Coat Hanger Neck Pain

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Coat Hanger Pain

Many individuals with chronic or intermittent neck tightness and pain are misdiagnosed.


They are told their vertebrae are out of alignment, have muscular injury from an accident, have a pinched nerve, “carry their stress there”, or have arthritic changes noted on an x-ray.

While certainly some individuals may have nerve compression from a serious degree of vertebral or disc issues, many others have been incorrectly diagnosed. They are actually suffering from a common cause of neck pain and tightness called coat hanger neck pain.

Coat hanger neck pain gets its name from the shape of the upper trapezius muscles that run on the upper back, from shoulder to shoulder and attaching to the rear of the skull. The coat hanger pain often affects both sides, but it is not unusual for it to be one-sided.

The pain and muscle tightness results from a lack of proper blood flow and oxygen delivery into the muscles of the shoulder and neck. Lack of oxygen into a muscle is very painful; just ask anyone suffering from a lack of oxygen into their heart muscle (angina) or their legs (claudication).


But unlike those examples, coat hanger neck pain is not from a narrowed blood vessel due to atherosclerosis, it is the result of residual brain injury to the Autonomic Nervous System.


The Autonomics can be injured by a physical blow to the head (concussions, sub-concussive events), intense emotional experiences (bankruptcy, betrayal, combat), or inflammatory traumas (vaccines, surgery, fractures, chemotherapy, radiation).

The body is designed to completely recover from these types of brain injuries within weeks to a few months but mounting evidence suggests that potentially 60-80% of the population can no longer completely repair their brain traumas due to a chronic inflammatory condition called inflammaging (See our recent post on Inflamm-Aging).


As a result of inflammaging, brain injuries are not completely repaired and result in residual brain injury through a process called cumulative brain injury.

As the damage from successive injuries accumulates, symptoms from dysfunction of the Autonomic Nervous System increase.

Autonomic injury makes it difficult to drive blood upwards into the head and neck leading to poor oxygen delivery and tight, painful neck muscles. Low blood pressure and oxygen delivery into the head and neck also results in muscle pain that causes migraine headaches, TMJ (temporomandibular joint) dysfunction, and pain.

The brain does not work well without enough blood pressure and oxygen and this is a common cause of chronic fatigue, lightheadedness or dizziness, poor concentration, ADD or ADHD, increased hunger especially for salt and sugar, and generalized anxiety.

Sitting or standing still tends to worsen the neck pain because autonomic damage commonly allows blood to pool abnormally into the leg muscles resulting in inadequate delivery of oxygen into the muscle.

The blood and oxygen delivery into the head and neck region are improved with the movement of the leg muscles, and this fact helps diagnose coat hanger pain.

If neck pain improves or is absent with physical activity, this is an indication that the patient has coat hanger pain from Autonomic injury. Physical activity improves blood and oxygen delivery into the neck muscles and alleviates symptoms.

Coat hanger pain is suspected when an individual can play tennis or work in the yard without noticing pain but they feel increased pain when sitting at their desk or in a car for extended periods of time.

Mechanical sources of pain such as herniated disc may also hurt when sitting still but commonly worsen with activity since movement of the body often moves the neck vertebrae which aggravates the mechanical defect (think about pinched nerve between a disc and bone) and that increases the pain.


Treatment of coat hanger pain requires reversal of underlying autonomic damage through the reduction of inflammation.

When autonomic dysfunction improves or recovers the brain is better able to control the body and once again receive the proper delivery of blood flow and oxygen into the trapezius muscles that run on the upper back, from shoulder to shoulder and attaching to the rear of the skull.

I have been testing and treating the Autonomic Nervous System for 12 years and I have developed a treatment program called “The Nemechek ProtocolTM for Autonomic Recovery” (Patent Pending) that is specifically designed to reduce multiple sources of inflammation and restore the body’s natural brain repair mechanism.

Within months of being on The Nemechek Protocol™, many of my patients experience significant improvement in their coat hanger pain as well as a wide array of other symptoms associated with autonomic damage such as headaches, heartburn, and GI distress.

Knowing these important facts about autonomic dysfunction, neck pain, and tightness may help you find the right treatment for your neck and shoulder pain and discomfort.

I believe that the key to restoring our natural inflammation control mechanisms is through a reduction of inflammation throughout the brain and body by using every scientific, nutritional, and bioelectric tool available.


I am an internal medicine physician (D.O.) from UCLA and my Internal Medicine and Autonomic practice is in the Phoenix, Arizona area. For additional information, call my office 623-208-4226 or go to

This post is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, and it does not create any patient-physician relationship.

© 2018. Nemechek Consultative Medicine. All Rights Reserved.

Dr. Patrick Nemechek and Jean Nemechek

Dr. Patrick Nemechek and Jean Nemechek

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