Between massages, you can do a lot yourself to calm down your achy neck.
You can injure or irritate your neck any number of ways:
- whiplash in a car accident
- heading a soccer ball too vigorously
- awkward slips or falls
- falling asleep on the couch or in an uncomfortable airplane seat
- “sleeping funny” on a motel bed, hide-a-bed, or a new mattress or pillow
- peering into a computer monitor, tablet, or smart phone for hours on end
- poor posture
Neck pain can also result from conditions like arthritis, changes to the vertebrae in your neck and the disks between them, and other orthopedic conditions.
Neck pain is usually more of an annoyance than a major health risk. However, some serious conditions can also cause neck pain. Seek medical care immediately if you experience any of the symptoms in the “When to Seek Professional Help” section below.
If you suspect that your neck pain might be related to a movement pattern – playing a musical instrument, staring into a computer screen, watching a tennis match, etc. – take a break. Simply stopping the activities that are stressing your neck muscles may begin to reduce your pain.
While you’re taking a break, you can also adopt a resting position:
- Lie on your back on a comfortable, firm surface
- Place a pillow, bolster, or rolled-up blanket under your knees (this breaks a tension pattern in your low back that can ripple up your spine to your neck)
- Place a small (no more than 2″ thick) bolster or rolled-up hand towel behind your neck
- Tuck your chin toward your chest, feeling the back of your neck lengthen as the back of your head moves up away from your shoulders
Simply relaxing like this for a bit can begin to ease the muscle tension that can cause or exacerbate neck pain.
If you don’t have access to a place where you can relax like this, check out the “Posture” section below.
One of the most effective ways to prevent and treat neck pain is to adopt better posture.
Neck pain can both result from and cause a forward-head posture.
If you frequently stare into your TV, computer screen, or car windshield, your head will end up following your eyes forward. This can irritate the muscles on the back of your neck, which strain to keep your head from pitching all the way forward.
Regardless of how it originates, neck pain can also cause head-forward posture. At its most extreme, the muscle-guarding posture that goes with neck pain can leave you curled up in the fetal position. But short of that, there’s a natural tendency hunch the shoulders and pull the neck forward and the head down when you’re in pain.
One way to visualize the physical dynamics involved in head-forward posture is to imagine that your head is a bowling ball balanced on top of a broomstick. The muscles on the front and back and sides of your neck act like guy-wires to stabilize the bowling ball. When your head is properly positioned, the tension on those muscles is minimal. If it moves forward even a little bit, it begins to strain the muscles on the back of your neck.
Forward-Head Posture Correction
Here’s how to get your bowling ball back to where it belongs.
First, set a stable base for your neck by undoing the forward-shoulder posture that accompanies this pattern:
- Roll your left shoulder forward to back a few times, exaggerating the up and back part of the motion
- Stop the motion with your left shoulder as far back as it naturally goes
- Repeat on the right – roll your shoulder a few times, and then stop when it is as far back as possible
- At this point, you’ll notice some slack in the muscles between your shoulder blades
- Tuck your shoulder blades together
Now that your shoulder girdle is tucked in, you can position your neck properly under your bowling ball:
- Tuck your chin down, feeling the back of your head rising up at the same time
- Slide your chin straight back, as if you’re closing a file drawer
- Slide your head back far enough to create a double chin and then relax just a bit
This sequence of movements both correctly orients your head on top of your neck and pulls your neck back into its normal, neutral posture.
A poorly situated computer monitor can contribute to the head-forward posture that can tweak your neck.
The fix for this is to position your computer monitor so that it lets you stay in that tucked-chin, long-neck posture.
The screen should be about 20-40 inches from your eyes, depending on the size of your monitor. The top edge of the screen should be at or a little below eye level. The bottom edge should be a little closer to you than the top (so that the plane of the screen is parallel to that of your eyes).
The monitor should also be stable, to prevent wiggling.
Visit the OSHA website for more on computer-monitor ergonomics.
If you sleep in a position that strains your neck and shoulders, you can be at more risk for neck pain.
To prevent this, make sure that your mattress, pillow, and bedding let you sleep in as neutral a posture as possible.
Here are some tips for better sleep posture that I have learned from sleep researchers and clinicians over the years:
- Sleep on your side to get the best opportunity for a relaxed, neutral sleep posture
- Prop up your head with a comfortable pillow that keeps your head, neck, and spine all aligned
- Place another pillow between your knees to keep pelvis from tilting (which can bother your low back)
- Whether or not you use a pillow between your knees, always keep the top knee behind the bottom knee (otherwise you can irritate your low-back joints as your pelvis twists forward)
- Throw your top arm over a body pillow (or a cooperative bed partner) to keep your shoulders from collapsing in front of you
Changing your sleep posture can be a challenge, of course, since you are unconscious most of your time in bed. Props like pillows and bolsters can give you physical cues to remind you to adopt these sleep posture best practices.
Movement & Exercise
When neck pain first starts, you may be inclined to stay as still as possible. That can be a good tactic to get some immediate relief. But to restore normal, pain-free movement you’ll have to get your neck moving again.
Some amount of movement is almost always possible – even in cases where your neck is so seized up that you feel like you have to move your head, neck, and torso as a unit.
Before you do any of the movements below, go through the posture exercise above a couple of times to get a feel for normal, neutral neck positioning. Start each of these exercises from that neutral posture.
If any of these activities causes pain or other disagreeable sensations, stop right awayand check the”When to Seek Professional Help” section below. Most of the time you can safely back off and do a less strenuous version of the movement, but if pain persists, don’t push it.
Here are some ideas to begin to get your tender neck moving again (again, always starting from neutral neck posture):
- gently wobble your head side to side, back to front, and in gentle circles, like a bobble-head doll
- laterally flex your neck, tilting your head toward one shoulder and then the other
- continue to laterally flex, but try pivoting around different points in the neck, first up high, just under the base of the skull, and then moving down to the middle of the neck, and then down to the base
- rotate your head and neck to both sides
- continue to rotate your head, but rotate around different points in the neck, working your way up and down, from the base of your skull to where your neck meets your shoulders
- flex your neck forward, tucking your chin and then dropping your head forward, pivoting first from the base of the neck and then flexing further up your neck, right up to the base of your skull
- combine the wobble, flexion, and rotation movements and draw circles with your head, reversing direction after four or five circles
You may discover as you do these exercises where your neck movement is most limited. If it feels safe and comfortable, return to those spots and try to get just a little more movement than you could the first time.
Many of the muscles in your neck attach to structures in your shoulders. So it can also help your neck to get your shoulder girdle moving.
Here are a few ideas to release tension in your shoulders:
- tai chi arm swing
- stand with your feet about hip width apart and rotate your upper body by rotating your hips side to side
- let your arms hang and swing from your rotating torso
- shoulder rolls
- roll your shoulders up and back together, making front-to-back circles with both shoulders at the same time
- then alternate, right shoulder up and back as left shoulder goes down and forward
- then reverse, left shoulder up and back as right shoulder goes down and forward
- shoulder shrugs
- shrug your shoulders up together and then let them drop
- repeat several times
You may reflexively rub your neck when it’s bugging you, and that instinctual treatment alone can help. But focusing your self-massage can help more.
Swedish massage uses gliding, stroking, kneading, and rubbing motions to warm and loosen your muscles. It’s the most natural form of massage imaginable. You simply follow the contours of your body and massage the muscles you encounter.
To massage the muscles that can irritate your neck, reach up with one or both hands and grasp the muscles that go from the base of your skull down to your shoulders. Gently glide at first, then connect a little more firmly, squeezing the muscles between your fingers and the palm of your hand. Explore the muscles at the back of your neck and work your way around toward the front.
Using one hand at a time, you can alsoreach across your chest and grip the neck and shoulder muscles on the opposite side.
Trigger Point Massage
As you massage yourself, you may come across little points that feel like a pea-like nodule embedded in your muscles. If they created pain in nearby areas as you press on them, or even if they are just locally tender, these may be trigger points.
There are whole books written about trigger-point self-care, and I encourage you to read them. But it’s safe to experiment with this simplified self-treatment method, too:
- feel around for pea-sized tender nodules in your muscles as you massage them
- identify the trigger point by firmly pressing on it, verifying that it produces local pain and/or pain nearby
- firmly press on the nodule for about 10 seconds
- release and do some more general massage around the trigger point
- repeat two or three times, or until the point stops creating pain when you press on it
- if the point seems hard to stay connected with as you press on it, try approaching it from different angles
Heat and cold can soothe sore muscles and loosen stiff ones.
Classically, cold is used to tame pain, and heat is used to reduce stiffness. But you can try either or both on your neck and see which works best for you.
Here are some hydrotherapy treatments to try on your neck:
- linger a little longer than usual in a nice, hot shower, aiming the warm water at the achiest spots in your neck and shoulders
- apply an icepack or cold compress directly to the most painful spots and adjacent
- apply a heating pad or hot-water bottle directly to the stiffest areas
- a warm bathcan alleviate stress that may contribute to your neck pain
Whether using heat or cold, always end the treatment after no more than 20 minutes.
When to Seek Professional Help
PainScience.com does a good job of explaining how most neck pain does not result from serious causes. Still, there are some conditions and situations in which you should seek professional medical care:
- if you’ve recently had an accident, slip, fall, or trauma of any kind
- prolonged pain that hasn’t resolved after 6 weeks
- pain that gets worse over time, not better
- severe, unusual, or never-before-experienced pain
- persistent nerve symptoms (numbness, tingling, “heavy” feeling, etc.) in neck, shoulder, or arms
- weakness, hard to hold up head
- accompanied by other symptoms – severe headaches, flu-like symptoms,dizziness, or nausea
I consulted a number of journalistic and scholarly articles as I wrote this page. These were the most useful.
- Most Neck Pain Improves with Self-care, Time, Mayo Clinic
- Neck Pain: Lifestyle & Home Remedies, Mayo Clinic
- Neck pain or spasms – self care, MedlinePlus
- What are the treatment options for non-specific neck pain?, InformedHealth.org
- Neck Pain, FamilyDoctor.org
- When to Worry About Neck Pain…and when not to!, PainScience.com
- Patient Care: Back & Neck, Osher Center for Integrative Medicine, UCSF
- Patient Education for Neck Pain,Cochrane Database of Systematic Reviews (Wiley)
- Complementary and alternative treatment for neck pain: chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais,Physical Medicine & Rehabilitation Clinics of North America
- Psychological Care, Patient Education, Orthotics, Ergonomics and Prevention Strategies for Neck Pain: An Systematic Overview Update as Part of the ICON Project,Open Orthopaedics Journal
- Development of a Preliminary Clinical Prediction Rule to Identify Patients With Neck Pain That May Benefit from a Standardized Program of Stretching and Muscle Performance Exercise: A Prospective Cohort Study,International Journal of Sports Physical Therapy