Neck pain: causes, prevention, treatment, best exercises
Neck pain can make it difficult to do just about anything. Get tips for how to prevent and relieve neck pain, especially with exercises from our physical therapists.
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Although neck pain can be, well — a pain in the neck, it’s something that affects millions of people every day. Whether it's from staring at a computer all day, carrying a heavy bag, or simply sleeping in an awkward position, neck pain can quickly become a nuisance. But it’s not something you have to just deal with. There are always ways you can prevent and manage neck pain.
Here, learn more about what causes neck pain, and how to prevent and treat it — especially with exercises from our Hinge Health physical therapists.
Our Hinge Health Experts
Dylan Peterson, PT, DPT
Raymond Hwang, MD
What is neck pain?
Neck pain impacts the cervical spine, which is the neck region of your spinal column. It begins at the base of the skull and includes seven vertebrae (bones) that are separated by shock-absorbing discs, nerves, muscles, ligaments, tendons, and more.
Neck pain can be localized to one specific spot or it can extend to your head, upper back, shoulders, and arms. It can be acute (lasting less than 12 weeks) or chronic (lasting longer than 12 weeks).
Neck pain symptoms
Signs and symptoms include:
Persistent achiness that gets worse when you hold your head in the same position
Neck and shoulder pain with muscle spasms
Stabbing or burning pain
Increased sensitivity to light touch or pressure
Stiffness or tension that makes it difficult to move your head
Headaches
Neck pain: a Hinge Health perspective
Whether you have a diagnosis for your neck pain or not, it’s common to assume that rest is best. Although movement can cause a slight and temporary uptick in pain, it’s actually one of the best things you can do for neck pain. “We now know that things can actually become worse with too much rest,” says Dylan Peterson, PT, DPT, a physical therapist at Hinge Health. “Not moving is riskier than moving in spite of some pain.” You’re in the right place to learn about gentle exercises and stretches to relieve and prevent your neck pain.
Causes of neck pain
Your neck is involved in a lot of your day-to-day movements. While it’s a very strong and resilient structure, it is prone to some injuries and conditions that can cause pain. Here are some of the most common reasons you may experience neck pain:
Muscle tension and neck strain. Everyday activities, such as sitting in one position for too long, carrying heavy items, sleeping in an awkward position, jerking your head during exercise, and gritting your teeth can cause neck strain and pain.
Staying in the same position for long periods. There is no such thing as “perfect” posture, but slouching, hunching over, or leaning forward (such as when looking down at a phone, computer, or tablet) for long periods of time can put extra stress on your neck and cause neck and shoulder pain.
One of the biggest myths I hear is that neck pain is solely due to ‘bad posture.’ How you hold yourself is not what’s important. What matters is how long you stay in one particular position.
Joint changes. Certain conditions become more common with age, and while these conditions are unnoticeable for many people, they can contribute to neck pain for some:
Osteoarthritis: gradual changes to the cartilage between bones
Spinal stenosis: narrowing of the spaces in the spine that house the nerves and/or the spinal cord
Degenerative disc disease: when changes in the spinal discs cause the vertebrae to sit closer together
Bone spurs: growths that can be related to arthritis that are generally harmless but can cause pain as they get bigger and press down on nerves
Pinched nerve (also called cervical radiculopathy). Nerves in the neck can become compressed or irritated where they branch away from the spinal cord, causing numbness, muscle weakness, and radiating shoulder or arm pain.
Herniated disc(also called a ruptured or slipped disc). Trauma or injury can cause intervertebral discs to protrude and push on the spinal cord or nerve roots, causing pain.
Injury, such as whiplash. Trauma that causes your head to jerk backward then forward (common in contact sports and car accidents) can injure the soft tissues and small joints of the neck and result in neck strain.
Emotional stress. Stress, anxiety, and low social support can all cause tension and neck and shoulder pain.
Physical stress. Repetitive movements or strenuous activity that your body isn’t prepared for can cause overuse injuries in neck muscles, tendons, and ligaments.
Conditions and diseases. Rheumatoid arthritis, fibromyalgia, meningitis, and, in rare cases, masses including tumors and cysts can cause neck pain.
When to see a doctor
Neck pain usually doesn’t indicate a serious problem, though it’s normal to be concerned about it. Many Hinge Health members ask us, “How do I know if my neck pain is serious? Shouldn’t I see my doctor, just to be safe?”
“Many people will experience neck pain at some point in their lives,” says spine surgeon Raymond Hwang, MD, Senior Medical Director at Hinge Health. “While the pain can be uncomfortable, most cases of neck pain improve with time and non-surgical treatments such as rest, NSAIDs, physical therapy, and spinal injections. Most episodes of neck pain are not dangerous, but there are some situations when you should seek medical attention for additional care.”
See a doctor if your neck pain:
Results from an injury such as a motor vehicle accident or fall
Occurs with loss of coordination, loss of dexterity, or weakness in your arms or legs
Is accompanied by numbness or tingling in your arms or hands
Occurs with headache, dizziness, nausea, or vomiting
Involves loss of bowel or bladder control
Occurs with chills, fever, or unexplained weight loss
Prevention tips
If you’re prone to neck pain, there are many things you can do to manage and prevent it.
Keep a neutral neck. Everyone is different and there’s no one way of sitting, standing or walking that works for all people. But there are a few techniques that help many people avoid neck and shoulder pain.
When sitting or standing still, try to keep your shoulders in line over your hips and your ears in line over your shoulders.
When on the phone, avoid tucking it between your ear and shoulder when you talk.
Mix it up. As our physical therapists say, “Your next position is the best position.” If you sit at a computer for long periods of time, move around and change positions frequently to avoid “tech neck” (pain and stiffness from looking down at a screen for too long).
Adjust your workspace. Adjust the height of your desk, chair, and computer so your monitor is at eye level and your knees are slightly lower than your hips.
Change your sleep position. Sleeping on your side or back tends to be best for preventing neck pain as it helps keep your spine aligned. (Think: You want your ears, shoulders, and hips to be in line with one another, more or less.) Feather and memory foam pillows that conform to that natural curvature of your neck also help.
Quit smoking. Smoking can put you at higher risk of developing neck pain as it’s been shown to advance cervical disc degeneration.
Do exercise therapy. Targeted movements, exercises, and stretches increase the strength and flexibility of your neck and surrounding muscles. This reduces stress on the cervical spine and helps prevent neck strain and pain. (More information on this below).
Treatment for neck pain
The best course of treatment depends on the nature and cause of your pain, but the following tips from our Hinge Health physical therapists and medical doctors can provide relief for most mild to moderate cases of neck pain.
Ice and heat. Alternate using an ice pack and heating pad for 20 minutes at a time as needed to reduce inflammation (ice) and increase blood flow to combat stiff neck (heat).
Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for neck pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.
Transcutaneous electrical nerve stimulation(TENS). A TENS unit is a special device that transmits a low-level electrical current to the part of your body that feels painful or stiff. TENS can be helpful for acute and chronic pain. A TENS unit is generally considered safe, non-invasive, and easy to use.
Traction. Neck (or cervical) traction uses weights, pulleys, or an inflatable device to gently stretch your neck. It often requires supervision from a medical professional or physical therapist, and it may provide neck pain relief for some people.
Steroid injections. If over-the-counter medication does not offer sufficient pain relief, your doctor may suggest cortisone steroid injections. A steroid solution is injected into different parts of the neck to reduce inflammation and pain. In certain cases, the spinal nerves are targeted, and in other cases the facet joints are targeted.
Complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for neck pain relief, such as massage, acupuncture, or chiropractic care.
While all of the above steps can help neck pain, one of the most effective is exercise therapy.
Exercises for neck pain
Want expert care? Check if you're covered for our free program →- Head Turns with Hands
- Chin Tucks
- Thread the Needle
Physical therapy (PT) is for more than just recovering from surgery or injury. It’s one of the top treatments for joint and muscle pain. It helps build strength, improve mobility, and reduce pain. And it doesn't always need to be in person.
Hinge Health members can conveniently access customized plans or chat with their care team at home or on the go — and experience an average 68% reduction in pain* within the first 12 weeks of their program. Learn more*.
Movement is the not-so-secret sauce to pain management. Once the worst of your pain has subsided, you should do gentle exercises to strengthen and stretch the muscles and other structures in your neck and shoulders as well as improve your range of motion.
The given exercises are recommended by Hinge Health physical therapists as a starting point, but you can also work with a physical therapist for more personalized guidance. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
Surgery for neck pain
Surgery is rarely needed to address neck pain. Most cases can be managed with exercise therapy and conservative measures. Surgery is usually most appropriate for people whose pain:
Does not improve with conservative treatments (those mentioned above)
Negatively affects their quality of life or daily function
Occurs with progressive neurological symptoms involving the arms and leg
Occurs with difficulty walking or maintaining balance
Talk to your doctor about whether you’re a good candidate for surgery.
How Hinge Health can help you
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
Looking for pain relief? Check if your employer or health plan covers our program
References
Chen, Z., Li, X., Pan, F., Wu, D., & Li, H. (2018). A retrospective study: Does cigarette smoking induce cervical disc degeneration? International Journal of Surgery, 53, 269-273. doi: 10.1016/j.ijsu.2018.04.004
Lin, I. H., Chang, K., H., Liou, T. H., Tsou, C. M., & Huang, Y. C. (2018). Progressive shoulder-neck exercise on cervical muscle functions in middle-aged and senior patients with chronic neck pain. European Journal of Physical and Rehabilitation Medicine, 54(1), 13-21. doi: 10.23736/S1973-9087.17.04658-5
Cohen, S. P. (2015). Epidemiology, Diagnosis, and Treatment of Neck Pain. Mayo Clinic Proceedings, 90(2), 284–299. doi: 10.1016/j.mayocp.2014.09.008
Verhagen, A. P. (2021). Physiotherapy management of neck pain. Journal of Physiotherapy, 67(1), 5–11. doi: 10.1016/j.jphys.2020.12.005