Between all the time we spend on our phones, tablets, and computers and all the daily chores and errands that must get done, daily life can start to feel like a pain in the neck- literally!
Neck pain can be highly debilitating- affecting everything from function to sleep- and can also cause head, arm, and back pain.
Since our bodies are adept at avoiding painful movements, those with neck ailments may stop moving their heads, which can lead to even more stiffness and decreased functional capacity.
The neck, or cervical spine, is an area of the body that often serves a thankless role. We don’t tend to appreciate how easy it is to turn our head to check a blind spot, or look up at the top shelf in the kitchen, or engage in weekly tennis matches until we no longer have those abilities.
Resorting to decreased head and neck movement is not the answer!
This article will demonstrate simple neck exercises and stretches that can be done to help decrease neck pain.
Is Neck Pain Caused Your Muscles?
Generally speaking when it comes to pain/injuries, physical therapists first classify them as muscular or non-muscular in origin. Meaning, pain is either originating from the muscle or it’s originating from something else.
If pain is “muscular” it may be caused by a muscle strain or due to muscle tightness. It’s also possible that other tissues (like fascia) could be causing tightness or pull, but in general, physical therapists use the term “muscular”.
Whether or not the pain is muscular can generally be determined based on reproduction of pain. If your neck pain is reproduced or caused by movement, it may be muscular.
It also could be caused by something the muscles pull on, like the bones. Muscle pain can be dull or sharp, and usually is increased with certain motions. Muscle pain may also feel more generalized to an area, whereas bone pain is easier to pinpoint. Bone pain also tends to be sharper and have a higher intensity than muscle pain.1
Being aware of the duration and intensity are also important. Bone pain lasts longer and at that higher intensity than muscular pain.1
Is Your Neck Pain Actually Nerve Pain?
Neck pain may also be caused by nerves or arthritis of the cervical spine.
Nerve pain is usually described in a variety of ways, including burning, tingling, numbness, and/or iciness.
It has a tendency to travel, which is usually described as radiating or shooting pain, sometimes both. It’s possible that if one is feeling pain in the shoulder, arm, hand, or upper back the pain is actually originating from nerve irritation in the neck.
Nerve pain may be caused by a disc herniation in the cervical spine. The disc is the cushy surface of collagen that sits between our vertebrae, helping to support our spine and acts as a shock absorber. The disc has a tough outer layer and gel-like inner layer.4
The disc is often assimilated to a jelly donut. When the disc herniates, the jelly is pushed out into the space where the spinal cord and branching nerves live. This puts too much pressure on the nerves, causing irritation and pain.4
Arthritis in the neck may cause spinal stenosis, which is a narrowing of the space in the spine between the spinal cord and the bones. This also has nerve-like symptoms. Numbness, tingling, and muscle weakness may occur.2
The joints on the back of the neck, known as facet joints, can also develop arthritis, which may cause stiffness, pain, and/or radiating pain which may be felt in the back of the head, shoulder, or ear.3
Why Does Knowing the Pain Origin Matter?
The tissue that is causing the pain is the one we want to focus on for treatment.
First and foremost, if you think you’re having bone pain, seek medical attention immediately! Even if you don’t think you did anything that could cause bone damage, seek medical attention immediately!
Fractures that occur in the vertebrae due to conditions like osteoporosis can happen seemingly spontaneously. Although osteoporotic fractures in the cervical spine are rare, it’s definitely better to be safe rather than sorry on this one. So one more time: if you think you’re having bone pain, seek medical attention immediately!
When it comes to nerve, arthritis, or muscle pain, these can usually be treated conservatively and tend to include exercises from a physical therapist.
As always, please go see a physical therapist if you’re experiencing neck pain and consult with them on the best course of action.
5 Exercises to Help Decrease Neck Pain
Click HERE to watch Dr. Katie demonstrate these exercises.
The following exercises are general and your own PT will be able to prescribe you specific exercises for your neck pain, but if you’re looking for a general place to start, here’s some of my favorite neck exercises.
First, a note on stretching. I personally like my clients to hold a stretch for 60 seconds. Why? Because stretching isn’t only about the muscle. A lot of the flexibility we get from stretching comes from allowance from the nervous system.
For this reason, I tell people to get in a “comfy” stretch position. This means you feel the stretch, but it’s not painful. Then we hold for a minute to signal to the nervous system that it’s okay that we are in this new, more elongated position.
If we are in a painful position, the nervous system wants to get us out of it and it may even cause more tightness/pain because it’s trying to protect us. So we want to train the nervous system that it’s okay to let go and over time, the aim is to get more relaxation and range of motion in those muscles/joints.
The caveat here is if 60 seconds is too much and you start experiencing discomfort or pain, then back it off. Start with 30 seconds and work your way up (or whatever time period you need). Stretching is truly a “no pain, allows for gains” activity.
1. Chin Tucks
Chin tucks are an exercise that I am a fan of! Generally speaking, most of us have really tight muscles in the back of our neck, which are trying to compensate for the weaker, less active muscles in the front of the neck.
This imbalance can contribute to a more forward head, alignment issues, and possibly pain.
With this exercise, we are working the deep cervical flexors and lower cervical extensors, which helps balance out the muscles of the neck.
A recent study on the effectiveness of exercises for deep cervical muscles found that they are not significantly better at reducing pain intensity compared to other exercises.5
What does that mean for chin tucks? Basically, the findings of that study found that chin tucks are just one of the exercises that can be utilized for neck pain, but they’re not the only effective exercise for neck pain.
Make sure you add other exercises (see below) to continue to help decrease your neck pain.
- Make an “L” with your thumb and index finger.
- Turn your hand so your thumb is pointing towards your chest.
- Place your thumb on the notch at the top of your breastbone.
- Bring your chin forward so it’s touching your index finger (if it’s not already).
- Pull your chin away from your index finger. ( Away is the key here. I tell people “Pretend someone is kissing you and you don’t want them to.” That way we pull the chin away, rather than lifting the head up or nodding the chin down too much).
- Hold for 5 seconds.
- Return your chin to starting position.
- Repeat steps 4-7 10 times.
- Rest for 1-3 minutes after you’ve completed 10 repetitions.
- Perform 3 sets of 10 total.
2. Upper Trapezius Stretch
Do you ever feel “knots” in your neck or upper shoulders? It’s likely that it’s a result from tightness in the Trapezius muscle.
The Trapezius is responsible for elevating, depressing, and retracting the shoulder blade (scapula). Basically, shrugging the shoulders, lowering the shoulders, and bringing the shoulder blades towards each other in the back.
There’s a tendency for people to tense this muscle (usually without realizing it) when stressed or when working at the computer, or just in daily life, which can lead to tightness and pain.
With this stretch, we want to allow the Trap to relax and ensure it’s not overworking unnecessarily.
- Sit towards the front of a chair with back straight and feet flat on the floor.
- Grab the bottom of the chair with your left hand.
- Lean your head towards your right shoulder (make sure you don’t bring your right shoulder up. Let the head come to the shoulder, not the other way around).
- You should feel a stretch in your upper shoulder/neck on the left side.
- Hold for 60 seconds, breathing. (If you can’t hold for 60 seconds, do two sets of 30 seconds, or whatever your body will allow right now).
- Repeat on the other side.
3. Levator Scapulae Stretch
The Levator and Trap muscles work together to elevate the shoulder blade. It also helps to extend the neck (bring towards the back).
Similar to the Trap, the Levator Scapulae can get unknowingly overworked and tight. Especially when we have weakened muscles in the front of the neck, the Levator has to work extra hard to try and pull the neck and head back so our head remains up over our shoulders.
This stretch aims to allow for some relaxation and release for that Levator Scapulae.
- Sit towards the front of a chair with back straight and feet flat on the floor.
- Grab the bottom of the chair with your left hand.
- Lean your head towards your right shoulder (make sure you don’t bring your right shoulder up. Let the head come to the shoulder, not the other way around).
- Turn your nose towards your right armpit.
- You should feel a stretch deep in your upper shoulder/neck on the left side.
- Hold for 60 seconds, breathing. (If you can’t hold for 60 seconds, do two sets of 30 seconds, or whatever your body will allow right now).
- Repeat on the other side.
4. Chest Expansion
Many of us sit with rounded shoulders and a forward head. The rounded shoulders may be caused by a variety of things, like your natural spinal alignment or possibly your learned spinal alignment from sitting at a computer for most of the day.
Whatever the reason, when our shoulders live in this rounded state we could be more at risk for impingement in the shoulder, which can also cause pain.
Also, this is a movement of the shoulder blades. Neck pain can be connected with decreased mobility in the shoulder blades and thoracic spine (which we will get to next). So increasing movement in these areas can be helpful to decrease pain.
- Sit up tall, with feet on the floor, or stand with feet hip distance apart.
- Allow your arms to rest down by your sides, palms facing your thighs.
- Move your shoulder blades together in the back (think about your chest getting wider in the front with this movement).
- Hold for three seconds.
- Relax.
- Repeat steps 1-4 for 8-10 reps.
- Take a 1-3 minute rest.
- Perform 3 sets total.
**Note: Many people try to complete this exercise by moving their arms, rather than their shoulder blades. While your arms will move slightly, try not to make the movement bigger with your arms. This whole exercise is about small, but effective movement.**
5. Thoracic Spine Rotation
As mentioned above, cervical spine (or neck) pain, can be linked to decreased mobility in the thoracic spine.
Which one came first is usually a “chicken or the egg” kind of scenario, but the point is that we want all parts of our spine to move correctly to allow for improved function and decreased pain.
The thoracic spine (or upper back) likes to rotate. So that’s what we are going to do to get some more mobility in there.
What’s important to know here is that if our thoracic spine is tight, there’s a tendency to use our neck or low back to compensate. If you’re noticing your upper back isn’t moving much, don’t try and push it! Just keep working on this to allow for more movement with time.
Or, if you’re not sure if you’re doing this correctly, go see your physical therapist and ask for their advice on your thoracic spine mobility!
- Sit up tall, towards the edge of the chair, with your feet flat on the floor.
- Place your hands on your shoulders.
- Rotate your ribs towards your right side (think of yourself as a spiral staircase. You get taller as your rotate).
- As you rotate, make sure both bum cheeks are still in contact with the chair.
- Hold this position for three deep breaths.
- Rotate back towards center.
- Repeat on the right three times.
- Complete on the left three times.
**Note: It’s very normal for one side to move more easily than the other. Once again, don’t try to force anything.**
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Sources:
- Shaw, G. (2021). What to Know About Bone Pain. Retrieved 11 February 2022, from https://www.webmd.com/pain-management/bone-pain-what-know
- Spinal stenosis – Symptoms and causes. (2022). Retrieved 11 February 2022, from https://www.mayoclinic.org/diseases-conditions/spinal-stenosis/symptoms-causes/syc-20352961
- https://sportsmedicine.mayoclinic.org/condition/facet-arthritis/
- https://www.spine-health.com/conditions/spine-anatomy/spinal-discs#:~:text=Discs%20are%20actually%20composed%20of,Annulus%20Fibrosus.
- Garzonio, S., Arbasetti, C., Geri, T., Testa, M., & Carta, G. (2022). Effectiveness of Specific Exercise for Deep Cervical Muscles in Nonspecific Neck Pain: A Systematic Review and Meta-Analysis. Physical therapy, pzac001. Advance online publication. https://doi.org/10.1093/ptj/pzac001
- All photos made on canva.com
