Neck Pain: A Self-help guide
Neck pain can result from poor posture, muscle strain, stress, or underlying joint issues. It often develops gradually due to repetitive movements, long hours at a desk, or improper sleeping positions.
If you have neck pain that has:
Sudden onset with severe pain that is getting worse
Come on, following trauma, car accident, etc
Also have tingling, weakness or numbness in arms and or hands
Have trouble walking/dizziness
Any fever or night sweats
Are you experiencing loss of Bowel or Bladder control -
Please consult your GP or another health professional before attempting the tips and exercises in this pdf, as doing so may make the condition worse.
Common Causes
Prolonged computer or phone use
Poor posture or slouching
Stress and muscle tension
Sudden movements or injuries
Sleeping in awkward positions
So I need to ‘fix’ my Posture?
Think of posture as the result of lots of different things. Rather than trying to ‘fix’ it, it will change naturally as you take care of your neck. It’s important not to try and force anything.
Forcing your neck straight will not reduce pain (even though it may temporarily relieve it)
Whether or not you have pain isn’t related directly to posture (though it may have a small long-term effect). It is more important to calm your nerves down and in acute pain (meaning short-term), to relieve any muscle spasm you might have.
Why does straightening my neck relieve it then?
It likely changes the tension/ forces going through different parts of the neck, which reduces the pain signalling from those tissues (temporarily). The key to easing neck pain is to calm the pain signalling itself down and help ease any inflammation that’s present.
Will Exercise/ Going to the Gym Help ?
Generally, yes, gentle exercise will help, and though it is usually best to avoid running due to the axial loading through the neck in the beginning. Some people will struggle with cycling due to the rotatory nature of the movement.
Walking is a great place to start to elevate the heart rate a little bit and get some blood moving into tissues. We recommend that you start with a 10-minute walk once or twice a day, keeping your neck warm if it is cold outside.
If you go to the gym, we usually recommend taking 2-3 days off, then if symptoms are at least 50% of what they were going back at around about 30% intensity and volume of the workout you were doing before, basically doing a warm-up and cool down. If this is ok, gradually ramp up over the next two weeks using your soreness as an indicator of when to step back if needed.
If you get some recurrence of the neck pain the day after the workout, take the next 2 days off, then do the same workout. If soreness (outside of usual DOMS) has gone, continue gradually progressing.
The same applies to any classes, such as yoga or pilates; a gentle ramp-up for a couple of weeks before returning to class is advised.
Note: Your highest risk of re-injury is in the first 2 weeks back; having a ramped programme like this will reduce the likelihood of recurrence/re-injury significantly.
What about Ice and Heat?
Both ice and heat can help, depending on the type of neck condition you have and when it occurred. If your neck feels tight and or stiff, you may have muscle spasm, in which case a gentle heat applied to the area wrapped in a tea towel or some other covering may help to ease it. You may have already found that something like a warm shower helps temporarily, if this is the case.
With heat, it is important to only apply it for 15-20 mins, then let the skin cool down. We find that over-application of heat can lead to congestion of tissues, which, over a few days, can result in a worsening of pain and/or other symptoms.
If the pain is pinpoint (more localised), has come on in the last 24/48 hours or has got worse with applying heat, then ice might be beneficial to reduce the inflammation that is there. You or your spouse/partner might notice that the area feels more ‘boggy’ and warm in this case (though not always).
Do I have a Slipped Disc?
People can get disc problems in the neck, generally as long as there isn’t any pain, pins and needles down the arm or weakness in the arm (radiculopathy), then it is unlikely that you have a ‘slip’ or protrusion of the disc. Following the tips and exercises in this sheet may help - as always, stop if it is sore and seek further advice. If in doubt/worried, we always recommend consulting a professional.
Are There Specific Exercises I can Do?
Yes! There are some simple stretches you can do that can help.
Scalene Stretch
When sitting down, gently side-bend or tilt your head away from the side that feels pain until you feel a stretch or pull sensation (not pain) on the outside of your neck. If 10 was a very strong stretch and 1 barely anything, this should be a 2 or 3 on that scale. Hold for 30 seconds and repeat on the other side, slowly on and slowly off stretch. If you feel pain, reduce the degree of sidebend. Really strong stretching won’t reduce the pain more.
Nucheal Ligament ‘Stretch’
Whilst sitting down, gently hold each shoulder with your opposite arm (like giving yourself a hug), then let your head drop slowly so it hangs like a heavy weight. Again, there should be no pain if there is stop at the point just before the pain starts. The Nucheal ligament is a thickening of tissue that runs up the middle of the neck and attaches to the base of the skull. As it isn’t a muscle, it doesn’t stretch like a muscle, so you’ll feel a vague pull (if you feel nothing is OK), hold for 30 seconds to a minute.
Trapizeus Stretch
In the same position as the Nucheal Ligament, stretch gently, let your head drop to one side. You should feel a stretch in the back of your neck along one side, sometimes into the shoulder, hold for 30 seconds to a minute and repeat on the other side. Do 1-2 repetitions of this. As you are stretching the muscle here should feel a lot stronger/different to Nucheal ligament, aim for a 3-4/10 stretch.
Rhomboid Stretch
Standing up, interlace your fingers and turn your hands so your palms are facing outwards as shown. Keep your neck in the same position and rotate your arms 20 degrees to oneside you should feel a stretch inbetween shoulder blades. Hold for 30 seconds to 1 minute, then do the same for the other side. Aim for a 3-4/10 stretch, do 2-3 repetitions.
General Advice
Little and often wins over prolonged stretches, keep repetitions low and hold for 1 minute or so at the most each time. You want to stretch enough to affect the muscles and connective tissues without irritating them further. A couple of times a day is enough for these sorts of stretches; doing 5/6 or more times a day can often irritate things. It is about creating the environment that allows the pain sensitivity to decrease, not pushing or forcing anything to relax.
We hope you find these exercises and tips useful. If you feel you want/need further advice or professional opinion, please book an appointment at our Baldock or Arlesey clinics.
Ben Adams Senior Lecturer and Clinical Tutor