Pain in the Neck
"Pinch Points" in and Around the Upper Neck Region
If you suffer from neck or shoulder pain or stiffness, headaches, or postural issues, here are a couple of little known anatomical stress response “pinch points” to consider.
The Nuchal Ligament
This is a little known fibroelastic ligament [or “a dense, bilaminar, triangular midline fibroelastic intermuscular septum”] - the shaded grey area in the left hand picture in the cover image of the video below (the video describes this in detail at the 7:57 mark). Just looking at the image of it impacted me viscerally. I could envision this fascia element tightening up under stress/defensive Nervous System states, and having had a major role in my [now residual] cervical dystonia (chronic neck tension and pain).
Indeed, like many people with a Parkinson's Disease diagnosis, when I was symptomatic I couldn't put by head back, nor lie flat without a pillow, as something would immediately feel so tight in my neck that it was like the blood supply to my brain was being cut off, and it would make feel like a zombie. Indeed, for years, I had to use a couple of very plump pillows, with my head propped up so much that my chin was nearly on my chest, and then I had turn my head 90 degrees to one side or the other, to be able to sleep.
So, like many people with PD, I get significant relief from the chin-to-chest head position. You can see this in the video below of Michael J Fox playing the guitar below. Could tucking the chin be providing relief via stretching of a very tight Nuchal Ligament?
Interestingly, I have managed to relieve a lot of this issue using a fascia decompression technique called Block Therapy, by sitting in a high backed chair and putting the smaller block between my neck and the back of the chair and then gently pushing back to generate some pressure on the Nuchal Ligament area. I am also certain that therapy with
of to remove body memories, which cause stress to tightened this whole area, has helped enormously.
Due to this I can now lie flat, and put my head back, and have much less "zombification", so it seems to have resolved the blood supply/nerve pinching that I had when my head was in certain positions before.
The Atlas and the Axis
I also wondered if this ligament has a key role in Stanley Rosenberg's model of how the nervous system swaps from calm “ventral vagus” to “dorsal vagus” freeze or shutdown states. According to Rosenberg, the two uppermost vertebrae in the neck get clamped down and cut off blood supply to the cranial nerves as the mechanism of a very rapid switch to freeze type of stress response. Perhaps a rapidly stiffening Nuchal Ligament lays a role in how this happens?
"Social engagement [the calm relaxed state] is not a fixed state, nor should the position of C1 [the first (uppermost) cervical vertebra or “Atlas”] and C2 [the second cervical vertebra or “Axis”] stay fixed. These bones move the instant that our psychological state shifts in moments of happiness, satisfaction, fear, anger, or withdrawal, or when our physiological state shifts among social engagement, dorsal vagus activation, or spinal sympathetic chain activation. A rotation of C1 and C2 can put pressure on the vertebral artery, which supplies the frontal lobes and the brainstem, where the five nerves necessary for social engagement originate."
"It only takes one negative thought to bring C1 and C2 out of joint, affecting our posture and physiology. Our nervous system is quick to be upset, it takes a longer time to settle down when we are safe again. Ten small muscles connect the occipital bone at the base of the skull with C1 and C2. Inappropriate tensions in any of these ten muscles are enough to shift and hold C1 and C2 out of joint."
"Our autonomic nervous system is constantly scanning both our external and internal environments. When everything is good, C1 and C2 come into place, and we get adequate blood flow to the brainstem. When there is a dorsal vagal state, or activity of the spinal sympathetic chain, C1 and C2 rotate out of position, reducing blood flow to the origin of the five cranial nerves in the brainstem and to some areas of the brain. This physiological mechanism takes us away from social engagement, but it also enables us to react when we are challenged or endangered. This mechanism is instinctive, immediate, and bypasses conscious thought. Usually we are not aware of the change”.
The solution according to Rosenberg, is to teach the Nervous System to spend more time in the calm, relaxed state, so that the Atlas and Axis aren’t triggered to go out of joint so often or so easily.
The Myodural Bridge
The Myodural Bridge is another ligament which may be involved in clamping down of the neck vertbrae, causing neck pain, and cutting off the blood supply. It is
“… a bridge of connective tissue that extends between the suboccipital muscles and the cervical spinal dura mater, the outer membrane that envelops the spinal cord. It provides a physical connection between the musculoskeletal and nervous systems, and the circulation of cerebrospinal fluid.”
Its functions include the articulation of the joint between the base of the skull and the Atlas vertebra, regulates cerebrospinal fluid, pain transmission, and nerve regulation of the cervical region. Abnormal tension in the Myodural Bridge can lead to postural problems, especially the forward head position, headaches, vertigo, and cognitive disorders related the cerebrospinal fluid.
Summary
Tightening of anatomical features in the neck, especially those involved in the Atlas and Axis (C1 and C2 vertebrae) region, due to stress can result in serious chronic issues, including “pinching” off the blood supply to the cranial nerves, headaches, neck and shoulder pain, vertigo, and cognitive issues. Targeting these areas with fascial decompression modalities, and with psychotherapies that remove body memories of prior stressful or traumatic episodes, which cause these areas to tighten up when triggered, can bring relief in the long term.
Learn more about the topics, and practical solutions, via the course that
and I developed, Emotional Trauma, Fascia And Breathing.
Interesting. I have a minor health “issue” which I’ve only recently realised is triggered by muscle facia movements. About 5 years ago (so not due to you know what) I developed an intermittent tingle in my right-side hairline, from above the ear to the temple. I went to a dermatologist who prescribed a special shampoo which did nothing. I decided to live with it as it was relatively trivial.
Then a few months ago I developed a pain in the neck. It started in the right shoulder blade, I think because I tried to put too much turn into my golf swing! This somehow exacerbated the tingle in my hairline. I realised that it switched on with certain movements such as turning the head to the left or leaning it to the right (but not vice versa), then switched off when returned to centre.
By coincidence, around that time my yoga teacher introduced the class to the mysteries of muscle facia and how it connects throughout the body from the soles of the feet to the temple. It made sense to me as I used to suffer from chronic lumbar backache (cured “just like that” by yoga magic 20 years ago) and a referred tingle in my thigh, emanating from tension in my right pelvis/psoas.
She introduced facia massage of soles, thighs, glutes, ribs, back and neck using doggie balls, golf balls and a foam roller. I found this excruciating in some areas at first but I think beneficial. My discomfort now seems limited to the neck area described in your post and my golf swing is better! I’m hoping that regular back/shoulder/neck exercises and massage will eventually sort it out.
Hi Gary, I am really appreciating your work on substack and your teachings/insights on Fascia. My focus is on the issue of wireless exposures and so-called Electromagnetic Hypersensitivity, (EHS) and I believe that part of the mechanism of injury for these individuals is the body contracting against the exposures, especially at nighttime when the body's energies are focused inward and designed to be free of external stressors. But humans are using the nighttime to transmit data, causing interference with the yin-yang balance. The meridians flow through the Fascia.
I believe your work it is applicable to many other health conditions, including other neurological issues and postural issues, and will share it with others. Thank you.