Neck pain from stress: it starts with your breathing.

At half past six you pull your jacket on and notice your shoulders are up by your ears. Neck pain from stress tends to arrive like this, with no injury, after a day of holding it together.

I see it often in the business owners and managers I work with. Most blame the pillow or the air conditioning. Usually the cause sits lower down, in how you breathe under pressure.

Symptoms of a stress-related stiff neck

• Tight neck and shoulders by evening. Fine in the morning, stiff by the end of the day.
• Shoulders that creep up. You find them raised on a call.
• It comes and goes. Easier on holiday, back with the deadlines.

Can stress cause neck pain?

It can, yes. When you're on edge it's almost impossible to keep the muscles between your skull and shoulder blades loose. They stay tight for hours, and by evening you feel it.

You breathe with your neck. You take more than twenty thousand breaths a day, and the job belongs to the diaphragm. Anxiety and stress can lock it. Your breathing then moves up. With each breath in, your ribs, collarbones and shoulders lift, pulled by neck muscles only meant to lend a hand.

Your shoulders stay up. Two muscles run from your skull to the shoulder blade and pull it towards your ear. Under tension they rarely switch off. The ones that pull it down often do little.

You clench your teeth. The jaw is one of the places where tension tends to settle, and from its joint it can pass into the spine.

Your head drifts towards the screen. Your chin pokes forward, your ear ends up in front of your shoulder and your upper back rounds. Your neck muscles carry that load all day.

What helps: three office moves, and what to strengthen

They fit into the two-minute break you take every hour. Go slowly, and stop if anything hurts or sends pins and needles down your arm.

Breathe low, shoulders down. In your chair, one hand on your chest, one on your stomach. Breathe in through your nose. The lower hand moves, the upper one stays still. Let your shoulders drop as you breathe out. That's for sitting. Standing, your ribcage widens sideways, shoulders still low.

Your jaw: try this. Index fingers in the hollow in front of each ear, thumbs under your chin. Open and close your mouth six times, slowly, against light thumb pressure.

Stretch the side of your neck. Take your ear towards your shoulder and rest the hand from that side on your head, without pulling. Shoulders low, chest open. Try thirty to sixty seconds, then swap sides.

At the gym, strengthen what pulls your shoulder blades down. To keep your shoulders down, build up the muscles that draw the blades down and in towards the spine. Train them by pulling a weight towards you, and with one move: draw them down and together and move nothing else. Put it into your two weekly strength sessions.

Start with your breathing, the move you repeat most in a day. And look after your sleep, because short nights and tight muscles often go together.