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The Practical Solution to Chronic Neck & Shoulder Pain (Manual Therapy + Root-Cause Fix)

Neck and shoulder pain diagram

Dear reader,


If your neck and shoulders feel permanently “on duty” — tight, sore, heavy, and irritated by screens, stress, driving, gym, or sleep — you’re not broken. You’re adapted… to modern life.

Chronic neck and shoulder pain is rarely one single “problem muscle.” It’s usually a system pattern: posture, breathing, workload, nervous system tone, and a few key soft tissues silently doing overtime.

In this journal entry, you’ll get a clear map:

  • the most common root causes,

  • the postural issues that keep pain alive,

  • the manual therapy techniques that change the pattern,

  • and a “back to nature” approach that makes results stick.


Important disclaimer


This article is for general educational purposes only and does not replace medical diagnosis or treatment. If you have severe or worsening pain, symptoms after trauma, unexplained night pain, fever, dizziness, numbness/tingling, or weakness, seek assessment from an appropriate healthcare professional. Manual therapy and exercises should be adapted to your individual presentation.


The real root causes behind chronic neck & shoulder pain


1) Your shoulders are living in “forward mode”

Modern life trains a subtle, constant forward pull: phone, laptop, steering wheel, desk work, cooking. The body adapts by:

  • rounding the upper back,

  • sliding the shoulder blades forward,

  • letting the head drift forward,

  • and locking neck/upper-trap tissues as stabilisers.

That’s why many people stretch their neck daily… and still feel tight.


2) Scapula dysfunction: the silent engine of neck pain

Your neck often hurts because the scapula (shoulder blade) isn’t sharing load properly.

Common signs:

  • one shoulder higher,

  • shoulder blade winging,

  • clicking/catching,

  • pain near the inner border of the scapula,

  • burning/ache into upper traps.

When scapula stability is weak, the neck “volunteers” to stabilise the whole upper limb.


3) Overactive “front” tissues: pec minor + lats + subscapularis

When the front side of the shoulder tightens, the shoulder sits forward and internally rotated. Mechanics change, tissues compress, irritation builds.

Frequent culprits:

  • pectoralis minor

  • subscapularis

  • latissimus dorsi

  • scalenes / SCM

  • levator scapulae (often becomes a permanent “coat hanger”)


4) Breathing + stress keeps the tension switched on

Shallow upper-chest breathing recruits neck muscles as breathing helpers. Add stress, and the body stays in “protect mode”: shoulders rise, jaw tightens, head pushes forward.

Chronic pain loves chronic guarding.


The posture pattern that keeps it going


Forward head + rounded shoulders + “locked” upper back

A classic modern mismatch: your body is built for movement and variety, but trained by repetition and static positions.

Typical cycle:

  1. head drifts forward

  2. upper back stiffens

  3. shoulder blades slide forward

  4. pec minor shortens

  5. upper traps + levator overwork

  6. neck becomes the stabiliser

  7. pain becomes “normal”


The manual therapy solution that changes the pattern


At JANMI Soft Tissue Therapy in Marylebone, London, the goal isn’t just “release tension.” The goal is to reset the system so the neck and shoulders stop re-tightening.


Step 1: Assessment beyond the pain spot

I look at:

  • head/neck alignment (forward head, side-shift)

  • scapula position and control

  • thoracic mobility (upper back stiffness)

  • pec/lat dominance and shoulder rotation bias

  • breathing pattern and rib movement

  • symptom behaviour (what worsens/relieves it)


Step 2: The key manual techniques (layered)


1) Myofascial Release Therapy

  • slow sustained pressure through pecs, lats, upper traps, thoracic fascia

  • restores glide and reduces protective stiffness

2) Trigger Point Therapy

Common referral patterns into neck/shoulder often involve:

  • upper trapezius

  • levator scapulae

  • scalenes

  • suboccipitals

  • infraspinatus / teres minor

  • pec minor

The point isn’t random “digging.” It’s precise, targeted work followed by re-patterning.

3) Neuromuscular techniques

  • down-regulating hyperactive muscles

  • waking up underactive stabilisers

  • restoring balanced tone between front/back lines

4) Gentle joint mobilisation (supportive, ethical)

  • thoracic mobility support

  • shoulder mechanics support.

  • Not aggressive — more “unlocking movement options.”

5) Scapula repatterning with touch

Big one. When the shoulder blade starts doing its job again, the neck usually has a reason to stop overworking.


The “back to nature” piece: why it matters


This isn’t poetry — it’s biology.

Your body evolved with:

  • walking, carrying, climbing

  • horizon-gazing (not screen-gazing)

  • daylight rhythm

  • breath + movement variety

  • real recovery (less constant stimulation)

So part of the solution is restoring natural inputs:

  • more movement variety daily

  • more outdoor walking

  • less fixed posture time

  • calmer nasal breathing

  • fewer hours in “always-on” nervous system mode


Warmly,

Paulius Jurasius

JANMI PosturalPain Clinic - Marylebone




 
 
 

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