There’s plenty of self-help advice and professional treatment, but proceed cautiously.
About 80 million Americans report they have neck pain, according to an American Osteopathic Association (AOA) survey.
It has many causes, but the majority of neck pain stems from muscle tension generated by poor posture, stress, a lack of sleep, poor positioning while sleeping, bad computer habits, or weakening muscles. Far fewer instances of neck pain are the result of diseases such as arthritis and degenerative disks, injuries, accidents, heavy lifting, and other spinal problems.
All those disparate causes, however, funnel back to anatomy. The Arthritis Foundation offers the analogy of a “bowling ball propped on our tiny neck bones.”
“The anatomy of the cervical spine is a marvelous construct that…provides support for the head and allows for a high degree of mobility and range of motion,” adds Spine-health, a subscription site for doctors. “But the same engineering that allows this area of the spine to be so flexible also leaves it vulnerable to injury.”
If you have chronic neck pain, try conservative, self-treatment first. The simplest advice is to move. Correcting bad posture takes focused work, but if you just get up and move around enough, your neck is less likely to have muscle strain from being in one position too long. That’s especially likely to happen at work.
Next, try to stay calm. Stress triggers muscle tension, so be mindful of what gets to you — and learn to practice relaxation techniques such as sequenced, deep breathing. You can add mediation, yoga, and exercise to that list. Even just listening to music or sounds designed for peace of mind can work. Listen to some whales sing, for instance.
There’s all sorts of advice based on ergonomics, the science of how you use chairs, desks, and other devices for comfort and usability. Make sure, for instance, that your computer is eye level so it’s easy to see. Keep related work materials at eye level as well. Use a speaker-phone or a headset instead of tucking the handset between your neck and your shoulder. Become aware of habits that put your neck in positions that strain its muscles. When you’re paying attention, you’ll probably be surprised at how many things you do to strain your neck.
You can also try cold packs and heat. While the cold helps reduce inflammation, heat helps promote blood flow. Both can promote recovery. Cold also numbs pain, and heat eases stiff muscles.
For sleep, use a quality mattress to keep your head and spine aligned, and use a low, comfortable pillow; using too many pillows can force your neck into unnatural positions. Get a good night’s sleep. Lack of sleep increases the risk of sore muscles and neck pain. Research suggests one sleep disorder in particular, sleep apnea, may contribute to osteoporosis.
Being just plain fit and trim can lessen, or eliminate, neck pain. You probably already know that being overweight can strain all of the body’s muscles. If you’re a normal weight and you stay in shape, you’ll put less stress on your body, and your stronger muscles will better support your neck. You particularly benefit from strengthening your core — athletes from all walks have taken that advice — because it lessens the risk of injury elsewhere in the body. Weak stomach muscles force the upper back and neck into positions that create tension.
Exercise specific to the neck helps as well. A study in Finland looked at the effectiveness of strength training in the neck, compared with stretching or no exercise. Results showed the strength-training exercises worked best to relieve neck pain. “The emphasis previously has been on stretching exercises, but the study showed their effectiveness alone is poor for chronic neck pain,” said lead researcher Jari Ylinen. “Stretching should be combined with strengthening neck and shoulder muscle exercises.”
You should also consider an occasional analgesics such as acetaminophen (Tylenol) or ibuprofen (Motrin) to reduce inflammation and pain, but remember that you can’t just keeping taking them for your neck pain. In many cases, that may be all it takes to relieve the neck pain long-term depending on the cause, but know all the precautions when taking over-the-counter medicine.
If you’ve had a massage before, then you know how much it can help sore, tense muscles. At home, have someone rub your neck and shoulders with a lotion or oil. Topical analgesics, such as Tiger Balm or Icy Hot, may also help. Some people like to make their own “natural” massage oil with analgesic properties, containing ingredients such as camphor, menthol, or eucalyptus oil. If no one is available, rub your neck yourself for up to 15 minutes.
You can also seek professional help, or course, such as a physical therapist, chiropractor, or orthopedic specialist. For severe cases of neck pain brought on by disease or trauma that may be your best course.
A study led by pain specialists at Johns Hopkins University School of Medicine reported that combination therapy seems most effective for a “common form” of next pain — a herniated disc or narrowing of the spinal canal called stenosis. The results suggested that spinal steroid injections and conservative treatment with physical therapy work equally well, but over time a combination of the two worked even better.
“We designed our study to answer the question that primary care doctors face when they see patients with neck pain: `Should I send them for a series of injections, try conservative measures first or do both?’” said Steven P. Cohen, MD, one of the study authors. Cohen added that the combination therapy has become a “cornerstone” in rehabilitation medicine. The rationale is that without the reinforcement of the physical therapy, relief from injections is usually temporary.
Either way, you have options. The AOA survey found that about half of Americans consider pain “part of life” and are unlikely to seek relief or treatment, let alone consult a medical professional. Don’t suffer in silence. In fact, you may not necessarily have to suffer at all.
March 27, 2020
Christopher Nystuen, MD, MBA