this to me right now". :grin:
 
help with neck pain

I had a similar issue myself....work all the trigger points you can in the obvious regions....i'd suggest encouraging her to do some scapular depression exercises to keep her scapula down...mine were elevated and relasing trigger points was only temporary relief. Once she goes back to her work and driving they'll be elevated and "stuck" once again unless she works on scapular depression.

Also, i realized i had issues with my finger extensors...if you look at anatomy trains it shows a fascial line running from your hands up your arms and then wrapping a lot of your upper back and part of the neck. There's one that also runs from pinky in a straight line up the tricep and to the scapula.... A third on the front runs from the thumb up the bicep and through the pec minor. Therefore, i'd suggest really concentrating on the arms now and the hand especially. Have her extend her fingers and check to see which feel restricted and lack extension.

She probably has head forward posture, so her platysma is probably tight as well, Especially in the lower area where it blends into the chest, right below the clavicle. Forward head posture also is tightening up her neck extensors (back of neck). After i did all this i had TERRIBLE soreness the day after in my neck extensor area because they finally released, relaxed, and stretched out.
 
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    Tomorrow's sneak peek: On Friday May 30, 2025, our attendants will be Ada ๏ธ, Carla ๐Ÿ”ฅ, Cici ๐Ÿค—, Opal ๐Ÿ˜ and Vicky ๐Ÿ‘. Call us at โ˜Ž๏ธ(905) 479-6668โ˜Ž๏ธ to book!
  30. SL Spa:
    ๐Ÿ’†โ€โ™€๐Ÿ’–Terrific Thursday ๐Ÿ’– Ultimate destination for Asian massages๐ŸŽ‰ Two fab spots: SL Richmond Hill & SL West Oakville โœจ Your passport to paradise with 10 enchanting girls fr China, HK โ€” ๐Ÿ†•Tiffany, Joey, Julie, Aaliyah, Cici, Coco, Yui, Meghan, Julia & New 34D Jasmineโ€”โ€” ready to pamper you๐ŸŽ๐Ÿ Ring us ๐Ÿ“ž647-695-6354 or text us ๐Ÿ“ฑ647-578-8169โœจ 160 East Beaver Cr., Unit 12, RichmondHill ๐Ÿ’ฐWhere Eastern charm meets Western comfort - your bliss awaits
  31. Lulu1980:
    Phoenix Blossom Spa ๐ŸŒน๐ŸŒน๐ŸŒน Table shower .body scrub ๐Ÿ˜˜Three girls every day ๐Ÿ”ฅ๐Ÿ”ฅ๐Ÿ”ฅ 5124 Dundas West Street, Etobicoke โ˜Ž๏ธ 416-817-3366 ๐Ÿ‘ Newโ—๏ธNew girl Angela ,so young Petite and pretty๐Ÿ˜‹ open service ๐Ÿ˜œ๐Ÿ˜œ Sweet girl Luna deep massage ๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜ Hot and sexy body very provocative service ๐Ÿ˜๐Ÿ˜๐Ÿ˜๐Ÿ˜โค๏ธ You are welcome to make an appointment at any time or walk in directly through the back door. We have ample parking spaces available
  32. Nu spring spa888:
    ๐Ÿ’–๐Ÿ’–๐Ÿ’–sexy hot busty Singapore ๐ŸŒน Indian ๐ŸŒน๐ŸŒนkorean girls๐ŸŒน๐ŸŒนworking ๐Ÿ’—๐Ÿ’—at markham โ˜Ž๏ธ416-669-8508โค๏ธโค๏ธโค๏ธ
  33. AliceSpa:
    THURSDAY at ๐—”๐—Ÿ๐—œ๐—–๐—˜ ๐—ฆ๐—ฃ๐—”.4915 Steeles Ave. E, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿฎ๐Ÿต๐Ÿด-๐Ÿฌ๐Ÿด๐Ÿต๐Ÿด. 3 girls here today at ALICE SPA. Open 10am to 9pm: JESSICA is from Hong Kong, super busty D Cup, 5'2", 109 Lbs, curvy, soft white cream skin, pretty face, can bbbj cim dfk 69 cof sf2, available all services, excellent treatment. KITTY is a new Korean girl, super busty, small body, new to the business.
  34. Spa in Markham:
    GOLDEN FS โ€“ 8380 Kennedy Rd ๐Ÿ“ž 905-258-0777 / 416-688-6886 ๐Ÿ‡ป๐Ÿ‡ณ JULIE (2PM), ๐Ÿ‡ธ๐Ÿ‡ฌ CANDY, ๐Ÿ‡ป๐Ÿ‡ณ๐Ÿ‡จ๐Ÿ‡ด MEGAN (9PM), ๐Ÿ‡ญ๐Ÿ‡บ VANESSA, ๐Ÿ‡ฎ๐Ÿ‡ณ SONIA (8PM) ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookinggoldenlove
  35. FLOWER Spa - BLUEXADO | Thornhill | VAUGHAN:
    BLUEXADO FS โ€“ #06-1102 Centre St ๐Ÿ“ž 416-357-9797 / 416-678-8668 ๐Ÿ‡ญ๐Ÿ‡ฐ๐Ÿ‡ป๐Ÿ‡ณ CICI, ๐Ÿ‡ฒ๐Ÿ‡พ AMY, ๐Ÿ‡ป๐Ÿ‡ณ MY LINH (2AM) ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookingbluexadolove
  36. FLOWER Spa โ€“ PINK | Scarborough | TORONTO:
    PINK FS โ€“ 3300 McNicoll Ave ๐Ÿ“ž 416-299-5515 / 416-817-3839 ๐Ÿ‡ฎ๐Ÿ‡ท ELINA, ๐Ÿ‡ป๐Ÿ‡ณ KELLY, ๐Ÿ‡ต๐Ÿ‡ญ MADY (12PM), ๐Ÿ‡ป๐Ÿ‡ณ๐Ÿ‡จ๐Ÿ‡ด MEGAN (2PM) ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookingpinklove
  37. Jennyโ€™s Spa:
    ๐ŸŽ‰๐Ÿ’JENNYโ€™S SPA๐ŸŽ‰๐Ÿ’ โœ…5170 DUNDAS STREET WESTโœ… ๐Ÿ‘ŒETOBICOKE ONTARIO M9A 1C4๐Ÿ‘Œ โ˜Ž๏ธ( 647-893-5196)โ˜Ž๏ธCall or Text โ˜Ž๏ธ( 437-888-3759)โ˜Ž๏ธCall Only (ETOBICOKE) OPEN 10am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…GRAND OPENING๐Ÿ’ฏNEW GIRLS EVERYDAY๐Ÿ”ฅEXCELLENT MASSAGE + SERVICE QUEENS NOW AVAILABLE AT JENNYโ€™S SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS๐Ÿ”ฅ๐Ÿ’ฏ๐Ÿ˜˜๐Ÿ”ฅโค๏ธ๐Ÿ‘Œ ๐Ÿ”ฅTWO BEAUTIFUL NEW YOUNG ASIAN GIRLS EVERYDAY๐Ÿ”ฅ ๐Ÿ’ฏREAL PICTURES OF ATTENDANTS๐Ÿ’ฏ ๐Ÿ”ฅ๐Ÿ’‹Limited Time Special Promotion๐Ÿ”ฅ๐Ÿ’‹ โœ…๐Ÿ’ฆ30 Minutes Nude Mass
  38. wonderspa:
    wonderspa: :wonderspa: โ˜Ž๏ธ416-5000-800,L6a4H8๏ผŒopen10 to10,Ensuit shower available ๐ŸŒน๐Ÿ”ฅbeautiful young Jessica sexy body,deep tissue to relax massage back walk,hot stone๐Ÿ…sexy face sunny is very good looking,slim body ,nice body slide sweet sensual touch ๐ŸŒนbeautiful long hair younge new lily Q,friendly,amazing massage,happy the end,really popular,must tryโค๏ธ
  39. wilson holistic centre:
    new girl works at ๐Ÿ’‹535 Evans Ave today ๐Ÿ’•๐Ÿ’•๐Ÿ’•โ˜Ž๏ธโ˜Ž๏ธ416-531-6969โ˜Ž๏ธโ˜Ž๏ธ
  40. Golden Sunshine Spa:
    โœจClick on our Username and FOLLOW US for updates and special services ! โœ… Click Here Today๐ŸŒธTina๐ŸŒธCindy๐ŸŒธIsabella๐ŸŒธNadia๐ŸŒธAnna Call us โ˜Ž 905 - 265 - 2158โ˜Ž๏ธ Your ultimate service awaits! โœจ
  41. Soul Relax Spa:
    โœจ Looking for a relaxing escape? โœ… Click Here Meet๐ŸŒธKelly๐ŸŒธKim๐ŸŒธValentinaCall us today for the best treatment and service experience. Click on our Username and FOLLOW US for updates ! Call now โ˜Ž 289 - 298 - 5662โ˜Ž๏ธ Your ultimate relaxation awaits! โœจ
  42. ForeverWarden:
    Thursday at ๐Ÿซฆโค๏ธ๐Ÿ”ด๐ŸŸฅโ™พ๏ธ๐“•๐“ž๐“ก๐“”๐“ฅ๐“”๐“ก ๐“ข๐“Ÿ๐“โ™พ๏ธ๐ŸŸฅ๐Ÿ”ดโค๏ธ๐Ÿซฆ๐Ÿซฆ2190 Warden Ave, Unit 201, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿด๐Ÿฌ๐Ÿฌ-๐Ÿณ๐Ÿด๐Ÿด๐Ÿณ: Cindy, Sophia & Tracy. Cindy is a slim beauty, 5โ€™4โ€, natural C Cups. Her massage is nice, her services will drive you wild & her finish is a dream come true. Sophia is a sweet & pretty Chinese lady with natural B Cups and an awe-inspiring smooth rounded ass. Sophia can provide top notch services
  43. HolidaySpa:
    Thursday at ๐ŸŒด๐Ÿ˜Ž๐ŸŒ…๐“—๐“ธ๐“ต๐“ฒ๐“ญ๐“ช๐”‚ ๐“ข๐“น๐“ช๐ŸŒ…๐Ÿ˜Ž๐ŸŒด3517 Kennedy Rd, Unit 4, Scarborough โ˜Ž๏ธ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฎ๐Ÿฐ๐Ÿณ-๐Ÿญ๐Ÿญ๐Ÿต๐Ÿตโ˜Ž๏ธ: ANGELA, LUCY & CINDY. Angela is versatile and responsive. LUCY is a beautiful and slim Asian lady with a happy disposition and great services. CINDY is a slim & incredibly sexy lady with a smile that will melt your heart, & an ass that will fire up your spirit.
  44. SugarLoveSpa:
    Thursday at โค๏ธ๐Ÿ’™ ๐Ÿ’œโŽ๐—ฆ๐—จ๐—š๐—”๐—ฅ ๐—Ÿ๐—ข๐—ฉ๐—˜ ๐—ฆ๐—ฃ๐—”โŽ ๐Ÿ’–๐Ÿ’—๐Ÿ’˜: LUNA, MIA, SARA, TIFFANY & VIVI. 1270 Finch Ave W (at Keele St), Unit 18. North York, ON โ˜Ž ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฏ๐Ÿฒ๐Ÿฑ-๐Ÿฎ๐Ÿฒ๐Ÿด๐Ÿด โ˜Ž LUNA is a slim, VERY PETITE and capable Vietnamese beauty, nice natural 34C Cups. Luna can do everything. MIA is a young & slim ๐™Ž๐™‹๐™„๐™‰๐™‰๐™€๐™, very PRETTY & PETITE Vietnamese beauty with perfect natural A Cups, 5โ€™1โ€ & 90 Lbs, very versatile.
  45. EMSpa_schedule:
    ๐ŸŽ‰Come visit us!๐ŸŽ‰ Today (Thursday), our amazing attendants are Ada ๐Ÿ’œ, Cici ๐Ÿคฉ, Vicky ๐Ÿฅณ, Sophie ๐Ÿค— and Monica ๐Ÿฅฐ. Call us at โ˜Ž๏ธ (905) 479-6668 โ˜Ž๏ธ to book your favourite and head on over to 7665 Kennedy Road, Unit 4, Markham!
  46. ใ™ใฟใพใ›ใ‚“:
    Top notch wellness: Ella , elena, Angela, Michelle, gabby , and Vanna. Call us now to make your appointment. 437-522-9961
  47. bnwellness_wilson:
    We have 4 young girls are working today, young Taiwanese Victoria slime 26โ€™s open mind and young flirty Tina 30โ€™s with curly body open min, young popular kitty 26โ€™s with curve body and pretty Ella are providing deep tissue massage, pls call 4163985777 book appointment and walk in always welcome,back entrance and parking available, 350 Wilson Ave North York
  48. luckywellness:
    Lucky Wellness Center 4379721888 295 Eglinton Ave E,Unit 7,Mississauga We have two girls working today. Judy and Kiki. They are young and beautiful, cute and sexy. Deep tissue massage and relaxation massage are both great. Back walking is very comfortable. They have sweet smiles and work seriously. If you are tired from work, come and make an appointment!๐Ÿค—
  49. Annie Spa:
    ๐Ÿ’‹๐Ÿ”ฅOur famous sexy superstar Suki is working today Thursday May 29th with busty 36DD young girl Bobo, Sexy New Petite Japanese Cutie Mico and Sweet Sensual Busty Coco๐Ÿ”ฅ๐Ÿ˜˜Call Annie Spa to book appointments ๐Ÿ’ฏ๐Ÿ‘Œ ๐ŸฉทAnnie Spa๐Ÿฉท 1001 Sandhurst Circle Unit #7 โ˜Ž๏ธ647-891-9688โ˜Ž๏ธ โ˜Ž๏ธ416-291-8879โ˜Ž๏ธ
  50. Lulu1980:
    Phoenix Blossom Spa ๐ŸŒน๐ŸŒน๐ŸŒน Table shower .body scrub ๐Ÿ˜˜Three girls every day ๐Ÿ”ฅ๐Ÿ”ฅ๐Ÿ”ฅ 5124 Dundas West Street, Etobicoke โ˜Ž๏ธ 416-817-3366 ๐Ÿ‘ Newโ—๏ธNew girl Angela ,so young Petite and pretty๐Ÿ˜‹ open service ๐Ÿ˜œ๐Ÿ˜œ Sweet girl Luna deep massage ๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜ Hot and sexy body very provocative service ๐Ÿ˜๐Ÿ˜๐Ÿ˜๐Ÿ˜โค๏ธ You are welcome to make an appointment at any time or walk in directly through the back door. We have ample parking spaces available
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