This is One Big Ass Pain in the Neck!

My neck

Only, not really so much my neck. You might recall a couple weeks back I blogged about having an impinged rotator cuff. Symptoms all made sense and here’s the confounding variable part: I was doing workouts that included heavy sets of exercises well known to cause shoulder injury.

But how easy it is to fool ourselves.

Thanks to some commenters to that post, I went to the same Chiropractor mentioned by Tim Ferriss in The 4-Hr Body, Janzen & Janzen here in San Jose, in order to get set up with ART — Active Release Therapy — which is supposed to do wonders. The problem is, you have to actually have a shoulder injury and I don’t.

I began to wonder because, after the 2nd treatment there was simply no improvement at all. Then the third or 4th time in, the chiropractor was doing some deep massage, pressure point stuff around my neck because I had begun to have pain there, too, and all of a sudden my shoulder and arm hurt in all the same places, only 100 times worse — like, "fucking stop that bullshit this instant or I’ll pass out" kinda pain. A little more prodding led us to suspect a nerve issue around C4-5. I should point out that the chiropractor stressed the importance of getting imaging on the very first visit so as to not be shooting in the dark — which kinda ended up happening anyway.

So now I had good reason to request an MRI from my provider, which was scheduled immediately (an x-ray of both neck & shoulder revealed nothing). First time in the tube for me and while I’m not claustrophobic, pain does interesting things to your mind. Thing is, being unfamiliar with the procedure and having a dumbass for a tech who didn’t bother to even mention that "this is going to be about 20 minutes," I was left writhing in that horizontal shit hole, wondering when in the holy fuck it was going to be over. At some point I adjusted my arms or something, I guess, ’cause when the thing was all over, dumbass tech comes on the speaker to tell me there’s blurs and they have to do it again.

"Get me outta here!" Actually, I didn’t even wait. With sharp, hot knives in my shoulder blade being twisted by the Devil himself, I really gave no shit whatsoever about ptotocal. I scooted right out of shit tube, then jumped off the table before it was even lowered, to the exasperation of dumbass tech who said: "you’re scaring me." I’d have loved to come back with some clever retort — something along the lines of "no, what you should be scared of is having me in that torture chamber for another 20 minutes." Instead, all I could do was bend over and writhe in pain until it subsided.

They rescheduled for a few days out and I came prepared: three Vicodin and a good 6-8 ounces of scotch on an empty stomach. Still substantial pain but definitely manageable. What’s more, I had smart & experienced tech who, when I explained the previous experience assured me she’d get me through this. And she was good at her word, giving me progress reports, letting me know when I could adjust my arms a bit. …"Just three more minutes." I froze in place. Too late to turn back now. Done.

In the meantime I’ve been having the chiropractor do neck adjustments (pop, pop) and traction with a machine that could probably second as a torture rack. Actually, I can perform traction on myself as well and it really helps.

Initial diagnosis came in today via a voicemail from my primary care guy. "Narrowing of the spinal cord channel at the base of the neck as well as narrowing of the nerve protrusion at C5-6." Something like that. Stenosis, from what I gather. No idea the cause, though I do suspect some congenital contribution since I have had "weird" issues in my right trapezius, shoulder and arm for as long as I can remember and it used to be that every couple of years I would be in a lot of pain in the trapezius that would resolve itself in 1-2 weeks. I’ve been at this for about 2 months, now.

So where I’m at now is that I have improved greatly during the day when up, moving around, using my body. I’m heading to the gym tomorrow for some very light exercises, nothing overhead, and…gasp…cardio — just to get the blood pumping. Then I’ll take 10 minutes submerged to the neck in the 40 degF cold dip.

What’s worse is laying down. There is no position that does not hurt and it builds to the point of screaming agony and that happens every 2 hours (even with Vicodin), all night. I have some stretches I figured out, and I basically just get up and move around. Then it’s back for another round. In much measure, I am handling this in many ways as a self experiment. And one thing is for sure: I am in charge. I don’t want a knife — anybody’s knife — anywhere near my spinal cord if there’s any way to get around it. But if that ends up being the only rational recourse I will not be irrational.

The newest self experiment is to sleep upright, in a chair. I feel like I’m killing my recovery by so irritating the nerve at night. Plus, I now have a supply of 50 Percocet….

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  1. Laurie D. on February 11, 2011 at 19:32

    I can second the inversion table. My horses’ farrier uses one because of back problems from obvious sources and he swears by it. He had severe pain and threats of surgery from his doctor before discovering it. I recommended the same to my husband’s co-worker and same result – no surgery and much pain relief.

    The other thing I might recommend is Aleve or Advil. I know, I know, these are lightweights compared to the hard stuff. BUT, I had back pain so severe once that I thought I’d rather die than deal with it. I took Advil and the inflammation was reduced so quickly I was amazed. It was almost instantaneous. Advil seems to work especially well with nerve damage and inflammation.

    Best of luck to you!

    • Lute Nikoley on February 11, 2011 at 20:48

      Aleve is Naproxen and Advil is Ibuprofen. Two entirely different pain relievers. Last year I had a herniated L3L4 disk. I had surgery, 2 weeks later I was pretty much to normal without severe pain. It may be the easy way out, but it works.

      • Daniel Kirsner on February 11, 2011 at 21:04

        “Aleve is Naproxen and Advil is Ibuprofen. Two entirely different pain relievers.”

        Both are propionic acid derivative NSAIDs; they are very similar pain relievers.

      • Dave, RN on February 12, 2011 at 07:09

        My opinion:
        Watch those NSAIDS. Long term use can cause some nasty side effects, like increasing your chance of a stroke or heart problems. Diclofenac, a prescription nsaid, is the very worst. My opinion, don’t take it. Patients taking diclofenac had a 91% higher risk of death from heart attack and stroke, much higher than the 66% increased risk for those taking Vioxx which is now off the market because of it’s nasty reputation of causing heart attacks. Ibuprofen showed a 29% higher risk of stroke.
        The good news is researchers found no increased risk of heart attack or stroke with use of naproxen.
        So if ya gotaa take ’em, Aleve (naproxin sodium) is the one to take.
        REf: June 8, 2010 issue of Circulation: Cardiovascular Quality and Outcomes,

  2. Angela on February 11, 2011 at 20:00

    I really have nothing to say that might help, but I just wanted to let you know I’m sorry you’re in so much pain. And I also really appreciate you sharing your experiences, good and bad, with your readers. It helps. Thanks.

  3. Todd on February 11, 2011 at 19:07

    Have you considered acupuncture for pain management? I have read of some success in treating those with pain from pinched nerves in the neck and those with spinal stenosis. It would not be a cure to the underlying problem, but may help with the pain until they can deal with the cause.

  4. Helen on February 11, 2011 at 19:09

    Your neck/shoulder reminds me of my butt when I had sciatica. I hope you get some relief soon.

  5. Joseph Dantes on February 11, 2011 at 19:10

    I tried the sleeping in a chair thing. Got swollen ankles, couldn’t hack it.

    However I found that sleeping on the floor kicks ass. Can’t sleep on my back on a bed, but I can on the floor.

    You may also want to try SPAMAYL polyphasic. That means only 20 minutes at a time lying down, which makes your body less sore when you wake up.

    Also, yeah I put some padding on the floor when I sleep on it, just not a lot. It’s great support… beds tend to sag.

  6. Bill J. on February 11, 2011 at 19:24


    Have you considered an inversion table? I don’t know if that would help or make it worse, but if the issue is you being horizontal, I would think you should be able to sleep and not put much stress on your neck/spine.

    • Lute Nikoley on February 11, 2011 at 20:40

      With the neck, I think he would probably have to hang from his neck, and I sure as he’ll wouldn’t advise that.

  7. Ann Marie @ CHEESESLAVE on February 11, 2011 at 19:41

    If you can travel down to Beverly Hills, I have the best chiropractor in the state. Possibly in the country.

    Every time I have effed up my neck for whatever reason, he fixes it instantly — pain is gone within 1-3 days every time. I have never been to a chiropractor this good.

    And I only see him when it hurts. He is not one of these chiropractors who believes in having patients show up every week. Once a year, once every two and that’s it.

    Seriously the man is a miracle worker. But yeah, you’d have to fly or drive.

    If you want his phone number, email me and I’ll send it to you. He can usually get me in within a day or two.

  8. Woody on February 11, 2011 at 19:44


    I know you are probably getting advice from all different directions, but if you decide you want to take another manual manipulative technique, I recommend seeing a good Doctor of Osteopathy. You can search for osteopaths that are solely use manipulation at It looks like there are 3-4 in your area.

    I’d definitely give them a call and talk to them before making an appointment, though, because they can range from scientific anatomical manipulators to airy-fairy spirit driven doctors, much like the range of chiropractors. I highly recommend you giving it a go, at least on the phone, because most osteopaths know whole body anatomy better than anyone else in the business.

    Good luck!

  9. Frank Dawson on February 11, 2011 at 19:44

    I have been reading your blog for the last several months, and I love it. Sorry to hear that you have been in so much pain recently. I cannot recommend strongly enough that you read either Healing Back Pain or The Mindbody Prescription by John E. Sarno MD. I believe that — if you keep an open mind — you will be able to cure yourself from the pain syndrome by reading Sarno. I also know that assertion I’ve just made sounds ludicrous — how can you cure your pain by reading a book and changing the way you think? Most people dismiss Sarno b/c they buy into the standard medical explanation for back, neck, shoulder pain, etc. and don’t have an open mind. I know you would be one of the rare folks out there who is an independent thinker. I believe you will find Sarno’s theories quite consistent with paleo approach to living (although Sarno has probably never heard of the paleo movement). You have nothing to lose by giving Sarno a try — except for the price of one paperback book.

    • mem on February 12, 2011 at 14:29

      Sarno is THE MAN. And for those not familiar with him, he is an MD (as per Frank’s post) – so an allopath – western medicine trained practitioner. HOWEVER, after practicing for years inside the machine, where infact, he still practices in a major leading medical center, he began to SEE everything that makes reading his work so important. Sarno will not tell you that you aren’t in pain or don’t have an injury. It is simply the nature/mechanism of the injury/pain and the “cure” that is very different, in all but a very few cases. Additionally, “getting” Sarno’s work can help you *prevent* injuries (specifically, back) even as they are *happening.* I got Sarno-ized in the mid 90’s, and have never looked back, having effectively self cured back, shoulders and L knee. But, he’s very hard to get for alot of folks…rather like paleo/primal by comparison to the SAD… However, it is my opinion that paleo -type/more natural exercise is very congruent with Sarno’s stuff.Hearing Sarno takes the investment of taking a good, long, ongoing “self-look” and an ongoing commitment to “the work.” Nice post, Frank. Heh! You obviously got my attention…didn’t mean to babble on so!

  10. bubba29 on February 11, 2011 at 19:53


    i have been through some painful situations in my life and haven’t had to rely on the drugs you are on. are you a wimp or kinda enjoying the high? be careful with those things. as for your current situation, it is tough i know. i was diagnosed with stenosis in the neck 16 years ago. thankfully it hasn’t progressed. i did lose significant strength in my right arm due for about 2 months due to nerve damage. the strength eventually came back then i tore my rotator cuff a year later. football can be rough. i really laid off the weights for a while after that with only small discomforts in the neck today.

    not sure the answer with you but i think you are right to fight the knife as long as you can just don’t get hooked on painkillers.

    • Richard Nikoley on February 12, 2011 at 14:50


      Unfortunately, neither the Vicodin nor now the percocet give me a high. Unless some measure (but not total) pain relief is a “high.”

      This began in early Dec, more than 2 months ago. For the first 3 weeks I took not so much as an aspirin, firgurimg it would resolve, as stuff usually does. Then over the holidays at the cabin I indulged in some ibuprofen at night to help with the sleep. It’s only in the last couple of weeks as this has morphed into excruciating pain that I have gone ahead with the narcos.

      But I guess I’m just a pussy about that.

  11. jordan on February 11, 2011 at 20:06

    feel better

  12. Jeremy on February 11, 2011 at 20:32

    I have nothing to offer that hasn’t already been said but I hope you find something to manage the pain, and then fix the source of the pain. Back and neck pain are debilitating and people that haven’t had severe back or neck issues will never understand. The very act of breathing can be excruciating and there’s only so much medicine you can take before you are sick from that.


    Grok on.

  13. Daniel Kirsner on February 11, 2011 at 20:59

    I’ve had intermittent pain radiating from my neck down my right arm; cervical epidurals have provided significant but temporary (months) reduction of symptoms.

    I’ve also had three facet joint nerve ablations (rhizotomies) to deal with severe lower back pain. While in many cases rhizotomies only provide temporary relief, the “temporary” in this case is typically about a year, and in my experience they are up there with LASIK as far as “working exactly as advertised.”

    For those in La La Land, I strongly recommend Haruo Arita, M.D. at the UCLA Pain Management Center–310-794-1841.

  14. lpdbw on February 11, 2011 at 21:10

    I have a C4/C5 injury due to a bad forward roll in jiujitsu, which ended my martial arts career.

    Which developed into stenosis.

    A good physical therapist helped me. Once I got through the therapy and a course of NSAIDs, it’s all good, so far, as long as I baby it.

    Good luck.

  15. Lute Nikoley on February 11, 2011 at 21:10

    I’ve never read so much bullshit in all my life. Narrowing of the spinal tunnel or canal is no simple or easy way out. It’s similar to CTS. When the nerves ate pinched, causing excruciating pain those easy answers aren’t always the best. My philosophy always has been, if it ain’t broke, don’t fix it. If it is broke fix it. I had a similar problem last year, except lumbar. I went with that, oh my God, awful knife, for the first time in my life, and I am so glad and happy that I made that decision. I’ve had CTS in both wrists though, and cured the narrowing of the carpel tunnel by taking vitamin B-6.

  16. Lute Nikoley on February 11, 2011 at 21:16

    In the end Richard, you and only you will make the right decision. I wish you well, son and hope that there will be an end to the pain soon. I was on morphine, which helped a lot. But what a relief when I woke up after a short 2 hour surgery. Back surgery ain’t what it used to be. It’s very high tech.

  17. Elenor on February 11, 2011 at 21:51

    So sorry you’re hurtin’ Richard! (And getting buried with advice — and here’s mine!) I second the acupuncture recommendation — my orthopedist was offering me a range of ‘fixes’ from injecting steroids into shoulder all the way to cutting off the end of my collarbone (and HOPING that would make the pain go away!). I wanted something WAY less invasive and found a good acupuncturist. The pain was about halved after the first treatment, and by the end of the 10 sessions, I had no pain at all and (returned to a) full range of motion. Western medicine can deal with a lot of things — pain is often not one of them!

  18. Sam on February 11, 2011 at 21:51

    That much Vicodin and that much scotch?

    Dude, you’re going to fry your liver – even on a paleo diet.

    • Richard Nikoley on February 12, 2011 at 00:23

      Every day, yea. Not once in 50 years.

      • Kurt G Harris MD on February 12, 2011 at 07:31

        Vicodin is full of acetaminophen – a true hepatotoxin. Better to take hydrocodone by itself for that reason.

      • Richard Nikoley on February 12, 2011 at 09:00

        Yea, the 30 Vicodin I got didn’t help much anyway and I had no idea they had acetaminophen. The hydrocodone is far better. Only side effect so far is a bit of drowsiness, which is good. Otherwise, I don’t feel the slightest bit “high.”

        I am a bit amused at some of the hand waving over some pain meds. Chist on a crutch, already. It’s not like a whiff of narcotics os gonna get you hooked. I had percocet one other time years back for pain after dental surgery. When the pain was gone, I stopped taking the meds. Simple.

        Such as this morning. Feel pretty good. Slept half the night on a comfy chair with little pain (with the percocet). Then I thought I try the bed around 4am. Took another pill, more pain but nothing like what I had been experiencing and once I got up around 7:30 this morning it took only 30 minutes to melt away vs the normal few hours.

        So, no need of a perc today. I’ll take one before bedtime again tonight.

      • Erik Cisler on February 12, 2011 at 11:25

        Even hydrocodone is also often accompanied by acetaminophen. If so, you can do a simple cold water extraction to isolate the hydrocodone and eliminate the bulk of the acetaminophen.

        Crush the pills to a powder.

        Stir them into cold water, mixing well. Do this for about two minutes to ensure most of the hydrocodone is extracted.

        Place the vessel in the freezer to chill – about 15/20 minutes.

        Strain the liquid through a coffee filter. The solid stuff left behind is the acetaminophen, and the liquid contains the stuff you want. Drink it. It’ll taste a little nasty but your liver is worth it.

      • Dave, RN on February 12, 2011 at 17:25

        Hydrocodone is always accompanied by Tylenol. I won’t take Tylenol (acetaminophen) because of the tap dance it does on your liver. It’s the number one cause I believe of liver failure… I personally think that hydrocodone alone is much safer than Tylenol. I tried and they claimed it did not exist. You just can’t get it separate. You can thank the misguided “war against drugs” going back to Nixon for that one.
        Erik, thanks for th home brew solution. Where did you get it from?

      • Richard Nikoley on February 12, 2011 at 17:36

        Dave RN, how much tylnol as compared to vicodin?

        At any rate, there is definitely a BS factor here that applies to some folks, including me. This is acute pain management in a for now, chronic setting for me, ie i used nothing for a few weeks, went on ibu, and now in the last week or so, marcs. The liver is hugely regenerative. If you’re paleo and as I showed in a recent post, liver enzymes for damage decrease, even though I favor my scotch.

        I just don’t think a regimen over a few months that may include some tylenol is a big worry so long as one is not going to use it for long term or lifelong pain management.

        And no way I’m doing that.

      • Dave, RN on February 12, 2011 at 18:25

        how much tylnol as compared to vicodin?

        Not sure what yo mean, unless its the ratio. I usually see these despensed as APAP5/500, meaning 5mg of hydro and 500mg of tylenol. Also comes in 7.5/500. There is a new ruling though, and if memory serves me correctly, they (the feds) are limiting the acetaminophen part to 325mg becasue of the afomentioned liver problems it causes. I think also it has to be called “acetaminophen” instead of “APAP” because most people don’t know that APAP is actually acetaminophen. Or maybe that was a propsed ruling. Can’t remember.
        All this because (acetaminophen) is in so many OTC drugs. You take 2 ES tylenol, so there’s 1000mg, then you take some Nyquil, not knowing it also has 1000mg in it. Take those two in the recommended amount over 24hours and you have a toxic level. I just avoid it in favor of Aleve or White willow Bark.
        “Some” Tylenol should be fine, as long as you’re not popping them like Pez.
        Pain is… such a pain.

      • Kurt G Harris MD on February 12, 2011 at 18:51


        A bunch of liquor and a few grams of tylenol can earn you a liver transplant. It’s not fatty liver from fructose we are talking about. It’s how much you get in a 24 hour period. Don’t fuck around with acetaminophen. Meperidine or demerol can be had solo – get a real doctor to prescribe you some of if you are in that much pain get a fentanyl patch.

        FWIW, the narcotics are relatively harmless health- wise. No puritanism here.

      • Kurt G Harris MD on February 12, 2011 at 18:54

        Some vikes have 500 mg, some have only 325 acetaminophen, so stick with the latter if you must take them.

      • Richard Nikoley on February 12, 2011 at 19:03


        Thanks. FWIW, I’ve always been a liquor self-medicator and it has always worked for me very well. I never take pills, even aspirin, so this has been new ground. Since I trust the bottle more than than the pills, I’m favoring that.

        But anyway, more than 15 hours without a pill. No alcohol, either. Just testing. :)

      • Erik Cisler on February 13, 2011 at 20:41

        Can’t remember exactly. Someplace online, back when I was recovering from knee surgery and was prescribed the stuff. It destroyed my stomach, so I looked for a way to mitigate the damage.

      • Daniel Kirsner on February 15, 2011 at 21:07

        FWIW, I’ve found (unscheduled) tramadol to be better than hydro for neck/lower back pain…it’s a strange drug, as it’s a weak opioid, a prodrug to a strong opioid, and an SNRI–all of which apparently contribute to the analgesic effect.

  19. Bill Strahan on February 11, 2011 at 22:59


    Damn sorry to hear all of this! You do have to get the pain addressed, since it can lead to desperation. Desperate men do desparate things. Judgement just degrades in the face of long-term significant pain.

    I agree with Sam that painkillers and alcohol may do more damage to other critical parts. When the neck is healed you need all your other systems working.

    I’ve gotten so much benefit from your blog I feel like I really owe it to you to try to help out, but no idea how. If any of us out here can do something concrete, please say so. Until then, I’m not attempting a game of “spin up the atheist”, but I will include you in my prayers.

    I’m sure I’m not alone in looking forward to your recounting how you overcame this painful and frustrating problem.

    Hang tough.

  20. lalo on February 12, 2011 at 01:52

    so thats leangains for you mr, give me one rep full effort!!! kyaaaaaa!! me? healthy, pain free toned muscles all around, with my crappy bodyweitgh metod of chins, push ups, squats a backpack and a set of dumbbells. ( yes im an ashole) give those muscles a rest!

    • Richard Nikoley on February 12, 2011 at 09:15

      No lala, that’s not fair to the Leangains approach at all.

      For one, as I explained, this is likely a manifestation of an issue that has persisted for a long time. Ever since I began working out almost 4 years ago I would have weird, nagging pain in my right shoulder (only) in the exact place I have it now, and sometimes twinges or tingles in the right arm. Whether it was Leangains heavier lifts, general age or something else that caused the pre-existing condition to advance is something no one can say, for sure.

      Moreover, how then would one explain all the folks reporting similar issues here, none of whom are doing Leangains to my knowledge?

      Finally, “give me one rep full effort!!!” is a gross misrepresentation. All the Leangains exercises are done in a rep range, 6-8 for 2 sets being the most common. The heaviest is the Dedlift at a 3-5 rep range for 2 sets. In no way is Leangains about 1RMs.

    • rob on February 12, 2011 at 12:52

      The price of being dissatisfied by mediocrity is stubbing your toe every now and then.

      /”toned muscles” … lol

      • lalo on February 12, 2011 at 16:26

        yea i know that sounded kinda … gay, is more like fuck yea, im fucking lean and ripped.

      • Richard Nikoley on February 12, 2011 at 16:35

        Uh huh, and are you 50, with a DL of 325 in the 3-5 rep range, with a goal of 500?

        No? Didn’t think so.

        Are you weak lean?

  21. muirsan on February 12, 2011 at 02:15

    6 mgs melatonin 2 hours before sleep and an ice pack under the neck while hopefully you are falling asleep. i have suffered from this same problem for 5 years and this is the only way i can sleep. sitting all night is not ideal. first thing in the AM into some body of icy water, a cold plunge. 60 percocets in one’s possession is also not ideal. beware of traction as it can make things worse.

  22. Art on February 12, 2011 at 02:57


    I agree with your father. Suffered from severe sciatica for almost three years, which became excruciating, in effect crippling my entire right leg. Tried chiropractic, acupuncture, drugs, and physical therapy, none of which helped. X-rays were useless, MRI just showed normal wear and tear for an active man my age. Finally went to a good (he’s actually great–I love this guy!) neurosurgeon who set me up for a myelogram, which clearly showed stenosis in L-4 and L-5 area. He told me I could do chiropractic and PT for the rest of my life, but nothing would get rid of stenosis except surgery. He went in and cleaned it out, and when I woke up it was like having a new leg! No sciatica in past 5 months.

    • Jeff on February 12, 2011 at 07:20

      My story exactly. Had it done on 11/30/10 and I’m back to walking 3 miles a day PAIN FREE. I suffered with the pain for over a year and tried PT, Chiro, pills, shots, everything. Surgery was the answer.

      Good luck with whatever you decide.

    • Lute Nikoley on February 12, 2011 at 10:36

      Amen to that Art, mine was L3-L4 herniated disk. after surgery no more severe pain. I still get some pain due to spinal stenosis in other area of my spine due to my age. But I can deal with that. I am back to doing my weight exercises and golf.

  23. dr. gabriella kadar on February 12, 2011 at 05:12

    Two suggestions with one explanation:

    Your medication profile prior to losing weight included meds given to people who have serious sleep disordered breathing. Of course, change of diet and weight loss has reduced the severity of the problem, but has not eliminated it entirely.

    The head posture assumed (head tilted ahead of neutral position over spine) indicates that the brain’s requirement for oxygen trumps postural adjustments which cause pain. The brain does not care about body pain. It only cares about getting oxygen. The head posture has remained the same from before and after the weight loss, diet changes and muscle development.

    Your face shape and mandibular position indicates a history of airway resistance most commonly caused by enlarged adenoids and tonsils. I don’t know if you’ve still got these but in photographs, you have your mouth open. I suspect you are partially mouthbreathing.

    Symptomatic relief of nerve pain in the neck can be provided by using a MediFlow pillow. Check out their website.

    Breathing can be assisted at night through the use of a mandibular advancement appliance (contact a dentist who understands sleep medicine).

    HOWEVER, if you have airway resistance during sleep, you need an evaluation by an otolaryngologist. There could be several issues in the nose, upper pharynx or throat that preclude comfortable nasal breathing. These issues need to be addressed first. The fact that you are more comfortable sleeping in a chair than in the bed, is a sign that when you are asleep in the supine position and the muscles of the throat and front neck relax, you are getting some airway resistance issues which result in tensing of the jaw elevator muscles and consequently the neck muscles as well. This is why you wake up with pain every few hours.

    The chronic appearance of problems in your trapezius muscles are indicative of head posture modifications due to airway limitations.



  24. Bodhi on February 12, 2011 at 06:13

    I feel your pain. I’ve been suffering through neck, shoulder, and trap pain for the last six months. My chiropractor hasn’t been able to help. I was listening to Robb’s podcast and Andy mentioned a guy by the name of Scott Sonnon and his method of Intuflow. It has helped me. Most of his videos are on Youtube. Hope you get better.

    • Tim Starr on February 12, 2011 at 12:26

      I’m a big fan of Sonnon, especially his active recovery techniques. I had similar problems to Richard’s, but not as severe. Stenosis is about as bad as it gets, and surgery may be the only solution (my wife had it in her spine, & she had to have a lumbar replacement/fusion). But Sonnon’s joint mobility & stretching exercises are the best!

      E.g., one of my favorite shoulder stretches came from one of Sonnon’s people. You get down on the floor on all fours, then reach your right arm out to your left side so it’s across your body, roughly under your left armpit. Put your right palm down on the floor, then lower your body so your arm’s straight, elbow locked, and your entire arm up to your shoulder is on the floor. Then lean into your elbow so that it’s pushed in the direction of your left shoulder. Hold for 60 seconds, then repeat on the other side. When I first did that stretch, I couldn’t believe the difference it made, I felt like I had a whole new shoulder.

      Richard: If you try that one, do it first w/ your unaffected shoulder, because I don’t know how much it would hurt your injured one.

  25. Cynthia K on February 12, 2011 at 07:42

    Anyone with chronic pain should at least consider the works of Dr. John E. Sarno. “Healing Back Pain” is a great book, and he has several others. I am afraid to even say what his theory is because people are so quick to dismiss it, but it is absolutely viable. Nothing to lose but a quick trip to the library and a bit of time (which I presume people have if they are laying there in pain).

    Best wishes, Richard. I hope you find relief soon!

  26. Jeff on February 12, 2011 at 07:46


    So sorry to hear about the neck problems and resulting pain you are experiencing. I have no doubt you’re going to get advice from hundreds of people who claim they have the perfect solution. Having gone through what you’re going through I can only tell you that there is no silver bullet– at least not that I have found. I’ve tried them all, from chiropractic treatment, acupuncture, drugs, to surgery and spinal fusion.

    My problem was originally at c6-c7. I eventually succumbed to surgery about 20 years ago and had the disc removed and spinal fusion. I won’t go into the details here, but the surgery left me with a paralyzed vocal cord which in many ways was worse than the pain I was seeking to avoid.
    The surgical solution is somewhat temporary, as well. The problem just progresses to the cervical discs above the removed disc. Eventually the problem just progressed to c5-c6 and c4-c5. I now have a similar problem to what you are experiencing.

    For what it’s worth the best non-surgical treatment I’ve found is called spinal or cervical decompression. You can find additional information here . This procedure does provide some relief. It’s expensive and what they don’t tell you is that it is only temporary. Eventually, the problem returns. Your results may vary.

    I’m a daily reader and I’ll follow along with your progress and I sincerely hope you find a better solution. I have not. I wish you the best in finding a solution.


    • blueb on February 12, 2011 at 08:17


      One day I walked into a Sleep Country store and purchased a Tempurpedic pillow for no real reason.
      About 3 months later my wife commented that I wasn’t complaining about sore necks and head-aches.

      I now attribute it to my pillow… it’s fairly hard but it didn’t take long to get used to (I had always liked a very small, soft pillow before this). Now, I love it.

      Coincidence… I don’t know, but I’d recommend these pillows for whatever reason!


    • Richard Nikoley on February 12, 2011 at 08:41


      Yea, by saying “traction” this is exactly what I meant. same kinda machine. Pain slowly melted away yesterday while on it for 20 minutes @ 28 pound pulls @ about 40 seconds in duration and then a 10 second relax. Going in again today.

      • Jeff on February 12, 2011 at 09:04


        Good, sounds like you found the same treatment. Several months and thousands of $$ later I did experience some very good results. Unfortunately, for me, it wasn’t sustainable and I eventually regressed. Maybe it’s because I refused to drink the gallons of water they advised along with the treatment. Just curious if they advise you to do the same.


      • Richard Nikoley on February 12, 2011 at 09:24

        Nope, no mention of water.

  27. Richard Nikoley on February 12, 2011 at 09:08

    Hi all:

    Rather than answer everything individually I’ll just shout out a thanks to all for any and all suggestions. Lots to consider and think about.

    And rest assured that I’ll leave no reasonable stone unturned, including surgery and I will be consulting with those folks next week.

    The one suggestion I consider somewhat dubious is the acupuncture. While I get that it can block the pain I see no real benefit to that over using pain meds temporarily, until the underlying condition is fixed.

  28. Mallory on February 12, 2011 at 09:34

    geez that sounds like a pain in the ass, i watched my dad recover from a rotator cuff injury and it took a good 10months. from the sleeping upright, to generalhate for life b/c he was ALWAYS in pain, to accidentally moving in the wrong direction and always lacking sleep. yeah, he was miserable and he is a pool guy for work so using his should is obviously a must, so with no health insurance, he had to get in his scuba gear, and fix pools.

    wishin you a speedy recovery!!

  29. Christ on February 12, 2011 at 10:41

    you could try an inversion table..I find it to be quite helpful…100x better than the traction machine at the chiro

  30. Rod on February 12, 2011 at 12:40

    Yeah, I guess we are all fucking experts. Two big mistakes to make are ignoring a cause and effect between a structural abnormality and ones pain.The other mistake is correlating pain with the necessity for abnormality.That isnt the way pain and our bodies work.If you were pain free before there was a arrow in your neck and now after finding an arrow sticking out of your neck you have pain then….. But if imaging studies were done when you were pain free and all that stuff was there then what? Classic examples are degenerative disc disease and osteoarthritis.Our models are strangely lacking in explaining the world that we suffer in.Stress comes in many forms and can be subtle or arrow in the neck like. They can also be cumulative. For most of us, just being us is enough stress to have aches and pains that have no tissue damage basis,especially at 50+.Lifting a heavy weight with some form problem is additive to whatever else you having going on.Take some time,examine your paradymes,relax a bit, , play some mind games,spend some time with wise people(not just technical experts) and see what happens.A wise man once told me I couldnt chase down and kill everything.The middle path.

  31. Rob on February 12, 2011 at 14:32

    Wow, sorry about all this! I sent you an e-mail asking for your opinion, but didn’t realize you were under all this.

  32. Richard Nikoley on February 12, 2011 at 15:06

    alright, so had another neck adjustment and then decompression session this morning after a big breakfast of eggs, hash browns and a hall pound of smoked ham. At the encouragement of the chiropractor, went to the gym with marchmg orders not to do anything overhead except pulls, like lat pulldowns. Don’t engage the traps, no squats, as that bar sits right on top of the injured area.

    Only thing I did to full force was legs, but just incline press, as squats were out. So, 200 x 30, 300 x 15, and 400 x 10. Then I did some chest press, seated dip, curls, tricep pushdowns and lat pulldowns all at a 30ish rep range, 1 set, so pretty light (but interestingly, about the weight I was lifting 6 months ago for 3 sets x 10.

    I feel fab. Absolutely no pain anywhere as I sit here.

    • Jeff on February 12, 2011 at 15:50

      Good advice on not doing squats. I meant to mention that earlier. I haven’t been able to do them for years due to the position of the bar and the pressure on the neck. Stick with Deadlifts or leg presses.

  33. David Csonka on February 12, 2011 at 15:42

    Wow Richard, I had no idea you were in so much pain. I hope this repairs itself. Take care

    • Richard Nikoley on February 12, 2011 at 15:55

      Well David, all I can say is to spend a lot of time thinking, trying not to let fear get the best of you. In some ways I have to wonder if self-defeat does not beome a self-fulfilled end in itself.

      Question to ponder is, did the exercises I did at the gym today actually help physically, mentally, or some combination of both? My immediate suspicion is that option three is optimal, but that depends on the individual. I’m happy to suspect that in my case, just reflection and determination are part of the therapy and that now I’m integrating part of the rest of the puzzle.

  34. Richard Nikoley on February 12, 2011 at 16:51

    Ome for the hand wringer puritans. My last percocet was at 4am. It’s now 5pm, 13 hours later.

    I’ll probably take one before bedtime in any case.

  35. […] the many comments to my last post, one stood out to […]

  36. Elenor on February 12, 2011 at 20:19

    “The one suggestion I consider somewhat dubious is the acupuncture. While I get that it can block the pain I see no real benefit to that over using pain meds temporarily, until the underlying condition is fixed.”

    Because pain killers affect more of the body than just the ‘system’ affected by the needling of acupuncture. Acupuncture doesn’t stress the liver by forcing it to metabolize and detoxify drugs. Acupuncture isn’t relying on the broken FDA to certify that it’s safe to use. Remember Celebrex? Avandia? Any statin? They were declared safe — and then it turns out they’re not! If you can ameliorate the pain without taking drugs, so much the better. If acupuncture doesn’t do it, then you can fall back on drugs.

  37. Jeanie on February 13, 2011 at 08:01

    Oh, Richard, my husband had the exact same problem as you. Couldn’t sleep unless he had one arm over his head, etc. Since no one else has mentioned this, the only thing that helped him was Pete Egoscue. He is a physical therapist who “wrote the book” on being PAIN FREE. My dh didn’t want to go under the knife either, and the doctors at VA wouldn’t touch him anyway because he had so many disks compromised. Please look into this. He took the time to cure himself – getting his neck back into the correct position so that the nerves were back in place NATURALLY. Yes, it takes time, but in the end there was no surgery.
    Here is his website:
    His main clinic is in San Diego, but you can get the book and DO IT YOURSELF! Seriously, you won’t need pain meds after a short time.
    Good luck, Richard. It’s hard to watch someone you love in pain. Your WIFE will thank Pete, too!!!

  38. Janey on February 14, 2011 at 08:59

    Another Sarno fan here. I was under the care of chiropractors, MDs, and DOs, and on and off muscle relaxers and pain killers from 1975 (age 18) until I read Sarno’s books in 1998. Since then I’ve had virtually NO back or neck pain, with the exception of a minor neck ache a year or so ago which lasted exactly two days.

    I know it sounds off the wall and really woo-woo, but it works. Check out this 20/20 segment by John Stossel, who also was cured of years of back pain.

    • Richard Nikoley on February 14, 2011 at 09:38


      I had already decided to look into this but your comment pushed me over the endge from sometime to TODAY.

      • Kent Cowgill on February 15, 2011 at 09:51

        Yeah, after all the Sarno gushing I’ve read in the comments to this post I was moved to buy the ebook. Got through the first couple of chapters, I think. Anxious to find more time to read it. Been having my own back pain for years, don’t know how many Drs, Chiropractors, Acupuncturists, etc I’ve been through so far – I’ll try anything.

      • Rod on February 15, 2011 at 10:42

        Sarno can be difficult to come to grips with if you dont have some background and come to the table with preconcieved ideas. Chris at conditioning research has a interview with a fellow who might be easier for some of you to deal with. I dont have the link right now but I believe it would be easy to find over there.

      • bob r on February 21, 2011 at 08:47

  39. Janey on February 14, 2011 at 09:56


  40. halotek on February 15, 2011 at 15:46

    Richard, have you contemplated that getting all these “adjustments” might be making things worse? Honestly, the best thing I’ve ever done for my neck or back issues was just to walk 30-45 mins a day. No major neck movements (minimal neck and back stretching). I feel the neck and back starts to realign itself with the simple act of walking. You may find relief too — probably a good idea to keep your heavy lifting to once a week if that while your healing.

    Secondly, have you modified your diet at all. You always seem to eat a crapload of protein. How about taming that down for a bit (Did you ever have this kind of pain before you were lifting a lot and eating a crappy diet). Maybe up the greens a little (since i hear you only like them as a garnish. Dont be afraid of a little tea.

    While it may not produce the fact lipid panel results you are looking for — I bet upping the carbs, lowering your protein, and increasing your plant intake will help you (at least for the short-term). You dont need to give up your paleo diet — just follow more a diet like Art de vany’s and cut down your massive fat intake. It will probably help <— why not try. If it does nothing, go back to what your doing.

  41. Joe on February 15, 2011 at 23:46

    Just want to ditto all the good things said about Dr. John Sarno’s approach. I’ve heard many say that his “Healing Back Pain” is the best of his books and I agree. Most of my back and neck pain went away simply from reading that book. It was amazing.

  42. Richard Nikoley on February 17, 2011 at 13:24

    Breaking news: Reading Healing Back Pain by John E Sarno, MD and with a likely understanding of the true cause of my pain, it seems to be melting away. Just like that.

    I’ll see about putting a post up on it.

    • Kent Cowgill on February 17, 2011 at 13:39

      Holy crap, maybe I picked the wrong Sarno book.

  43. […] forward a few weeks and I posted this: This is One Big Ass Pain in the Neck! Here, I revealed that what I had learned in the interim is that I actually had no shoulder injury, […]

  44. nada on May 4, 2011 at 02:26


  45. April Herbert on May 21, 2015 at 17:51

    I like to know the remedies on neck pains, I got neck pains after sleeping and it took hours to heal.

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