Last updated: September 2019

Neck pain advice and exercises

Introduction

Neck pain is very common with most people experiencing it at some point in their lives. It usually improves within a few weeks/months, though some people may experience flare ups and others may have more persistent neck pain.

A key thing to remember is that the spine is a strong structure. It consists of bones, muscles, ligaments and discs which all work together. The spinal column consists of 24 bones (vertebrae) and is split into the cervical, thoracic and lumbar spine.

The vertebrae are connected by discs, ligaments and facet joints. Your muscles and discs act as ‘shock absorbers’ in the spine and, along with the facet joints, help to provide the spinal column with its flexibility. You also have nerves which exit from each level of the spinal column.

Changes within the spinal column are completely normal with the ageing process, and these changes will occur at different rates in different people – much like the appearance of grey hair and wrinkles will happen at different ages in different people!

Management

The most effective way to manage your neck pain is through exercise and consideration of posture.

Key Tips: For a Flare Up

• Keep moving! Avoid keeping your head still
• Avoid carrying bags on affected side
• Try using a backpack or a bag on wheels
• Consider sleeping position
• Stretch little & often daily
• Stay in work & resume normal activities
• Use painkillers, as advised by GP/pharmacist
• Use hot/cold packs; whichever is comfortable
• Try to stay positive

Key Tips: General

• Consider manual handling techniques
• Find a type of exercise that you enjoy and do this regularly
• Consider posture when sitting, standing and lying
• Avoid prolonged static postures – move little and often
• Complete a work station assessment
• Maintain a healthy weight
• Find effective ways to manage stress

You can find more information regarding the general management of neck pain via the following links:

• Chartered Society of Physiotherapy: www.csp.org.uk
• National Institute for Health & Care Excellence: Low Back Pain Guidance: www.nice.org.uk
• Arthritis Research UK: www.arthritisresearchuk.org

If you would like some more specific advice regarding your work duties/work station please email the Staff Physiotherapy Service and/or discuss it with your manager.

Posture

There is not a ‘one size fits all’ approach to posture. What is comfortable for one person may not be comfortable for another. The most important thing is to make sure that you are changing position and moving regularly during the day. Bodies do not like staying in the same position for a long time, no matter what that position is.

As an aim: try to change position every 20-30 minutes. This may just involve doing a couple of quick stretches.

Key Tips: Things to Consider

1. Break up your tasks: instead of doing the same activity for a couple of hours, mix your activities up so that you are not repeating the same movements or staying in the same position for too long
2. Go for regular short walks, even if this is only to the printer or to get a drink
3. Stretch regularly – find stretches that help you and do these little & often throughout the day
4. Avoid being in awkward postures e.g. twisted to the side
5. Avoid holding the phone between your ear and shoulder – consider use of a headset if you are on the phone a lot
6. Ensure you are using correct manual handling techniques when lifting or moving object
7. Make sure that your workstation is set up for you
8. Use the stairs instead of the lift
9. Take breaks if you drive long distances – the Highway Code recommends that drivers should take at least a 15 minute break every 2 hours.

If you are unsure whether your workstation is set up correctly for you or you continue to get pain, you may wish to consider asking your manager for an ergonomics assessment.

Exercises

N.B. You do not need to do all of these exercises. Find the ones that seem to help you and focus on these. Do as many repetitions as you feel able to, without working into high levels of pain. Download this leaflet for images to help you with the exercises.

Here are some exercises which may help you to manage your neck pain. It is beneficial to do a combination of flexibility & strengthening exercises. When doing exercises:

• Do them in a comfortable range
• Ensure you do them regularly – little & often through the day is ideal!
•  Try using heat prior to doing the exercises
• Progress them if they are becoming too easy (e.g. increase repetitions)
• Regress them if they are too difficult (e.g. decrease repetitions)
• Persevere! If you have had neck pain for a while, they won’t work overnight
• Expect to ache afterwards – this is normal and should ease fairly quickly

1. Stretching Exercises

• Tilt your head forward until you feel a gentle stretch. Hold 20-30 secs
• Tilt your head to each side until you feel a gentle stretch. Hold 20-30 secs.
• Turn your head until you feel a gentle stretch. Hold 20-30 secs.
• Bring your chin backwards, without tilting the chin down/up. Hold 5 secs.

2. Strengthening Exercises

• Lie down on your back. Press the back of your head down, whilst pulling your chin in. Hold 5 -7 secs.
• Lie on your front. Tuck your chin in and lift your forehead and nose 1cm up. Hold 3 secs.

When to Seek Help

You may want to seek help if you have tried the advice in this booklet and one or more of the following statements apply to you:

• Your pain doesn’t start to improve
• Your pain continues to stop you from doing day-to-day activities
• Your pain is very severe and is getting worse over time
• You’re worried about the pain or are struggling to cope

Symptoms to be aware of:

It is rare that your neck pain is due to a serious problem, but you should contact a doctor urgently if you experience any of these symptoms:

• Difficulty with speech or swallowing
• Blurred or double vision
• Tingling, numbness or weakness in your arms
• Fainting without known cause
• New onset of dizziness
• Vomiting, in relation to your neck pain

Key Messages

• Neck pain is common – it affects most people at some point
• Don’t be afraid of the pain – it is unlikely that it indicates serious damage
• Neck pain usually gets better quickly if you keep moving and use the ‘flare up’ advice
• Be proactive in the management of your neck pain – exercise regularly
• Remain at work or return to work as soon as possible, even if you have to request light duties
• Be aware of when to seek help, and do so accordingly

Further information

Visit the Chartered Society of Physiotherapy for more information about managing neck pain.