I carry all of my stress in my shoulders...

Clients with neck, shoulder, and head pain often explain their problem in these terms. I ask them about their stress because that's relevant. But the fact that someone relates their pain to psychological stress isn't very helpful from an orthopedic perspective.

I could lightly touch the shoulders and neck while uttering low pitched hmmmms between telling them their muscles are tight. And perhaps they are tight. But diagnosing and treating a chronically painful condition based upon tight muscles is misleading at best.

Ultrasound and topical creams like Biofreeze are rarely helpful for more than a few days. Massage has it's place. But Chronically tight and sensitive muscles are a symptom of something else, and I'm not willing to throw my hands up and say "oh well it must be fibromyalgia."

I won't deny the existence of myofascial pain syndrome. But please remember that health care providers diagnose fibromyalgia through a process of ruling out other issues.


While locking wayward daughters out of the house or punching annoying coworkers in the face may be legitimate short- and long term solutions to your stress, I can offer a few more practical suggestions. If you're looking for a confirmation of tight muscles and a massage, these are probably not for you.

1. Remember that psychological stress is, well, psychological.
Psychological stress absolutely effects the body in a myriad of ways. It's good to keep in mind that pain is purely a psychological event. While stress alters our perceptions, especially our pain perceptions, it does not literally bind our bodies in whack positions. Gravity, fatigue, and arthritis have that covered.

2. Your posture is probably bad.

In my 11 plus years of treating clients with headaches and neck pain (many of whom also have fibromyalgia), I recall very few who have had those symptoms with good posture. It's far more plausable to assume that poor posture causes pain and tightness that's exacerbated by stress than it is to say that stress causes tightness and bad posture.

When posture is poor, the head, neck, and upper back muscles all must work overtime just to hold the head up. The only thing stressful to the muscle tissue itself is the weight of your head! Thoracic kyphosis and forward tilted (protracted) scapula also work against you, as they give many of those same muscles a poorly positioned, unstable base from which to work.

3. Your poor posture probably begins in your thoracic spine.

Stretch his neck? The neck
has nowhere to go!

Pretty much everyone who sits for any length of time aquires some degree of tightness through their thoracic spine. The thoracic spine is the base of the scapula, cervical spine, head, and about a zillion muscles. All efforts to stretch and correct the neck aren't going to work until your thoracic situation is improved.

4. Your trunk and back muscles are probably weak.

Your back muscles have likely suffered misuse and neglect. Due to postural changes noted above, they don't have the right line of pull to do their jobs effectively. The muscles that transition the upper back to the head take a pounding, which tends to cause them to heighten their tone. Viola - tight muscles! Massaging those rocks does help for a time and there is value to that, but it does little to correct the problem.

5. You're not being nagged enough about your posture.

Impossible, you say? Well, did you know that stretching doesn't fix poor posture? Neither does joint manipulation or strengthening. While those give you the potential to improve your posture, the only thing that improves posture is constant attention to your posture. Wiring the brain into a new habit of sitting tall and standing tall and moving tall is definitely a lot more difficult than exercising. Go ahead and try it.

So, the moral of the story is "mechanical treatment for mechanical problems."

And stress? I'm no expert on that, but I've found that Luke 6:28 seems to work a lot better than punching people.

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