If you are experiencing neck pain, you belong to a steadily growing group of individuals who understand how frustrating and debilitating this pain can be.  Whether you are suffering from a sudden, acute bout of neck pain, or have been trying to cope with pain for months or even years, you know how much it can interfere with your daily life.

Studies report that at any given time, 10-20% of the population is experiencing some type of problem with their neck, and it seems safe to say that this number may only increase with the years to come [1].  While neck pain frequently will resolve without further intervention, chances of recurrence are high, along with the risk of the pain becoming chronic.  Another study found that 37% of individuals with neck pain reported persistent problems for at least one year following their initial onset of pain [2].  Such statistics are nothing short of startling, especially if you have just recently experienced your first bout of neck pain.

The less you move, the more you will hurt Click To Tweet

At this point, you are probably wondering why some individuals are lucky enough to have the pain resolve, while others are perhaps not quite as lucky.  There is no short answer.  Pain itself, as well as the perception of pain, can vary so widely from individual to individual, that there is never one single, easy answer.  However, pain that is remedied and treated earlier has a much lower chance of becoming chronic in nature. And when I’m talking about “treatment” I’m not referring to medication or surgery— that rarely works for chronic pain.

Perhaps you have been experiencing your pain for the past several months.  Does this mean that it is now too late to make a change?  Has too much time passed for more conservative treatments to be just as effective and useful?  The answer is NO.  While pain that has persisted for a longer period may seem to pose more of a challenge, it absolutely does NOT mean that you will be unable to find relief from your neck pain.

Relief from neck pain does not suggest that a medical visit is always necessary, especially if your pain did not start immediately following a traumatic event.  Below are five ways that you can work to address your neck pain.  Any one of these strategies, and especially a combination, should be able to provide some relief from your neck pain.

5 Ways to Alleviate Neck Pain

1.    Increase Your Awareness

According to Merriam-Webster, posture is defined as “the way in which your body is positioned when you are sitting or standing.”  It sounds simple, but why does it seem just the opposite?  We frequently hear about the importance of posture, but there seems to be controversy over what good posture actually consists of and to what extent posture plays a role in causing or perpetuating pain.

We can all easily pinpoint examples of “bad” posture, and we probably all THINK that we know what “good” posture is supposed to look like.  Through a quick internet search, it is clear that there is an abundance of information available regarding posture, but little accord among sources as to “proper” posture and its importance or lack thereof.

We know that bodies come in all shapes and sizes, and we also know that not everyone will get pain for the same reason or reasons.  It seems safe to say that there is not simply one good posture, but rather a spectrum of various postures- that you should move in and out of on a daily basis. Therefore, we can venture to say that neck pain is not simply caused by having “bad” posture, but that pain may occur when we are not operating within our own individual spectrum of healthy posture, positions and lack of movement.

If this concept regarding a “spectrum” of postures is still a bit abstract, here is a common example that may help to get the point across. Take your pointer finger and observe its position when your hand is at rest.  This is the position your finger naturally falls in, the position where it most likely feels the most comfortable.  Now using your other hand, bend that finger into your palm as far as it will go.  Now try bending it just as far in the opposite direction toward the back of your hand.  Think of these as the two extremes in which your finger is capable of moving.  When your finger was temporarily at each of these extremes, or end ranges, you were most likely experiencing minimal discomfort, if any.  However, if you were to hold your finger in either of these positions for an extended period, you would most likely begin to feel soreness, cramping, discomfort, or pain.

The concept behind the previous example can be applied to your neck pain.  You have a spectrum of postures with which you can function without placing undue stresses onto the tissues and other structures within your neck.  You have neck flexion and extension-the movements that allow you to look down toward the ground and up toward the sky.  You also have a rotation, or the movement that allows you to look over your shoulder, as well as side-bending, which allows you to bring your ear toward your same-sided shoulder.  These motions can be performed individually, but can also be combined.  While each motion is important to our ability to function daily, whether at home, at school, or at work, visiting the extreme ends of these motions too frequently can be contributing to your neck pain.

Therefore, take note and address your positioning.  Next time you feel your pain beginning to set in or flare-up, take a moment and observe your posture.  How long has your neck been near one of the end ranges of your motion?  How frequently within your day are you in this position?  When we become aware of our own movements, we can take steps to correct or adjust them, whether that means simply being more conscious of our positioning or modification of our environments.  We want to keep moving, but not too aggressively. Movement is always good for pain. The less you move, the more you will hurt.

Myth: The spine is delicate and easily injured.

Fact: The spine and its surrounding muscles, tendons, and ligaments comprise a well-designed structure that’s incredibly strong, flexible, resilient and supportive. To help maintain the health of the spine, proper conditioning is needed, including strengthening, flexibility, and aerobic conditioning. While there are some exceptions to the rule (such as an unstable spinal fracture), the spine does not need to be overprotected after recovering from a typical episode of neck or back pain. The goal is to keep moving!

2.    Modify Your Home and Work Environments

Once you become more aware of your own spectrum of posture, you can begin to modify your environment, whether that refers to your time at home or at work.

Our homes tend to be our most modifiable environments.  However, if we are frequently out in the community, we are typically not spending the majority of our waking hours within our own walls.  Therefore, we need to consider modifications to our morning and nightly routines.  Consider factors such as the placement of items within your home.  Are you constantly having to struggle your neck in order to find the toothpaste on the top shelf in your bathroom?  Are you always ducking down, trying to find the dishes stored in the back of the bottom cabinet in your kitchen?  Maybe you are constantly turning to watch the television as you prepare dinner?  Keep in mind that these daily routines may place your neck into more strenuous positions.  While it is unrealistic to expect everything to be positioned directly in front of us at eye level, oftentimes moving these little things to easier locations can make a difference. As you become stronger and pain is less of a problem modifying your environment won’t be a priority or cause pain.

Some studies have found that office and computer workers, as well as manual laborers, seem to have higher incidences of neck pain [3]. This increase in reported neck pain can again be connected back to our information regarding positioning our bodies within our own spectrum of movement.  We frequently hear about the “forward head” and “rounded shoulder” postures that are often associated with desk jobs and the prevalence of neck pain.  Forward head posture simply implies that when we are protruding our heads and necks too far forward, we are approaching our own end range and putting too much stress and strain on the tissues within our necks.  Additionally, rounded shoulder posture implies that our shoulders are slumped forward.  We know that the shoulder can often refer pain up to the neck [4].  We also know that when in this rounded shoulder posture, we are decreasing the space within the shoulder joint.  This means that all the tendons that comprise the shoulder joint have less room to move and glide past one another and have a higher chance of becoming irritable, and potentially contributing to your neck pain [5].

So how can we attempt to improve our posture?  When possible, try to make sure that your computer or laptop is close to eye level so that you can look straight ahead.  Also, make sure that screens or reading materials are close enough in order to reduce the forward head posture that may result from straining to read from a distance.  Changing your chair height or sitting surface is also an option when your workspace isn’t quite as easily modifiable.  Try to make sure that typing or writing surfaces are low enough that your shoulders aren’t “scrunched” up, but also not so low that you’re constantly bending over.   Other tips include avoiding holding your phone between your shoulder and ear as this may be putting your neck near one of our end range positions for extended periods.

A lesser-known fix for neck pain includes using a lumbar support or a lumbar roll for your low back when sitting at work.  Our spine has a series of natural curves and when even slightly slumped in a chair, we are decreasing our low back’s natural curve.  This can actually contribute to more slumped posture throughout our upper body, almost like a domino effect.  Therefore, by maintaining this lower curve, we are actually improving the posture throughout our upper body and neck as well.

Considering that much of our time may be spent in the workplace, such modifications are important.  Unfortunately, they are not always possible.  If you are unable to modify much of your work-space or work routine, it may be beneficial to take frequent breaks at work, even if it just means setting an alarm to stand up for a brief moment to reset your posture each hour.  Not only will this give your body, and especially your neck a break, but it will remind you to be conscious of your positioning throughout your workday.

Here is a video I created on posture and working at your computer!

Why The Perfect Workstation Might Not Fix the Problem

If you sit and watch television four hours a day that equals 28 hours each week or two months of sitting and watching each year. In a 65-year life, you will have spent nine years glued to the tube! And once we pass 65, we watch more than seven hours a day during a time in our life when physical activity is the most crucial! People who watched the most TV in an eight-and-a-half-year study had a 61 percent greater risk of dying than those who watched less than one hour per day.

A significant portion of our challenges with pain can be explained by declining physical activity during the workday. Most of us sit at least eight hours behind a desk and at a computer. This shift translates to an average decline of about 150 calories a day from physical inactivity and is directly impacting our nation’s steady weight gain. In total, most people sit close to 12 hours a day, when taking into consideration their work, commute, and television time.

Sitting will increase your chance of heart disease, cancer, diabetes, and obesity, and it will take years off of your life. A 2010 study in the Exercise and Sports Sciences Reviews journal found that even when adults meet physical activity guidelines, sitting for prolonged periods can compromise metabolic health. Put simply, too much sitting is distinct from too little exercise. Sitting is not only causing you to be in more pain but also affecting your metabolism and your efforts to lose weight. Most guidelines by the government and health-care officials recommend getting at least 150 minutes a week of moderate-intensity aerobic activity—about 30 minutes a day—or 75 minutes a week of vigorous-intensity aerobic activity, or an equivalent combination of the two. Learning to live a life where you are aware of and consistently try to incorporate small bouts of movement to break up your sedentary day may just be more important than getting 30 minutes daily, as it does not allow your metabolism to slow. Movement is important and a sedentary lifestyle has been linked to joint pain, including neck pain.

Here is a simple video on how to break the sitting habit and alleviate back pain!

3.    Don’t Stop Moving:  Strengthening

When we think of exercise, the neck is probably the last thing that comes to mind.  However, there is evidence that gentle strengthening of the muscles within and around the neck can actually lead to decreases in neck pain.

It has been shown that impaired deep neck flexor muscle strength has been correlated with the acute and chronic phases of neck pain [6].  You are probably wondering how neck muscles can be weak, especially when they are supporting the weight of the head for the duration of each day.  More specifically, you have these deep muscles within the front of your neck that works to bend your head forward.  These include the longus colli and capitis.  You also have more superficial muscles that serve to complement these deep muscles, such as the sternocleidomastoid and anterior scalene.  However, when these smaller, deeper muscles are inhibited by pain or are weak, the more superficial muscles have to compensate for the job that the deeper muscles are not performing [7].  Therefore, the superficial muscles can become overworked and painful from compensating for the deep muscles day in and day out.

The good news is that there is strong evidence for the strengthening of these deep neck flexor muscles.  One of the simplest ways to specifically strengthen these muscles is by performing a chin tuck or nod.  While laying down on a flat surface without a pillow, you can perform a very small chin tuck, just enough to clear your head from the support surface [8].  You can perform individual chin tucks and can eventually progress to holding each tuck for an increasing number of seconds.  It is important to make sure that your chin tuck is, in fact, very small.  With larger chin tucks where the head lifts significantly off the support surface, we are no longer isolating the deep neck flexor muscles and are instead recruiting our more superficial muscles once again.

Here is a great video I created on how to strengthen your neck!

4.    Don’t Stop Moving:  Stretching

Many times when we experience pain, our instinct is to avoid movement.  However, this avoidance may not actually be beneficial for your neck pain.

You have countless muscles that comprise your neck.  We know that when muscles become tight, they can limit motion and contribute to pain.  We also know that if we avoid certain movements and positions, this lack of movement can cause muscle tightness and perpetuate this cycle of limited motion and discomfort.  In fact, studies have found that stretching exercises are an appropriate therapeutic intervention for reducing neck pain, especially in the short term [9].

Neck stretches may have increased benefit if performed while lying down, as this position allows your muscles to relax because you are not holding your heads up against gravity.  However, stretches are entirely appropriate to do while seated or while standing, especially considering the busy nature of the average individual’s day.

When first beginning stretching, holding for shorter periods of time such as 15-30 seconds is entirely appropriate.  As you build up a tolerance to the stretch, you can progress to 1-2 minute stretches or can do multiple bouts of shorter stretches.

One stretch that you can perform is an upper trapezius stretch.  Say for example, that you want to stretch the right portion of this muscle.  You can bring your left ear to your left shoulder and can then use your left hand to apply some additional pressure on your head in order to increase the stretch.  Similarly, to stretch the left portion of this muscle, you can bring your right ear to your right shoulder.  This stretch will be felt in the upper part of your back, entering into the lower part of the back of your neck.

Your scalene muscles may also need to be stretched.  You can tilt your head to the side and then look down to target the back portion of this muscle.  You can also tilt your head to the same side and then look upward to target the front portion of this muscle.  This stretch will be felt more on the side of your neck.

Lastly, another useful stretch is for your neck extensors or the muscles that help you to bring your head backward as if looking up to the sky. This stretch simply involves bending your neck forward and will be felt in the back of the neck.

5.    Think Beyond the Neck

Have you ever considered that the pain you are feeling in your neck is NOT actually originating from your neck?  It is possible that the pain you are feeling is actually referred pain.

Referred pain, by definition, is “pain felt in a body part other than its source.”  One of the best-known examples of referred pain is the pain felt prior to a heart attack.  We know that one of the warning signs of a heart attack is pain felt in the left shoulder.  However, in this example, there is absolutely nothing wrong with the individual’s shoulder.  The heart can refer pain patterns to the left side of the chest, as well as the left shoulder and arm.  Therefore, the actual problem is the heart, yet the individual may be experiencing the pain in areas other than the heart itself.

The neck works in a similar fashion.  Muscles in the upper back, such as the upper portion of the trapezius, and muscles in the sides of the neck, such as the sternocleidomastoid and the scalenes, can refer pain to the back of your neck.  Therefore, it is important to keep these other areas in mind when considering the source of your neck pain.

One of the easiest things to check for in terms of referred pain is the presence of a trigger point.  A trigger point is a hyperirritable nodule of muscle fibers that can cause pain locally at its site but can also refer pain to other areas [10].  Trigger points can be found using a technique similar to giving a massage.  The nodules are often easily found, and the presence of pain or the reproduction of your symptoms can give you a good clue as to whether a trigger point may be contributing to your neck pain.

Releasing, or relaxing, such trigger points can be done through massage and through strong, sustained pressure directly over the nodule. While this release is often uncomfortable, the disappearance of such a trigger point can actually make a huge difference in your level of comfort.

Balancing your breath can do a body good and alleviate stress Click To Tweet

Tried All of the Above But Nothing Has Worked?

Try 4 x 4 Breathing for Stress Relief

Stress is a significant contributing factor to pain and the perception of pain. Due to stress, poor posture, and lack of physical activity, the way you breathe may not be optimal for taking air into your lungs. Healthy breathing is mostly driven by your diaphragm, which causes your belly to pouch out with a deep inhalation and flatten with an exhalation. When you’re stressed, your breathing pattern goes haywire. You begin to breathe fast and shallow. You use the muscles in your shoulders, upper chest, and neck instead of your belly. When this happens not only is your breathing altered and you take in less oxygen, but pain can also develop. Focusing on deep breathing relaxes the body’s stress response, drops the levels of stress hormones, and brings in fresh oxygen.

Here is a great Video I created to help you!

How to do it: Balancing your breath can do a body good and alleviate stress. To start, slowly inhale for a count of 4, hold for 2 seconds, and then exhale for a count of 4—all through the nose. As you practice and become more advanced, you can aim for a balance of 6 breaths and finally increase to 8 breaths (inhale 8 counts, hold 2, exhale 8 counts). This calms the nervous system, increases focus and reduces stress.

When it works best: This is one technique that’s especially effective when you’re in pain or right before bed—the two times when you need relaxation. If you’re having trouble falling asleep, this breath technique can help take your mind off the racing thoughts and relax you. This also works well in stressful situations or sitting at your desk to bring in some fresh oxygen!