This page provides you with information and self-help advice for managing musculoskeletal neck problems.
Neck pain is a common condition that affects most people in their 30s and 40s. In most cases, neck pain is not caused by a serious problem. Around 50 per cent of people with neck pain will experience a recurrence of their problem. It’s important to understand what may have caused your neck pain, if you want to try to prevent it from returning.
When to speak to a health professional
These symptoms are very rare but you should contact a doctor if you experience any of them:
- Severe head, neck or arm pain that is constant or disturbs sleep.
- Weakness and loss of feeling in the arms or legs (especially simultaneously on both sides of the body in the same area).
- New onset of issues with sensation and/or control of bladder and/or bowel.
- A history of inflammatory arthritis, immuno-suppression, cancer, TB, drug abuse, AIDS or other infection.
- If you feel unwell, have a fever or unexplained weight loss.
- A history of violent trauma (e.g. a road traffic accident or a fall from height) or a history of neck surgery.
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Self help and recovery
There are various treatments for neck pain with short-term and long-term effects.
Top tips to prevent neck pain:
- Try to take regular breaks from work that involves sustained positions. Consider taking a brisk 15-30 minute walk in your lunch break to move your joints.
- Shrug and lower your shoulders, or wave your arms up and down, away from your sides to help reduce neck tension.
- Practice relaxation if you are prone to stress, to reduce tension across your shoulders and neck.
In most cases, it is not possible to identify the exact cause of neck pain. It’s important to know that any kind of serious structural damage is rare, and the most likely cause is a strain of one of the small joints located on the side of the neck. These joints are called ‘facet joints’. Additionally, neck pain may be caused by sensitivity or soreness of the muscles and/or other soft tissues supporting the neck. Less commonly involved are the intervertebral disc and even less so, the nerves.
With the widespread use of x-ray and MRI scans it is not uncommon for people with neck pain to have a diagnosis based upon their x-ray or scan results. However, it’s important to know that there is not a strong link between x-ray and MRI scan findings of ‘spondylosis’ and ‘degeneration’ and a person’s pain.
Neck pain is less common as we grow older, but normal changes to your spine like ‘arthritis’ and ‘disc degeneration’ are more common and can be found in people who do not even experience any neck pain.
To understand what has triggered your neck pain it can be useful to look at ‘lifestyle factors’. Research suggests that these can play an important part in making the neck structures more sensitive.
Lifestyle factors include:
• poor quality and quantity of sleep,
• noticing more muscle tension in your neck,
• low levels of physical activity,
• and more stressful periods of life
These factors can all build up the sensitivity and make it more likely that you will experience neck pain.
Does posture plays a part in neck pain?
There is increasing evidence that posture plays a much smaller role in neck problems than previously thought. It does not appear to be poor posture that is related to pain (although these remain strong societal beliefs).
What does appear to contribute to neck pain is our more sedentary lives, where we hold our bodies in sustained positions for extended periods of time e.g. sitting at an office desk or watching TV on the sofa.
If this is the first time you have suffered with neck pain, it is most likely that you will recover over the next few weeks. Most neck pain problems get a lot better within three months.
Do
• take paracetamol or ibuprofen – or use ibuprofen gel on your neck
• use a comfortable pillow
• put heat or cold packs on your neck
• try neck flexibility exercises
Don’t
• do not wear a neck collar – it's better to keep your neck moving (unless a doctor tells you not to)
• do not do anything that could be dangerous because you cannot move your neck – for example, driving or cycling
The important points for recovery are:
• remaining as active as the pain allows,
• taking simple painkillers if needed, and
• advice from a healthcare professional.
If simple painkillers and staying active are not helpful, then other treatments may be recommended. If you have an ongoing neck problem, say more than three months, then research suggests that the most effective treatment is exercise.
It is important to remember that the longer you have had neck pain, the less ‘hands on’ treatments are indicated. So ask your physiotherapist what it is you can do to help yourself, in terms of activities and exercise.
Exercise can help your neck pain and there are also ways to help prevent it coming back. The right sort of exercise, as advised by a physiotherapist, may make a big difference. Lifestyle changes, such as being more active may also help.
Consider the 'bigger picture' and lifestyle factors.
Ask yourself the following questions:
• Have you been sleeping less?
• Have you been more stressed?
• Have you not had the opportunity to exercise as much as usual?
• Have you been working in sustained positions for longer periods of time?
All of these are possible triggers for neck pain.
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Exercise has been shown to be the most helpful treatment for on-going neck pain. In most cases, it doesn’t appear to matter what type of exercise you do, as long as you remain active. So choose something that you like to do it, and keep at it! If your neck pain is not improving, keeps returning or prevents you from doing the things you enjoy even though you are keeping active, then it may be useful to consult a physiotherapist to get more specific exercises for your neck and / or upper body.
Reduced physical activity is a risk factor for neck pain and people with stronger necks from doing exercise are less likely to suffer from neck pain. Read the NHS physical activity guidelines recommended for adults.
Here are some example exercise videos:
You can also make use of the following exercises where appropriate:
- Neck progressive strengthening programme - word document or PDF
- Neck movement programme - word document or PDF
Please visit this page for additional exercises for you neck.
Physiotherapists are highly skilled at supporting people with neck pain. Your physio will likely advise you on suitable exercises and pain relief, as well as tips on how to prevent further problems. They may give you hands-on treatment such as manual therapy as addition to the main treatment programme. Physiotherapy has been shown to work through clinical studies and research and is a treatment you can trust.
What happens when I see a physiotherapist for neck pain?
When you see a physio, they will assess your problem and give you advice. They may give you a physical treatment. Everything you tell the physio will be completely confidential. So that your physio can have a good look at your neck, they may need you to remove some clothes. It’s a good idea to dress comfortably and wear suitable underwear.
When should you self refer?
Most neck pain will settle naturally in time with little or no medical help. Most people do not need further treatment or investigations, and your physiotherapist is ideally placed to advise if you do. If the above self-help information is not improving your symptoms within 6-8 weeks or if your symptoms are getting worse, then see a healthcare professional. To do this, you will need to fill in our self referral form.
Please see below specialised advice on various neck conditions:
The information on this page is adapted from CSP and NHS. Please note: This information is not a replacement for professional help but may aid you and any further information or advice given to you by a medical professional. If you are accessing this site for self-help information in the absence of professional advice, please be aware that the advice and/or exercises may not be suitable for you. If you have any concerns or in the event of any problems, please seek professional advice.