Neck Pain

Do you neck pain that never seem to go away? The knots in your neck may be the cause! I see so many patients who have undergone every test under the sun–from Xrays, to blood exams, and MRIs of their entire body–and tried every single pharmacologic modality yet continue to have headaches. Let’s explore this condition and some treatment modalities!

Myofascial Trigger Point (“Trigger Point”)

Trigger points are a tight knot within a taut muscle that can only be diagnosed through physical exam by your physician. No expensive testing needed! An active trigger point is painful and can radiate pain to other areas. Some of the causes of trigger points include: 1) repetitive strain (trauma, injuries, or even work place ergonomics), 2) poor posture, 3) stress (social, work, familial, and environmental stressors, etc). 

Trigger points can cause referred pain to other areas and can cause autonomic disturbances (sweating, ear pain, lacrimation, eye pain, tinnitus, dizziness etc). Myofascial trigger points are different than fibromyalgia (which also causes tender points), but does not cause referred pain–a key distinction. 

Home Self-Care Modalities

Self-care is very important (if not the most CRUCIAL component) in treating myofascial headaches. 

Modalities for self care include:

If it hurts, try to minimize or stop doing it!

  — I see a lot of young adults who have myofascial headaches and pain from significant weight lifting or poor posture. Yet, they don’t want to stop doing it. Like the old adage says, if you keep doing the same thing, you cannot expect different results!

  — I know that sometimes it’s hard to stop sitting for prolonged periods at the a computer or car, but think about optimizing your ergonomics.


 Stretching is SO important! Getting up, moving, stretching those muscles are important to releasing those taunt muscle knots. I advise patients to have a LARGE water bottle (64oz) on their desk. If they continue to sip it throughout the day, they’ll need to get up to use the restroom. That’s a perfect time to STRETCH. 

Warm packs

  — Place warm packs instead of cold packs on areas of tight muscles on neck/shoulder

  — Although the common knowledge is to ice areas of pain and inflammation, this works opposite for myofascial pain. Ice causes muscles to contract which may worsen pain in the long run. Warm packs help relax those tight knots.



Salonpas Pain Relieving Patches,  60 Count

— Instead of using ice to decrease inflammation caused by muscle aches/pain, use methol instead. Menthol is a natural analgesic compound that provides a cooling sensation by stimulating the thermoreceptors in the skin. This sends signal to your brain which relieves the uncomfortable heat of inflammation.   

  — Types of menthol products I like are Salon Pas and Po Sum On Oil

  — If you don’t like the methol smell, you can try Magnesium Cream.



TEC.BEAN Dual Channel TENS Unit with 8 Electrode Pads, Rechargeable Muscle Stimulator TENS Machine Mini Massager for Pain Relief

  — I love this! I see it as an economical at home acupuncture/massage. The unit that I have is TEC.Bean because it’s the cheapest one that is easy to use and the battery lasts forever. However, you can get any TENS Unit. (Please don’t use this if you have a pacemaker or metal in your body. Consult your doctor before using. This article talks more about the TENS Unit.)




— Magnesium works great because it acts as a muscle relaxant, stress reliever, and sleep aide. If you have constipation, it’ll also help loosen up your stool (Magnesium is generally safe, but you need to consult your doctor prior to using) 

  — For myofascial pain, I usually recommend CALM Magnesium Citrate.

  — An alternative is Magnesium Glycinate


  — Without sleep, your body cannot heal. Studies have shown that SLEEPLESSNESS is associated to elevated inflammatory markers in your body and increased risk of chronic musculoskeletal pain. So catch up on those ZZzzzs!!!

  — Melatonin may help with sleep.  If you like melatonin, consider getting time release or delayed release. 

Stress Relief

  — Much easier said than done. I will talk more on this at another timepoint


  — Poor posture can contribute to significant pain in neck/shoulder muscles. My patients have told me to develop a good habit of good posture, they use posture trainers (such as the Upright GO). However, the best treatment is just to be mindful and sit up straight! 🙂

In Clinic Treatments


Trigger Point Injections (or as I like to call it, “Dry Needling with a little Liquid”)

Myofascial Release Massage


Chronic tension-type headaches and myofascial trigger point connection are still not well defined. It is possible that tight muscles in your neck may be causing your headaches. In either case, the treatments above will help with both tension headaches and myofascial headaches. If you think trigger point may be a culprit, consider discussing with your healthcare provider. Headaches are very complex, and it’s likely that the cause is multifactorial!

*whitecoatXS Note: The information in this article is intended for your educational use only. Although I am a physician, the information here is NOT a substitute for professional medical advice, diagnosis, or treatment. I can ONLY render a treatment plan if I see you in person. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health programs.