Most neck pain is psychosomatic. In order to understand this, though, it is first necessary to debunk the myth that spinal degeneration or tissue damage is the primary culprit. A degeneration problem that causes physical pain in the neck is a convenient and easy diagnosis for many doctors to make, because images of spinal degeneration can often be pointed to on an X-ray or MRI and named as the cause for pain. However, research has proven that degeneration problems are not the cause of most neck pain. The Orthopedic Clinics of North America published a study in July of 2005 that stated that degenerative disorders of the cervical spine (neck) do not usually cause any symptoms.(1) Confusion persists about this topic, because many times degeneration problems are found in conjunction with neck and other spinal pain issues, making doctors assume that they are the source of discomfort. This type of thinking has been around for so long and is so prevalent that it is hard to change the mentality of most doctors about what causes neck pain. Simply perusing the medical advice Web sites for the search term “neck pain” can show examples of this. For example: Web MD states that the cause of neck pain is “abnormalities in the bone or joints, trauma, poor posture, degenerative diseases, tumors, muscle strain.”—no mention of mental stress.(2) This contrasts with a study published in the Journal of Rheumatology in December of 1991, stating: “Our findings show that neuroticism [mental stress] is a more powerful determinant of neck pain than radiological signs of disc degeneration or OA [osteoarthritis] in the general population.”(3) Even the well-respected Mayo Clinic Web site fails to mention that mental stress can cause neck pain, giving only muscle strains, worn joints, nerve compression, injuries, etc., as possible causes.(4) The Mayo Clinic’s information is contradicted by a study published in the medical journal Spine in January of 2003, concluding, “. . . there is no difference in reported pain and disability levels between those with and those without evidence of cervical spine [neck] degeneration.”(5) Tissue Damage? Another myth that is prevalent among doctors and the general public is that some sort of tissue damage has to occur in order for pain to exist in muscles. The fact is, no tissue damage has to occur for muscles to send a pain signal. The book Muscle Pain: Understanding Its Nature, Diagnosis, and Treatment (recommended by the New England Journal of Medicine for doctors dealing with muscle pain),(6) states, “The stimulus intensity required for activating a muscle nociceptor [nerve cell that sends a pain signal] is usually lower than that for causing persistent tissue damage.”(7) In other words, you can feel pain in a muscle without any tissue damage occurring. So what is the physical source of your neck pain if doctors are usually wrong about degeneration and persistent tissue damage being the cause? Cells Are People Too The muscles and tissues in your neck are made up of cells. These cells have a whole life of their own, just like your body. They eat and breathe just like you do. You could think of cells in your body as miniature people. These tiny people need to breathe oxygen in order to function correctly. If they are deprived of oxygen, then their normal function is impaired and a pain signal may be sent to the brain as a result. This is known as tissue hypoxia. If you have ever gone from a low elevation to a very high elevation, you understand the dynamics of oxygen deprivation. I went into the mountains on a ski trip once, and I was reminded of what low oxygen feels like. As I was moving my luggage into where I was staying, I began huffing and puffing as if I had just run a marathon. My body was not acclimated to the lower oxygen levels at the higher elevation of the mountains. This created a reaction in my body that caused me to breathe heavily, trying to get more oxygen into my system, even though I was only moving small carry-on bags. Just like I was huffing and puffing in the mountains, your cells have a reaction from low oxygen levels. But instead of “huffing and puffing,” cells actually have a chemical reaction that tells your nerves to send a pain signal to your brain. Dr. Majid Ali states in his article “The Oxygen View of Pain,” “t is important to recognize that oxygen drives chronic pain pathways primarily by its absence.”(8) According to the neuroscientific journal Neurologija, “In the chronic muscle pain syndrome . . . the most likely cause of the pain is a combination of muscle tension and muscle hypoxia [low oxygen levels]. This conclusion is supported by the finding of a pathological distribution of tissue oxygen pressure in painful muscles. . . .”(9) This lack of oxygen causing pain in muscles is seen in many studies across several disciplines, conducted by a variety of doctors and scientific organizations. Why? Why is your autonomic nervous system not making sure that your muscles are supplied with adequate oxygen? The central control for your autonomic nervous system is the non-conscious mind. It’s also known as the unconscious mind, but I’m going to refer to it as the non-conscious because the word “unconscious” is usually used to mean something like passed out or asleep. I call it the non-conscious mind because you’re not mentally aware of all the decisions it’s making for your body. It tells your digestive system, kidneys, liver, etc., what to do without your having to think about it. Your body is running on automatic, controlled by your non-conscious mind. Autonomic nerves go from your brain out to your body and tell all of your body systems what to do without your being aware of it. You might feel the results of what your non-conscious mind is telling your body—for example, when you are nervous and your heart races—but you are not consciously controlling those physical reactions. Your non-conscious mind sends out signals to your body, and your body responds to these signals with physical reactions, as in the case of lowered oxygen levels that cause pain. Why would your non-conscious mind want to cause you to have neck pain? Dr. John Sarno, a pioneer in information therapy for musculoskeletal problems, says that the non-conscious mind causes the body pain in order to distract a person so that repressed emotions like anger don’t surface.(10) I don’t agree with everything Dr. Sarno says, but I strongly agree with this assessment. Protecting You With Pain The non-conscious mind decreases the oxygen supply to muscles in your neck and causes you to have pain in order to keep you from acting in an anti-survival or anti-self-ideal way by distracting you. When you have a stressful thought, you might be compelled to act contrary to socially acceptable behavior (anti-survival) or against your idea of who you think you are (anti-self-ideal). You might yell at your boss, for example, or act out your anger against a loved one. Yelling at your boss could be interpreted as anti-survival, and yelling at your loved one might go against your idea that you are a nice person. Even though you consciously believe that you are not going to do anything outrageous, your non-conscious mind does not believe this, so it tries to protect you by distracting you from strong repressed emotions with pain—causing you to focus on your body instead of your anger. If you are focused on your neck pain then you are not feeling the anger or rage that might make you behave in a socially unacceptable way. You might think that there is no way the non-conscious mind would try to hurt you. And that’s right. Remember the information from earlier—that no tissue damage has to occur for pain to be felt in the muscles? The non-conscious mind can use this aspect of pain receptors in muscle tissue to its advantage and create pain without damaging any tissue. Since life can be stressful and many people don’t wish to act in anti-survival or anti-self-ideal ways, neck pain remains rampant in our society. The solution is making effective mind-body therapies widely available to the general public. By Bruce R. King, D.C.