Whether it’s a shooting pain or a dull ache, neck pain is extremely common: about 71 percent of Canadians will experience neck pain at some point in their lives. After all, your neck has the difficult and important job of holding up your heavy head. Plus, you move your neck around a lot, and it’s not as well protected as the rest of your spine, making it more vulnerable to injury.
According to a 2015 review published in the journal Mayo Clinic Proceedings, as much as 30 percent of the population experiences neck pain each year. It’s the fourth leading cause of disability, and nearly 50 percent of those with neck pain will continue to experience some pain on and off.
Fortunately, though, most cases of neck pain will go away, and there are some simple things you can do at home to help, or even prevent, these minor injuries.
“Neck pain can have many causes,” says Stuart J. Fischer, MD, an orthopedic surgeon in New Jersey. “It can result from a single injury, a repetitive stretching, or in older people, arthritic change. In some cases, neck pain can be caused by an infection,” he says.
If you did something specific to hurt your neck, it could have been as simple as one bad stretch that injured neck muscles, Dr. Fischer says. “You might pull too hard on your neck muscles when you lift something heavy or lift in an awkward position,” he says. “You may not feel the injury as it happens because the pain doesn’t set in until inflammation develops. This can be several hours later or even the next day.”
A traumatic injury, such as whiplash from a car crash, can also cause pain, or, your pain could be the accumulation of a bad habit that puts a strain on the ligaments and muscles in your neck. “In some people, pain can develop after multiple repetitive strains such as bending over a computer screen day after day,” Dr. Fischer says.
This can also happen due to poor posture, reading in bed, or even stress, which causes you to clench your teeth and tighten your muscles, says Tammy J. Penhollow, DO, a pain management specialist and anesthesiologist in Scottsdale, Arizona.
Arthritis and infection
With arthritis that causes wear-and-tear on the neck joints, Dr. Penhollow says this narrows the space between the joints as well as the space for the cushioning discs between the neck’s spinal bones, leading to neck pain. Arthritis can also cause nerves to compress, creating radiating pain into your head, behind your eyes, into your jaw, and even down the arm, she says.
“Neck pain from arthritic or degenerative change tends to happen in older people,” Dr. Fischer says. But, “arthritic pain can develop in younger patients who have had a serious neck injury in the past such as a fracture. Years after the fracture, the neck may become painful.” In addition, “you can also get pain in the muscles of your neck as the result of a viral or bacterial infection,” Dr. Fischer says.
For example, this can happen when you have the flu. “A viral infection takes the form of muscle aches and will resolve as the infection clears,” he says. “In rare cases, severe neck pain can come from an infection in your spine such as meningitis.”
“The most common symptoms are tight muscles in the back of the head, along the back and sides of the neck, to the tops of shoulders, and between the scapula, or shoulder blades,” Dr. Penhollow says. You may also experience “headaches—occipital [behind the eyes] or back of the scalp are very common, but they can be top of the head ‘tension’ headaches from muscle tightness,” she says.
Also, you may feel “weakness in the arms from muscle fatigue or from nerve compression; or numbness and tingling in the arms from nerve compression,” she adds.
Because most acute cases of neck pain can be treated successfully at home, you may want to try an over-the-counter medication, such as a nonsteroidal anti-inflammatory drug (NSAID) or another simple pain reliever.
“For many people, acetaminophen [such as Tylenol] is enough to relieve mild pain symptoms,” Dr. Fischer says. In addition, “simple pain relievers such as acetaminophen are often taken by patients who need relief from pain but cannot take anti-inflammatory medications. These are available in standard and extra strength doses.” NSAIDs such as ibuprofen act to relieve the inflammation in the body that is causing the pain. “They also have a direct pain-relieving effect,” Dr. Fischer says.
Common over-the-counter anti-inflammatory medications include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). Larger doses are available by prescription. Just note that NSAIDs can sometimes irritate the stomach or have an effect on blood clotting. “They shouldn’t be taken by anyone with a history of ulcer disease, acid reflux, or colitis,” Dr. Fischer says. “They should also be avoided by patients who are taking blood thinners such as warfarin (Coumadin), apixaban (Eliquis), and rivaroxaban (Xarelto).”
In addition to oral medications, you can also try drugstore remedies that are put directly on the place it hurts. “Topical ointments or patches can be applied to the skin and often help relieve pain in the underlying soft tissues and muscles,” Dr. Fischer says. “Some of the more popular are lidocaine patches, which gives a local anesthetic, and diclofenac (Voltaren) gel, which is anti-inflammatory.”
Ice and heat
Ice may help calm the initial inflammation, so you can use it for the first couple of days; then, try heat for pain relief. “Heat, whether a moist or dry heating pad, will often soothe and relax underlying muscles; sometimes a hot shower may have the same effect,” Dr. Fischer says. “While these modalities do not cure the pain, they make you feel better for a short time.”
Dr. Penhollow also has a trick for using heat. “One of my favourite recommendations for heat is to take a bag of brown rice-not white as it will burn-empty it into a pillowcase [or a clean sock] and tie a knot in it,” she says. She suggests microwaving it until it is warm, but not too hot, or you can get burned. And then place it on your skin.
“The rice molds to the shape of the neck and can help release tension in tight muscles and allow loosening, followed by stretching,” she says. “Heat is better for stretching because warm muscles stretch better than cold, tight muscles.”
You shouldn’t do any strenuous exercise if you’re having neck pain, but “gently moving your neck in all directions may relieve stiffness,” Dr. Fischer says. However: “hard or forceful stretching should be avoided. Most neck injuries actually occur as the result of a stretch or strain. Repeating any kind of vigorous stretching or strain may actually make the neck pain worse.”
Dr. Penhollow advises making sure you’re warmed up, and consider applying heat to the muscles before stretching. “Then, start with simple side-bending of the head from right and left, head forward flexion [bending] and gently looking up toward the ceiling, but only to the point of mild tightness,” she says. “Upper back and arm stretches can also help with the neck. If dizziness or numbness occurs, back off and return your head to neutral.” You could consider yoga, but you should consult with your doctor before starting any stretching program.
Especially if your neck pain is frequent, “a course of prescribed physical therapy may first be warranted to assess for specific restrictions, and may result in supervised teaching of the stretches, as well as feedback and correction if anything is not being done correctly,” Dr. Penhollow says.
In addition to stretching the neck itself, “having a strong core is also important for neck pain, as the muscles that make up the core on the backside run from the base of the skull to the base of the spine,” Dr. Penhollow says. “Core stabilization exercises can include forearm planks, and can be for as short as 15-second intervals of good form.”
To prevent neck pain from happening again (or better yet, in the first place), think about what you do during your day. “For many people who spend all day in front of a computer, screen neck pain can be a problem-this has been particularly true during the pandemic because people have been working at home in non-office settings,” Dr. Fischer says.
If you’re in an office or other official place of work, your workspace may be following Occupational Safety and Health Administration (OSHA) guidelines for best ergonomic practices. When working remotely, though, this isn’t the case for many workers. “Often they are bent over a small laptop screen and are straining their necks to watch the screen, keyboard, and bend over to look at a paper document on one side of the computer,” Dr. Fischer says.
“The best way to avoid this is to bring your screen to eye level so that your neck is straight and you are not bending forward. It helps to raise the height of your keyboard so that your hands are in a natural position and you do not have to lean to type.” A standing desk converter , or simply a surface that’s at eye level when you’re standing, can be more comfortable and help to ease the problem, Dr. Fischer says. If sitting, the best office chairs for back pain may help as well.
Think about what else in your life may be causing you problems. In addition to your computer, you should also avoid cradling your phone between your head and shoulder with your neck tilted awkwardly to one side, Dr. Fischer says. “Using earbuds or Bluetooth can eliminate that and help with an upright posture,” Dr. Penhollow agrees. Also, avoid bending over when texting to avoid “text neck.”
In addition, “women carrying heavy purses may benefit from downsizing to a smaller purse and using a cross-body strap,” Dr. Penhollow says. “Even students with heavy backpacks are subject to neck pain and may benefit from a rolling backpack rather than wearing it.” If your job involves a lot of physical work, “proper lifting, carrying, and load transfer techniques are important any time a weight is involved,” she says.
Many of us have woken up with a kink in our neck from time to time. “When you are sleeping it helps to have a small pillow or rolled towel beneath your neck,” Dr. Fischer says. “When you think about it, your head is resting on a hard pillow and your shoulders on the mattress. Your neck is completely unsupported. So putting a small soft pillow underneath your neck may give the muscles more support and help you sleep better,” she says. You can also purchase a special neck pillow if your neck pain at night is frequent.
Sore muscles can benefit from the gentle pressure of massage, which can be done at home by a willing partner—you can even massage yourself. “Soft tissue massage can have the effect [of easing pain short-term] but you need to be careful not to massage too hard and actually injure the muscles,” Dr. Fischer says.
There are also self-massaging products you can buy if you want to spend the cash; but again, make sure the pressure is not too forceful. Although massage has been shown to reduce neck pain temporarily, that research is usually based on professional massages.
Although it should be used under the supervision of a medical professional, a transcutaneous electrical nerve stimulation (TENS) device can be purchased without a prescription for use at home to treat pain.
TENS units deliver low voltage electric current to relieve pain. It’s a small box with electrodes and pads that are placed on the muscles that ache. “Different levels of stimulation are applied—various frequencies and intensities are dialed in for comfort,” Dr. Penhollow says. This stimulation blocks your perception of pain. For neck pain the most common electrode placements are over the neck, back, and shoulder muscles.
This non-invasive, painless therapy is recommended for neck pain by the American Physical Therapy Association in 2017 guidelines published in the Journal of Orthopaedic and Sports Physical Therapy. Check with your doctor if you have health conditions or an implantable electrical device like a pacemaker to make sure you can use TENS.
Any neck pain that doesn’t get better after a week or that is severe warrants a call to your doctor. In addition, “you should see a doctor for your neck pain if you get numbness in one or both of your arms associated with the pain, you lose strength in one or both of your arms [or legs], you have headaches, dizziness, or double vision, or you develop fever,” Dr. Fischer says.
If you have a sudden loss of bowel or bladder control, you should also call the doctor, Dr. Penhollow says. All of these other symptoms indicate something else might be going on other than regular neck pain.