Real Causes of Neck and Shoulder Pain, Explained

A familiar scene opens the discussion: someone has a deep ache under the shoulder blade, a constant tight neck, or that one stubborn “knot” in the upper back. They massage it, stretch it, maybe even buy a new pillow.

And then, a few days later, it is back.

The unique angle here is that recurring neck and shoulder pain is not always “local.” Sometimes it is a message traveling from deeper structures, especially the area just above the diaphragm where a key nerve can get irritated. At the same time, the video does not ignore the obvious, posture and weak support muscles are still the most common driver. The point is to stop treating only the surface and start looking for the repeating pattern that keeps reloading your neck and shoulders.

Why the “knot” keeps coming back

If you only chase the painful spot, you can end up in a loop.

The discussion highlights two broad buckets of causes that can overlap:

Here is why this matters. Muscles like the upper traps are built to help, not to hold your head up for hours while you scroll, type, and drive. When they become the primary stabilizers all day, they tighten, develop trigger points, and feel like they need constant “release.” But if the underlying load stays the same, the knot is basically doing its job, bracing.

The video’s framing is practical: first reduce the hidden drivers that keep the system irritated (pressure under the diaphragm, diaphragm tightness, and stress chemistry in muscles). Then release what is overworked. Then strengthen what is underactive.

Did you know? Pain felt at the shoulder can sometimes be “referred pain,” meaning it originates elsewhere and is perceived in the shoulder region. This pattern is recognized in mainstream medicine, including classic descriptions of gallbladder-related referred pain to the right shoulder area, often discussed as part of biliary disease symptoms in clinical references like Merck Manual Consumer VersionTrusted Source.

The surprising digestion and diaphragm link

This perspective suggests that a deep ache under the shoulder blade or persistent neck tension can be driven by irritation “just above the diaphragm.” The nerve named in the video is the phrenic nerve (first mention, phrenic nerve), which helps control the diaphragm.

When the area under the right ribs is inflamed or congested, the argument goes, pressure can increase under the diaphragm. That pressure can irritate the nerve, and the body can interpret it as shoulder and neck pain.

A simple self-check under the right ribs

The video offers a quick test that is meant to be informative, not diagnostic.

If shoulder and neck tension eases during this, the video treats it as a clue that pressure under the diaphragm is contributing.

Important: New, severe right upper abdominal pain, fever, jaundice (yellowing eyes or skin), vomiting, chest pain, or shortness of breath should be assessed urgently. Referred pain can happen, but it should not be used to self-diagnose gallbladder or liver disease.

Why bloating can matter in a neck pain story

Another twist is bloating. If shoulder pain worsens after eating “a bit too much,” the video links this to a bloated stomach pushing up on the diaphragm area.

This is not presented as the only cause. It is presented as a common, overlooked amplifier.

In broader digestive health education, bloating has many possible contributors, including meal size, carbonated beverages, food intolerances, constipation, and gut-brain stress patterns. Clinical overviews like Mayo Clinic’s bloating guidanceTrusted Source emphasize that gas and bloating are often benign but can sometimes signal conditions that need evaluation.

Reduce pressure under the ribs: a simple plan

This section in the video is very “do this, then that.” It centers on reducing upward pressure on the diaphragm and calming irritation around the phrenic nerve.

Step 1: Address bile “sludge” and liver or gallbladder irritation

The speaker’s claim is that bile sludge trapped in the liver or gallbladder can contribute to pressure beneath the diaphragm. To address this, the video mentions TUDCA (tauroursodeoxycholic acid) as a commonly used supplement.

Specific details given:

What the research shows: Ursodeoxycholic acid related compounds (UDCA and derivatives) have been studied for certain liver and bile conditions under medical supervision. Reviews discuss potential effects on bile composition and liver cell stress responses, but supplement use is not a substitute for diagnosis or treatment. For background on UDCA as a medication, see LiverTox (NIH)Trusted Source.

This is also where medical neutrality matters. If you have gallstones, gallbladder attacks, bile duct obstruction, pancreatitis history, or are pregnant, you should speak with a clinician before trying bile-flow supplements. Even “natural” products can be risky in the wrong context.

Step 2: Reduce bloating pressure with a morning drink and habits

The video’s suggested mixture is specific:

Mix well and drink on an empty stomach in the morning.

The reasoning is straightforward: improve how efficiently the stomach breaks down food throughout the day, which may reduce gas and bloating that pushes upward.

A small but important caution: acidic drinks can irritate reflux for some people and can affect tooth enamel. If you try it, consider rinsing your mouth with plain water afterward and avoid brushing immediately if you have enamel sensitivity. If you have GERD, ulcers, kidney disease, or sodium restrictions, ask your clinician whether this fits your situation.

Then come the behavioral levers, which are often the biggest wins:

Pro Tip: If a 10-minute walk feels unrealistic, do 5 minutes right away. Consistency beats intensity for post-meal digestion habits.

Step 3: Cut foods that may thicken bile and inflame the system

This approach places heavy emphasis on reducing highly refined foods that may irritate the liver and contribute to thicker bile.

The video specifically calls out:

The suggested experiment is short: cut these down even for one week and watch whether shoulders loosen.

Nutrition science is nuanced, but there is broad agreement that diets high in ultra-processed foods are linked with worse cardiometabolic outcomes. For a general, evidence-based overview of limiting added sugars, see the American Heart Association guidanceTrusted Source.

Posture, muscle imbalance, and the 60-second release

Now the video pivots to what it calls the most common cause: poor posture.

If your head leans forward and your shoulders round while using a phone or laptop, the upper traps and levator scapula are forced to work overtime to keep your head from dropping. Over time, they tighten and ache, while the muscles that should share the load become underactive.

This view holds that massage can feel great, but it does not fix the imbalance. The pain returns because the workload distribution never changes.

Magnesium glycinate as a “permission slip” to relax

Before doing release work, the speaker suggests reducing baseline muscle tension with magnesium.

Specific details given:

The claimed mechanism is that magnesium helps muscles relax by influencing stress chemistry and calcium handling in muscle fibers.

Magnesium supplementation can be appropriate for some people, but it can also cause diarrhea or interact with certain medications. The NIH Office of Dietary SupplementsTrusted Source provides a practical overview of magnesium forms, dosing considerations, and safety.

The 60-second neck and shoulder release sequence

This is one of the most “signature” parts of the video because it is simple and memorable.

Do it gently, no forcing.

The intended targets are the upper traps, levator scapula, and deep neck stabilizers.

A key insight here is pacing. If you rush, your nervous system stays guarded. If you go slow, you are more likely to get the “letting go” sensation the video describes.

»MORE: If you want a printable routine, create a one-page checklist titled “Neck and Shoulder Reset,” including the right-rib self-check, side-lean stretch, long exhale, 60-second release, and YTW sets. Keep it near your desk.

Massage gun, optional but specific

The video also mentions using a percussion massage gun, especially with a ball attachment, to work on tough knotted fibers around the upper traps and shoulder blade.

This can be helpful for some people, but avoid aggressive pressure near the front of the neck, directly over the spine, or on areas with numbness, tingling, or sharp pain. If you bruise easily or take blood thinners, ask a clinician before using strong percussion tools.

Rebuild support with YTW and upper spine mobility

Relief is not the finish line.

The video’s story arc is “release, then rebuild.” Once tight tissues calm down, you strengthen the support muscles so the upper traps stop being the default stabilizers.

YTW strengthening sequence (the protective layer)

Before starting, the video suggests warming up by gently squeezing your shoulder blades together a few times.

Then the YTW sequence:

Dosage is also specific:

This is a practical way to “pay back” the muscles that posture debt has undertrained.

If you feel pinching in the shoulder joint, reduce range of motion and slow down. The goal is control, not height.

Unlock the missing piece: the thoracic spine

The video calls the upper spine the missing piece of the puzzle.

When the thoracic spine (first mention, thoracic spine) is stiff, shoulders and neck compensate for the lack of movement. That compensation can look like constant trap tension, shoulder blade knots, and neck fatigue.

A simple chair drill is offered:

Done well, this is less about “cranking” and more about restoring a hinge point in the upper back.

Light hanging stretch (optional decompression)

If you have a pull-up bar:

This is framed as decompression for the spine and rib cage, plus a way to reduce tension under the diaphragm.

If you have shoulder instability, dizziness with overhead positions, or nerve symptoms down the arm, get personalized guidance before trying hanging work.

Stop rebuilding tension overnight: sleep setup

Sleep is where you either recover or reload.

The video makes a simple point: if you spend 7 to 8 hours in a position that twists your neck or collapses your shoulder forward, you can undo your daytime work every night.

Avoid stomach sleeping if possible

Stomach sleeping forces the neck to rotate for hours, tightening traps and small stabilizers. It can also compress the diaphragm against the mattress, which conflicts with the “reduce diaphragm pressure” theme.

Changing sleep posture can take time. If you are a lifelong stomach sleeper, try gradual steps, like placing a pillow to block rolling fully onto the stomach.

Side sleeping: support the top shoulder

Side sleeping is framed as “absolutely fine” if you support the shoulder properly.

The suggested setup:

Small adjustments like these can reduce the all-night pull on the traps and rhomboids.

Back sleeping: keep the neck neutral and open the mid-back

Back sleeping is described as the second best position and often the easiest on the neck.

Two specific tweaks:

This combination aims to reduce morning stiffness by keeping the rib cage and upper spine from collapsing into a rounded posture all night.

Expert Q&A

Q: If my shoulder pain improves when I press under my right ribs, does that mean I have gallbladder disease?

A: Not necessarily. A change in symptoms with pressure can be a clue that the diaphragm area is involved, but it cannot confirm a specific diagnosis. If you have recurring right upper abdominal discomfort, nausea after fatty meals, fever, or jaundice, it is worth discussing with a clinician because gallbladder and liver issues require proper evaluation.

Jordan Ellis, MPH (Health Education)

Expert Q&A

Q: How long should I try the posture and strengthening plan before deciding it is not working?

A: Many people feel some short-term relief quickly from release work, but strength and posture changes usually take weeks of consistency. If pain is worsening, waking you at night, causing numbness or weakness, or not improving after a few weeks of steady practice, consider seeing a physical therapist or clinician for an individualized assessment.

Jordan Ellis, MPH (Health Education)

Key Takeaways