Dr. Jeffrey I. Kennis,  D.C.
205 Commercial St.
Boston, MA 02109

( 617)720-2329




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Posts for: June, 2018

There’s no question that tension and stress can manifest itself in the body. Whether it’s a headache or tight muscles, psychological factors can take a toll on our physical body.

If stress-induced neck pain does not subside after a week or two of self-care, see your doctor for diagnosis and treatment

How stress triggers pain

Stress-induced neck pain is defined as pain that is either triggered or worsened by psychological or emotional factors. For example, the initial neck pain may be caused by an injury that strains the muscles in the neck, but the pain continues for days or weeks afterward as stress caused by the injury or other factors builds—maybe even long after the muscle tissue has healed from the initial accident.

That’s not to say that stress-induced neck pain is “all in your head”—the pain and symptoms are very real. It’s just that the causes are not physical in nature.

Some experts think that stress-induced neck pain is caused by a physical factor: namely, a low but constant level of activity in the trapezius muscles that stretch from the back of neck out to the upper shoulders. However, studies found no correlation between neck pain and muscle activity.1 The only positive connection was between neck pain and perceived tension/stress.2

6 tips to tackle stress-induced neck pain

By focusing on ways to treat both the mind and the body, you can help lessen stress and the toll it can take on you. Try these methods to manage stress-induced neck pain:

See Trigger Point Exercises for Neck Pain

See Healing Benefits of Yoga

  1. Neck stretches
    If done regularly, stretching exercises for the neck can loosen muscle tightness and maintain or expand range of motion for the neck. Try these 2 stretches to get started.
  2. Therapy or support group
    Cognitive behavioral therapy has proven benefits for helping to develop healthy thought patterns, but even a support group or online forum where you can share your concerns and receive support can help you manage day-to-day stressors.

    Visit our very active Spine-health Forum to find online support.

  3. Meditation
    Practicing meditation is a good way to calm your thoughts and anxieties. Look for a guided meditation video on YouTube or attend a class to learn how.
  4. Enlisting help from family and friends
    You don’t have to tackle stress alone; let your family and friends help carry the load. Be clear about ways they can help you—ask if a friend can run an errand for you, or assign your children extra chores around the house during stressful periods.
  5. Massage
    Massage is not only relaxing and stress-relieving overall, but it can specifically ease the tightness of the muscles of the neck and shoulders.

    See Massage Chairs for Pain Relief

  6. Exercise
    Exercise is good for your body and mind. It releases endorphins, a hormone that dulls pain and generates feelings of well-being.

    See Low-Impact Aerobic Exercise

  7. Prioritizing
    You’re not a superhero—let inconsequential things go if they’re taking a toll on your health. Focus on what’s most important and don’t worry if things further down the priority list get delayed or undone for a while.

See Noninvasive Pain Management Techniques

If your stress-induced neck pain is not relieved by a week or two of self-care, see your doctor. He or she can offer other treatment option and diagnose possible underlying conditions.

See Diagnosing Neck Pain

Learn more

Stiff Neck Causes, Symptoms, and Treatment

9 Lesser-Known Tips for Easing Neck Pain


  1. Trapezius muscle activity as a risk indicator for shoulder and neck pain in female service workers with low biomechanical exposure. Ergonomics. 2001 Feb 20;44(3):339-53.
  2. The effect of pain reduction on perceived tension and EMG-recorded trapezius muscle activity in workers with shoulder and neck pain. Scand J Rehabil Med. 1995 Dec;27(4):243-52.

When back pain strikes for the first time, it brings with it many decisions to be made: How long should you wait before seeing a doctor? What do the test results mean? Should you get surgery?

When back pain begins, an initial course of stretching and other nonsurgical treatments is often recommended before considering surgery. Watch: Hurdler Stretch for Low Back Pain Relief

There are no set of right or wrong answers to these questions—each person's individual situation is unique. But through the collective wisdom of spine specialists and others who have dealt with back pain, these six choices seem to be factors that may make your back pain worse or delay getting relief through the right treatment.

Mistake #1: Ignoring your pain for too long

While it's true that low back pain usually gets better within a few weeks, don't make the mistake of ignoring it too long. Go to a spine specialist to get a diagnosis and treatment plan. With a correct diagnosis, you can start to map out a recovery plan that may include exercise, massage therapy, or a visit with a physical therapist.

Looking for a doctor? Check our directory of Spine-health certified physicians.

Mistake #2: Relying on your general practitioner for too long

Primary care physicians and general practitioners typically don’t have in-depth training in spine medicine, so it may be harder to get an accurate diagnosis and/or treatment plan. The best way your primary care doctor can help you is by referring you to an excellent spine professional.

See Specialists Who Treat Back Pain

If your back pain is severe and lasts for more than a couple of weeks, it's time to ask your primary care doctor for a referral to a chiropractor or a spine specialist such as a physiatrist.

See How To Select The Best Chiropractor

Mistake #3: Choosing surgery too quickly

For many, it's tempting to view spine surgery as a "quick fix." However, it is typically recommended to try nonsurgical treatment for at least several weeks or months before consulting a spine surgeon (with a few exceptions). While surgery can fix a specific anatomical problem, such as a herniated disc pressing on a nerve, conditions like degenerative disc disease are better managed with a long-term plan for physical therapy and exercise.

See Back Pain Medication Overview: Understanding Medication for Back Pain Relief

back surgery

Back surgery aims to correct an anatomical lesion in individuals who fail to show improvement with nonsurgical treatment. See Back Surgery and Neck Surgery Overview

Mistake #4: Postponing back surgery for too long

On the other hand, for certain conditions patients tend to do better if they have surgery sooner. For example, when there is arm or leg pain and weakness because a nerve root is pinched, known as radiculopathy, it is often best to take pressure off the nerve root through surgery sooner to avoid developing nerve problems.

See Guidelines for Evaluating a Spine Surgeon

Mistake #5: Focusing on imaging results

Imaging tests like MRI or CT scans are just pictures; they do not show pain. In fact, you may have terrible pain and a scan that shows a normal-looking spine, or you may have a scan that shows a large herniated disc, yet have no pain. A skilled physician will be able to read your imaging test results and combine them with information from your patient history and physical exam to produce an accurate diagnosis.

See Diagnosing Lower Back Pain

Mistake #6: Remaining inactive

If you are in acute pain, a few days of doctor-recommended rest is fine. However, lack of activity can in fact lead to more pain over time, so don't stay idle too long. Keeping your back and supporting structures flexible and strong means that they can better support your spine, hasten the healing process, and minimize the chance of future pain or injury. The core abdominal and back muscles don't get much exercise from everyday activities and need specific attention.

See Back Exercises and Abdominal Exercise Recommendations

Back pain is different for everyone, so trust yourself—and get educated about your situation—so you have the best chance of getting better quickly.

See When to Seek Medical Care for Low Back Pain

Learn more:

40 Questions to Ask Your Surgeon Before Back Surgery

Easy Exercise Program for Low Back Pain Relief

No matter if you’ve lived with chronic lower back pain for 1 year or 10, there are certain experiences that most lower back pain sufferers have in common.

muscle strain in the lower back

Lower back pain can be caused by a variety of problems with any parts of the muscles, nerves, bones, discs or tendons in the lumbar spine. See Lower Back Pain Symptoms, Diagnosis, and Treatment

The type of pain and the location of your lower back pain will help your doctor form a treatment plan.

See Lumbar Spine Anatomy and Pain

Here are four experiences that help sum up living with chronic lower back pain—and we hope you’ll share this list with your friends and family so they can better understand your condition.

1. Waking up in the middle of the night

Unfortunately, chronic lower back pain doesn’t keep to your schedule—so you’re often jarred awake by your pain during the middle of the night. Not only is this a frustrating experience, but it can also make your pain worse. That is, your chronic lower back pain

Certain nights are better than others—but one of your biggest desires is for a few nights of uninterrupted sleep.

See Sleep Aids for People with Chronic Pain

2. Difficulty standing up

This next experience can feel embarrassing. After a few hours of sitting around a table with friends, you find that you can’t stand up—at least not right away. Going from a prolonged sitting position to a standing position can cause excruciating pain, and you often need a few minutes to loosen up your muscles before you can leave a chair.

Back Muscles and Low Back Pain

You’re sometimes worried that people think you can’t stand up because you’re lazy or out of shape. But the fact of the matter is that you struggle to stand up because of a condition that is beyond your control.

Watch Causes of Lower Back Pain Video

3. People assume you’re all better

Your friends and family might mean well, but they can be all too eager to proclaim that you’ve been cured. In fact, it seems like every time they catch you smiling or laughing they assume that you no longer struggle with chronic lower back pain.

Types of Back Pain: Acute Pain, Chronic Pain, and Neuropathic Pain

But you know that the truth is some days are simply better than others. There seems to be no rhyme or reason to it, but on Monday you might feel mostly pain free—and on Tuesday you can barely get out of bed. Also, you don’t allow your pain to dictate your mood—so a smile doesn’t necessarily mean that you’re pain free.

Depression and Chronic Back Pain

4. Doctor’s visits, lots of doctor’s visits

Sometimes it feels like you spend more time at the doctor’s office than in your own home. You’ve seen all kinds of specialists—surgeons, physiatrists, physical therapists—and you’re on a first name basis with most of them at this point.

See Specialists Who Treat Back Pain

You’re not a hypochondriac, and you certainly don’t like spending time at the doctor’s. But between diagnosing and treating your chronic lower back pain, doctor’s visits are simply a consistent part of your life.

See Diagnosing Lower Back Pain

I hope all of the experiences described above will help your friends and family better understand the reality of living with chronic lower back pain.

Learn more:

Pulled Back Muscle and Lower Back Strain

Chronic Pain Coping Techniques - Pain Management

As an orthopedic spine specialist, I can tell you that your posture is essential to your health. Good posture helps reduce back and neck pain, minimizes your chances of needing spine surgery, and enables you to live an active lifestyle.

See Good Posture Helps Reduce Back Pain

But how can you learn to practice good posture? It’s as simple as ABC.

Experience good posture

Spine specialists use the term sagittal balance to describe a patient's spinal alignment or posture. The best way to learn good sagittal balance is to experience what it feels like.

Here are the ABCs that I teach my patients to help them experience the feeling of good posture:

Step A

  • Begin standing up with your hands by your thighs—slowly arch your lower back and elongate your stomach muscles.
  • Gently pull your belly button towards your spine.

In this position you should feel your lower back muscles, upper torso, and shoulders aligning over your heels.

See Stretching for Back Pain Relief

Step B

  • Rotate your shoulders outward so that your thumbs are pointing away from your body.
  • At the same time, draw your shoulder blades together.

Adding this step should allow you to feel the muscles between your shoulder blades.

See Neck Stretches

Step C

  • With your neck muscles relaxed, look up until your ears line up over your shoulders.
  • During this step it’s vital that you relax your jaw and breathe through your mouth and nose.

After step C, you should feel your elongated stomach and lower back muscles, the strong muscles between your shoulder blades, and your supporting neck muscles.

This is the feeling of good posture.

Identify poor posture habits

On top of experiencing good posture, you can protect your spine by identifying your poor posture habits. Here are some of the posture issues I see at my practice:

See Identifying Incorrect Posture

  • In today's world of smart phones and iPads, from a young age we spend countless hours staring down at devices with our necks flexed forward and shoulders slumped. This practice is so widespread that it has led to an epidemic of back and neck pain, or “text neck,” amongst children and teenagers.
  • As we grow older, we enter the workforce and spend untold hours—with few breaks—sitting at our desk while staring at a computer. This unfortunate habit deconditions our postural muscles and stiffens our spines.
  • Towards retirement, the cumulative effect of decades of poor posture may result in postural kyphosis, or a permanent flexed-forward posture. A flexed-forward posture comprises quality of life by limiting function, inhibiting balance, and increasing the risk for spinal fractures and chronic back pain.

See Workplace Ergonomics and Neck Pain

Make posture a good habit

You can quickly improve your posture by practicing the ABCs several times a day. If you feel that you need more personalized instruction and strengthening exercises, a physical therapist can evaluate your posture and provide you with additional instruction.

Remember that good posture can’t prevent all health problems. If you experience severe back/neck pain or numbness in your arms/legs consult with a spine specialist—these may be symptoms of spinal stenosis or another condition.

See Leg Pain and Numbness: What Might These Symptoms Mean?

Take a break right now and practice your ABCs. Good posture can go a long way towards keeping your spine happy and healthy for a lifetime.

Learn more:

Is Poor Posture Causing Your Back Pain?

How to Avoid Neck Pain from Texting

Walking can relieve your sciatic pain by spurring the release of pain-fighting endorphins and reducing inflammation. On the other hand, poor walking form may aggravate your sciatica symptoms.

Watch Video: 4 Little-Known Natural Pain Relievers

To help improve your form—and avoid sciatic pain—try these 2 walking tips:

See How Your Walking Posture Affects Your Sciatic Nerve

1. Shorten your stride to protect your sciatic nerve

Long strides can irritate your sciatic nerve by compressing your lumbar discs.

Follow these pointers to shorten your steps:

  • Don’t reach with your toes. Land between your midfoot and heel, then gently roll onto your toes and push off into the next stride. This will naturally shorten your strides because it’s difficult to roll your foot when it’s far from your body.
  • Slow down. A slower pace typically means shorter steps. You should be able to comfortably hold a conversation while walking.

See Techniques for Effective Exercise Walking

2. Engage your core muscles to support your spine

Actively engaging your abdominal muscles protects your sciatic nerve roots by minimizing pressure on your spine.

Here’s how to use your abdominal muscles:

  • Stand upright. Keep your head and shoulders tall and focus on a spot in the distance.
  • Suck in your stomach. Pull your stomach slightly toward your body for the duration of your walk. Take deep breaths and keep a comfortable pace, otherwise you’ll find it challenging to engage your abdominal muscles for your entire walk.

See Exercise Walking for Better Back Health

If walking isn't for you, try one of these low-impact aerobic exercise options:

Learn more:

Treadmills for Exercise and Pain Relief

Myths About Sciatica Treatment Options