"I'm Just Not Getting Better" — What's Actually Behind Your Back, Neck, and Headache Pain

"I'm just not getting better." If that sounds familiar — you've been suffering from headaches, you've had a bit of pain and tension in your shoulder and your neck, a lot in your lower back, and it feels like there's a lot of inflammation — I want to walk you through what I would actually be looking at, and why the things you've already tried may not have held.

Low back pain usually starts with how we move

Low back pain and shoulder pain are very, very common.

Low back pain stems from the fact that a lot of times we are either not moving enough, or not moving with the appropriate posture. When we don't have good posture, it leads to a cascade of things, because we generally are not in good form doing multiple things. It's not just one thing, and is very much connected.

Low back pain is common to begin with if we're not using our core to support our back muscles. We oftentimes use back muscles that, for a lot of people, are stronger than our core, and then we're not evenly distributing our weight between all of the muscles we do have — unless we train our bodies to do this with good posture and strengthening, both the front and back of the body.

We're on our devices so much that we're not connected to our bodies

Another thing that is both a shoulder and a low back issue is that we are also on tech devices so much at this point, that our minds are very much distracted. We're not connected to our bodies.

When I'm looking at my phone and walking, I might think I’m getting the exercise of walking — which, for the definition of exercise, is true. But I'm not necessarily going to be in touch with my body, then my posture is off, I could be hunched and not notice it. My mind is on whatever I'm looking at, so I'm really not listening to my own body signals.

Occasionally checking in with what I'm actually doing is really, really helpful. That's why taking breaks frequently is so well recognized as a helpful thing, even though it sounds really simple. Most of us don't do it, because we get super caught up in whatever we're doing.

That's a double-edged sword. Being able to walk while we get work done is helpful for the life that we often have to live in, in our current world, and I'd rather somebody be walking and using their phone than sitting static to use their phone — that's not any better. It's more about taking breaks and checking in with our body to give it the attention that it needs.

Much like how we maintain our cars, often having to give our car a tune-up. Or if the house has something weird going on, we think “let's look into that, because I want to live here for the next ten years”. But sometimes we forget that we live in our bodies forever and ever ...and ever.

Where your headaches are matters

For headaches, I would definitely want to ask you first where your headaches are, before I assume anything.

It's not uncommon with shoulder tension, that you're raising your shoulders as if they're earrings all the time. We have all this tension going up from the shoulders and neck that is pulling on our head — So it depends what kind of headaches you have and this kind of tension headache is coming back to a posture issue again.

A lot of times, temple headaches have stress components to them, whether they're conscious or unconscious stress. Unconscious stress might be about the fact that your plate is very overfull. While we consciously are focused on what is on top of our plates, it might be the holding of the overflowing plate, that sends us into a headache. So even when we don’t think we are operating from a stressed body, working on tension relief is very helpful for headaches.

In this case, instead of giving more homework to an already stressed lifestyle, starting with something as simple as drinking enough water can make a difference too. Your muscles get moisture, and you get to stop and breathe, even if just for a moment, multiple times a day. We're not just talking about one thing causing the headache, but when we're dehydrated, we're working from an empty cup, almost literally, because we have not put anything into it.

It's rarely one single thing

Dehydration as a headache trigger is more common than people think. But for a lot of people, it's not usually just a single thing.

Water might be the piece that just breaks it, for your body to be like, okay, I can't hold back this headache — But it is very likely multiple things, between hunching the shoulders, clenching the jaws, dehydration, and stress. All these things are working together, and maybe none of them on their own would be enough to cause it. Usually it's about slowly figuring out the things that are helpful for it, rather than being able to attribute it to one thing.

Sometimes it's a beautiful thing and we can make one adjustment and the problem goes away. But a lot of times it's more about how we got here, and learning the pathology of it. Has this been something on and off for years? Or is this something that just started for you alongside — say — a new job that you'd had several months before the headaches started? It might not seem super duper obvious that they're connected, but after being stressed out for a while, our body kicks into, “I'm burning out here, something's got to give” mode.

Why I ask about your desk, your chair, and your pillow

As a natural medicine, when we're working on more than one thing, it does take time. That doesn't mean you won't feel changes starting right away, but it does take time to really train your body to undo, where we've gotten to. Essentially, we want to get your body training that new posture and alignment.

Most people are just bombarded by health information online, and there's so much out there that we can't do it all, and we feel more stressed. So when we talk, I like to ask each person exactly what is going on for them. Then we do acupuncture treatments, learn what works for your body, and when you go home, you put into place the steps that we talked about that are actually helpful to you.

When we have posture issues, we can start off with: do we have an ergonomic setup? If we don't, we might start with getting a more ergonomic setup, because we're supporting you to stay in good posture after treatments by setting up your space to be helpful. We create an environment to reduce the burden of you having to force “perfect” posture all the time.

But if your space has been ergonomic for years and years and it's not working, then we want to know — okay, are you taking breaks? Are you resetting your body? I don't care if you have a sitting desk, a standing desk, or a walking pad. If we don't reset, then as we keep working, we just tend to go into our bad posture, because we're losing focus on the body as we're giving all our focus to our work.

There's always got to be a reset. I really like sit-to-stands, because we get the chance to change positions within our workday. Even standing, people will create bad standing posture if we never shift and reset our bodies.

More than one chair. More than one mouse.

If someone doesn't have a sit-to-stand, I will have people get more than one type of chair, and I will have people get more than one type of mouse, if they are mousing a lot.

If computer work is what you're doing, then we are looking at how we can actually make the one thing you're doing for so many hours a day more varied. One position all day is just not natural. Until computers, most of us weren't doing one thing forever and ever. You would switch from cooking, to cleaning the home, to hunting, to gathering, to whatever else. We're not doing any one thing for eight hours a day.

Alternates to a chair include a kneeling chair or a big yoga ball. You sit in these seats differently, so ideally switch for half-hour windows and then back to your normal chair. You do want to make sure the yoga ball is the correct size as it should keep your hips level with your knees when you sit on it.

With mouses, we're looking to avoid carpal tunnel. I like for people to have a trackpad option, a vertical mouse, to have a trackball mouse, — different things that change the shape of the hand and the way we move the hand, arm, or fingers gets rotated to avoid one joint getting overfatigued.

You don't have to have ALL of them if you don't already have pain like carpal tunnel. But if that's what you were coming in for, then we would talk about it, because it would be worth changing how you're using that anatomy.

We change one thing at a time, on purpose

For a neck and shoulder issue, I would want to know about your pillow, your sitting posture, and all of those types of things. This gets to come out in conversation as we work and see results week to week, we're certainly not having one conversation that is one and done.

I can't know what thing is going to be most effective for you. It's more about you coming in, telling me what you are using, and me making a couple of suggestions based on what you are currently doing. Anything that you implement, you come back and we talk about — did that make a difference? If it did, here's where we go from there.

We may not do the thing that is the biggest difference right off the bat, because I don't want you to go spend thousands of dollars on a brand new mattress. But if we've changed your pillow and that made a big difference that seems to be a bigger difference than your entire work setup that we've made changes to, then maybe it's worth getting a new mattress.

It really is about figuring out getting the answers for your body, and what it's responding to.

Why stretching gives you relief that never quite lasts

A lot of people come in and they'll say that they've done PT and it hasn't been helpful. They stretch every night for months and it hasn't done nearly enough. It's made a difference — if they stretch, they feel a little bit of relief, but nothing is lasting. They have to continue to make time to do it every single day, month after month, and it's not sustainable for them.

Those are the kinds of things where I'm able to go in with a needle, help by releasing or activating specific muscles. The acupuncture is helping to actually release the muscles that are inhibited or train certain muscles to fire and “wake up”. What happens next — and why the work you do at home between treatments matters as much as the treatment itself — is where I'll pick up in the next post.

If you've been living with this for a while and you're at the point where it's affecting what you can do, I'd be glad to talk it through with you.