When treating someone for neck pain, a common question I get asked is: “Should I change my pillow?” or “I slept badly, my pillow is not good”. In fact, there is a common belief that a pillow or a bad night’s sleep is the cause of constant neck pain. While pillow comfort matters, clinical experience in myotherapy in Melbourne shows that pillows are rarely the root cause of ongoing neck pain. At a clinical level, neck pain is usually driven by: movement dysfunction poor spinal cervical stability previous injury history and reduced muscular control Therefore, a good pillow can support symptoms, but it does not fix the underlying issues that drive your pain. Coburg Myotherapy Insight: What Actually Causes Neck Pain? At Melbourne Massage and Treatment, a myotherapy clinic in Coburg, I consistently see neck pain linked to five key factors. 1. Spine Mobility and Stability Dysfunction The neck’s vertebrae are part of a full kinetic chain involving the thoracic spine, shoulders, and rib cage. Under this aspect, indeed, we should look into the lack of thoracic mobility which may cause the stable portion of your cervical (C3-C7) to seek that mobility capacity. But as we well know, a stable joint can’t act as a mobile, and vice versa. In more detail, poor spinal mechanics lead to: muscle overload in the neck joint irritation tension during rest and sleep And about the pillow, it is an object that cannot restore spinal movement or control. Isn’t it? 2. Whiplash History and Incomplete Rehabilitation Other patients with chronic neck pain may have a history of whiplash that was never fully rehabilitated. Indeed, a whiplash accident, as a result of a car crash or even during a contact sport incident, can lead to chronic neck pain, especially if not rehabilitated correctly. This happens because during a whiplash, the cervical joints get put under extreme force and can lead to a torn ligament or laxation. However, without structured rehab, long-term changes in: deep neck flexor control proprioception postural endurance can persist for years, or even show up after years of post-injury. So again, no pillow can change these symptoms or help you recover from such an injury. 3. TMJ Dysfunction and Jaw Tension Temporomandibular joint (TMJ) dysfunction is another underlying cause of neck pain. By following the kinetic joint chain we discussed earlier, we see that the TMJ is the next joint in the chain, after the cervical one. Therefore, Jaw clenching and TMJ irritation can: increase suboccipital muscle tension contribute to forward head posture amplify cervical joint stress That’s where you may wake up with more neck pain than during the daytime. The clantching can be heavily responsible for that. This is why neck pain is often worse under stress or during sleep. 4. Hypermobility and Joint Instability Following the concept of a torn ligament, as per a whiplash incidence, joint hypermobility is clearly another underlying issue for neck pain. This happens because there is a lack of stability and control in those cervical ligaments. This leads to: reliance on passive ligament support early muscle fatigue poor tolerance of sustained sleeping positions A “supportive pillow” alone may not solve instability and can sometimes reinforce dependency on external support rather than active control. 5. Neck Strength and Motor Control (8–12 Week Rehab Window) In my experience, this is the big issue. Most people don’t even think about the strength of their neck or upper shoulder muscles, and this is where things can go really wrong. Indeed, one of the most effective long-term treatments for neck pain is a structured strengthening program that targets: deep cervical flexors scapular stabilisers postural endurance muscles As per many exercise programs that intend to strengthen the body structure, we look at 8–12 weeks of progressive exercise-based rehabilitation. This is why many patients searching for neck pain treatment in Melbourne benefit more from rehab than passive support strategies. What the Research Says About Pillows and Neck Pain To support with evidence, why a pillow is not going to change in the long term, your neck pain, we can look at a systematic review from Pang J. et al. (2021), which found: Some pillow designs may reduce symptoms But long-term structural or functional improvements are limited and inconsistent Therefore, pillows may improve comfort, but they do not fix the underlying cause of neck pain. And yes, the pillow consistency can make a difference, but, again, it does not fix the neck pain, nor would it cause neck pain. Melbourne Myotherapy Approach: What Actually Works At Melbourne Massage and Treatment – Myotherapy Clinic in Coburg, I focus on evidence-based management of neck pain. Indeed, my approach to a client who presents with neck pain is structured as follows: Detailed analysis of clinical history – including previous history of injury and past/current sport activities Clinical assessment – active and passive range of motion, and neurological test where/when needed Outline your short-term and long-term treatment – what you want to achieve in today’s session and in the upcoming weeks/months, and what you are ready to do about it (exercise-wise) Treatment plan outline – what I believe could be a tailored treatment plan given the results of the above findings, including your short/long-term goals In all of these, Remedial Massage plays a crucial initial role to relax the nervous system, reduce initial pain and discomfort, promote healing and movement, but even techniques like mobilisation are ideal for treating neck pain and improving the initial outcome. But again, hands-on treatment is only the first step of the journey, and along with other myotherapy sessions that follow the initial consultation, exercises have to be the main focus. Exercises for the neck, for the shoulders and for your back. In summary, here is a dot point list of what a treatment plan aims for: cervical + thoracic mobility restoration deep neck flexor strengthening scapular control TMJ and jaw tension management (if needed) graded load tolerance programs These interventions address the true drivers of pain rather than just […]
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Neck pain is such a common presentation, and often I have to hear from my clients that it is due to them storing stress in their neck or shoulder. I can’t think of how many times I heard this, and how many times I than have to ask questions like: “When was the last time you did some neck-strengthening exercises or movement for your neck?” “If you work in an office, how many screens do you have in front of you, and which one do you look at more often?” “Have you ever had a whiplash? And if yes, have you done anything about it?” As you would imagine, the answers are anticipated by a moment of silence, thinking and then in order of question: “I never do neck strengthening exercises, at best I do some stretching”. “2 or 3 screens and I look at the one on one side most of the time”. “Yes, but it was xx years ago, and I haven’t done anything about it, as I was too young to care about it”. Now, I believe that those answers are already going to give you an idea of where that pain may come from. In fact, the neck isn’t just tight, it’s often weak and poorly controlled. To fix that, we need to understand how the neck actually works and how we can strengthen it. Why Neck Strengthening Matters (Mobility vs Stability) Each cervical spine is unique, and we can all present with different needs and capacities for movement. Indeed, a hypermobile person may find their neck to be really mobile and easy to twist and turn. Hypermobility, as discussed many times, is an advantage for flexibility, but it comes with the cons of joint weakness and a higher risk of joint injuries. So, when looking at the cervical area, we may notice that it sits at the top of the joint chain, meaning everything from your shoulders to your lower back influences it. Specifically, the cervical is made of 2 joint sessions: The upper neck (C1-C2) is built for mobility (turning, nodding) The lower neck (C2-C3) is built for stability (supporting your head) When that balance is off, you’ll often notice: Neck stiffness Headaches “Poor posture” (forward head position) Ongoing discomfort Fortunately, those statements are backed up by recent research that shows how strengthening deep neck muscles improves pain, posture, and neuromuscular control, especially when mobility and stability training are combined. Chin Tucks (Deep Neck Flexor Strengthening) Chin Tucks are simple and effective neck strengthening exercises that I often prescribe for neck pain. Let’s then look at a series of progressions for this type of exercise: Chin-Tuck in all four: Position yourself in all four, with hands under the shoulder, and knees under the hips You will be looking at the floor where you have placed an object, right between your hands. Now retract the chin, while you keep looking at the object between your hands. Release the chin and repeat. This version of chin tuck is ideal for: Early rehab. People with pain or poor control. Learning correct movement without compensation. Chin-Tuck in sitting or standing position: Sit or stand upright (standing is the ultimate progression). Gently pull your chin straight back (like making a double chin). Keep your eyes level. Anyhow, you are going to do these exercises, ensure to do them slowly, and take your time doing them. 4 to 5 second tempo. Why Chin Tuck Works for Your Neck Strengthening This exercise activates your deep cervical flexors, which are the stabilising muscles that support your neck. Those muscles can be defined as stabilisers as they go from the thoracic vertebrae to the upper cervical vertebrae, for the longus capitis, which originates in the lower portion of the cervical (C3-C6) and inserts at the basilar portion of the occipital bone. When these muscles are weak: Your head shifts forward Larger muscles overcompensate (SCM) Pain builds over time Isometric Neck Exercises (Build Stability in All Directions) Isometric exercises are an optimal exercise that places major focus on tendons and ligaments, and are ideal for acute symptoms and warm-up pre-training. How to do it: Place your hand on your forehead and gently push into it (no movement) Repeat on: Back of your head Left side Right side Hold each for 5–10 seconds Perform 5 reps per direction This form of exercise can be applied in any direction of movement, such as flexion, extension, lateral flexion, rotation and mixed movement, like flexion on the diagonal side. Why it works: Isometric exercises are applied to pain-free range of motions, so while you move and contract the tissues, you are not experiencing pain, your brain gets triggered to be safe while the body moves, and your musculoskeletal tissues get looked after as they get activated and contract. This would help in improving joint stability and control. Shoulder Shrugs – Let’s Make Those Muscles Work Shoulder shrugs are a simple but effective way to build neck stability through the upper trapezius, which plays a key role in supporting the cervical spine as part of the broader joint chain. How to do it: Take in your hands a pair of weights, or an elastic band, which would you make pass under your feet. Gently lift your shoulders up toward your ears, pause briefly, then lower them with control. Why it works: Shoulder shrugs exercise does work by placing shared-load capacity between the neck and shoulders, reducing the strain on the cervical spine. On the other hand, when working on the cervical joints, it is ideal to intervene also on joints that are muscle-connected to the cervical itself, by adding global muscular support, which is essential for everyday loads. How These Exercises Fit Into the Joint Chain Your neck doesn’t work alone. As mentioned in many other blogs, all the body’s joints are part of a bigger system, the joint chain of mobility and stability. Therefore, if you present with: Tight shoulders A stiff thoracic spine Lack of movement […]