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  • Writer's pictureTeresa Heitzmann, MSPT,

Managing your Pain in the Neck

Neck pain is one of the most common complaints we hear as physical therapists. Approximately 30% of the U.S. population will be affected by neck pain at some point in their lives, so you are not alone! The good news is that there are many things you can do to treat your ailing neck. Understanding the cause of injury, knowing when to seek medical attention, and knowing how to improve your symptoms will all enhance your return to pain free function.


  • Neck pain can be caused by a variety of things, such as a car accident, a sports injury, trauma, stress, age related wear and tear, poor posture, sitting in prolonged positions, a new and strenuous activity, or degenerative changes in the spine.

  • Muscle, ligament, nerve, disc injury and disc degeneration are the common culprits of neck pain. Muscles can become tight and imbalanced due to pain, weakness, overuse and poor posture. Ligaments can become inflamed, torn and frayed due to poor posture and injury. Discs may become herniated due to poor posture or degenerative changes.

  • Osteoarthritis is the most common cause of age related neck changes in the spinal vertebrae. Other conditions known as spondylolisthesis and spinal stenosis can arise due to degenerative changes in the vertebrae. These can be identified on x-ray, but don’t panic if these are found on your x-ray. Interestingly, findings on an x-ray often do not correlate with how much pain/immobility someone experiences.

When to Seek Prompt Medical Attention:

  • At times neck pain may be due to a serious problem that requires prompt medical attention. Neck pain accompanied by a fever and headache can be a sign of meningitis. Neck pain with shortness of breath, jaw pain, and nausea/vomiting can be a sign of a heart attack. In both cases seeking medical care ASAP is strongly advised.

  • Car accidents and other significant trauma to your head and neck also warrants immediate medical attention to rule out serious injury/internal damage.


People with neck pain often wake up the next day with “a stiff neck”:

  • unable to move in certain directions

  • sharp pain

  • headache

  • muscle weakness/head feels heavy

  • muscle tightness and spasm across the shoulders and the back/side of the neck

  • tingling and pain radiation from the neck up into the back of the head, across the shoulders and/or down the arms (sometimes one or both)

  • Impaired daily activities such as driving, playing sports, working, or even simply walking.


The great news is that there is a lot you can do to manage your own neck pain!

1. Decrease your activity level

  • With a new onset of neck pain, it is important to eliminate any new stress to the neck. Excessive movement, lifting and head turning, tilting or stretching should be minimized.

  • Studies have confirmed that for every 10 degrees the head is moved from a neutral position, the weight of the head and neck increases by about 10 pounds! This can put a great deal of stress on the already injured/inflamed structures around the neck.

  • Stay away from excessive lifting, straining, driving, and high impact exercise.

2. Ice/Heat

  • Immediately following a distinct injury or onset of pain, ice is recommended for up to 48 hours. Ice will reduce inflammation, desensitize muscles, and act as a local pain reliever.

  • Following the 48 hours, applying heat will soothe the area, reduce muscle spasms, and increase blood flow to promote healing to injured tissues.

3. Medication

  • Over the counter medications can be a beneficial way to reduce pain and inflammation following a neck injury.

  • Consult your physician if you have any concerns/health risks that may contradict the use of pain medication.

  • NSAIDS, also known as Motrin/ibuprofen, have anti-inflammatory and pain relieving benefits, while Acetaminophen, also known as Tylenol, have pain relieving benefits found to be more tolerable for people with stomach problems.

4. Massage

  • Gentle massage by a family member can help to provide relief by loosening tight muscles.

5. Keep Moving

  • It’s important to keep moving your neck in pain free directions to avoid more stiffening.

  • Gentle range of motion exercises will help keep things flexible and moving.

7. Physical Therapy/Medical Consultation

If after a week or so your symptoms are not improving, contact your physical therapist or Medical provider for further assessment and treatment. PT is a great way to gently but effectively speed up the recovery process. Manual therapy techniques, modalities, exercise, and patient education are proven treatments to successfully reduce symptoms and improve function quickly.

Protect your Neck from Future Injuries:

The best option is to avoid nagging neck problems altogether. With a little attention and practice in good postural habits, you may find your neck pain free forever!

1. Posture

  • Maintaining good sitting and standing posture is probably the single best way to keep your neck healthy and pain free.

Standing - Stand tall with your chin tucked slightly in, with shoulders back and down, and maintain a small curve in your low back. Making these corrections on and off a few times throughout the day will begin to change your negative posture habits.

Sitting - Sit up straight, with low back well supported, with feet flat on the floor. Always try to maintain a neutral neck position when possible.

2. Workspace/Tech Use:

  • Set up your workstation so your monitor is at eye level.

  • Keep your knees at or slightly below the level of your hips. Use a headset whenever possible.

  • Avoid looking at your cell phone constantly. This is a big culprit in putting your head in a poor, forward head position.

3. Sleep

  • Use the right pillow for you. Choose a pillow that allows your head to be well supported and in a neutral position while you sleep. This can be done in a back lying position or a side lying position. It is best to use just ONE pillow under your head to avoid pushing your head forward during sleep

  • Getting adequate sleep each night will help keep muscles rested and prepared for a busy day of moving around and supporting your head/neck throughout the day.

4. Body Mechanics

How you stand, sit, and move while performing your daily activities is called Body mechanics. Using good body mechanics will not only protect your neck and back, but will save energy and make moving and performing everyday tasks easy and pain free.

  • Always carry objects close to your body.

  • When bending down to pick something up, bend at the knees with a straight back.

  • Always face the item you are picking up to avoid rotation with flexion of the spine.

  • Work at eye level whenever possible, avoiding excessive extension or head rotation for extended periods.

5. Exercise and Diet

Maintaining a healthy diet, drinking plenty of water, and exercising regularly is always a giant plus in keeping our bones, joints, and muscles healthy, flexible and strong!

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