Self Care for Neck Pain and Stiffness

Why Your Neck Hurts

Why does my neck hurt? is a question many people ask.  Neck pain, like lower back pain is quite common in the adult population because, thanks to its natural design there are more opportunities for things to go wrong.  Of the three sections of the human spine– the cervical, thoracic and lumbar–the cervical spine is the most complex in design.  It is tasked with balancing the weight of the head over the body while enabling nearly 180 degree range of motion.  It is the only region of the spine that contains major blood vessels, the left and right vertebral arteries, which supply blood to the lower part of the brain.  And, the nerves that service your arms emanate from between your neck vertebrae.  Because of these functional requirements, nature designed the cervical spine to be thinner and more nimble; extra flexible, and strong enough to support the head.  It does a good job, but its design also subjects it to degeneration and breakdown.  

Your neck muscles work in close conjunction with your brain in order to position your head so that the axis of vision is where it is needed.  Thanks to the invention of video screens (laptops, tablets, smart phones, television and other video terminals) and the invention of chairs and desks, we position our head in an angle that takes the cervical spine out of its power position, which is directly over the thoracic spine and in its natural, lordotic curvature with chin level, head facing straight ahead, ears directly over shoulder tops, and eyes looking forward.  This flattens the lordotic curve, which functions as a weight and shock-absorbing spring, and alters the center of gravity of the head (which weighs 8-10 pounds in adults) so that it is forward of the thoracic spine.  The neck muscles tighten to counteract the weight of the head that the cervical lordosis normally absorbs, and the cervical discs get subject to excessive compression in this forward head position.  Over time, you develop forward head posture (FHP), the neck discs and joints degenerate and neck muscles lose their proper tone and responsiveness, setting the stage for pain.

Studies suggest that neck problems can be a source of headaches.   This class of headache is called cervicogenic headache, and may arise from obstructed nerves and/or blood vessels passing through the cervical spine and into the head and brain region.  There are anecdotal cases of neck problems causing sinus congestion, malocclusion/ TMJ pain; distorted vision, muffled hearing, and even mental fogginess.  It makes sense, due to the mechanical relationship/proximity between the neck structures and sensory organs inside the cranium.

Make sure to get evaluated by a doctor first to better understand and confirm the nature of your neck pain.  Neck pain may be due to serious conditions requiring immediate medical care which include, but are not limited to vertebral fractures, esophageal or tracheal disorders; anastomosis of blood vessels; advanced osteoporosis, syringomyelia and cancer.  Also, you should know if you have congenital malformations in your cervical spine because some physical rehabilitation methods may be contraindicated, and even dangerous for you.  Examples of cervical congenital malformations are fused cervical vetebrae and Chiari malformation.  Chiropractors and physical therapists know that these two conditions are contraindicated for neck manipulation.  This is why it is important for everyone to have a cervical neck X-ray before having their neck treated with any form of manual therapy.

Neck Pain Rehab Tutorial

This tutorial features self-care methods for general neck pain that is musculoskeletal in nature; that is, originates from muscle or joint problems.  If any procedure causes increased pain, stop immediately.   Always check with your doctor first to rule out any condition that requires medical attention.

Common musculoskeletal neck pain may be due to muscle strain related to poor posture or ergonomics; abnormal neck vertebra alignment and movement; a compressed intervertebral disc, ligament or facet joint, and degenerative joint disease.  The goal is to improve joint movement, posture and muscle coordination; reduce irritation to the soft tissues thereby reducing pain.

You will need an able-bodied partner for some of these procedures.

Apply infrared heat to your neck muscles for 20 minutes.  Infrared heat penetrates deep into your muscles, increasing blood circulation.

Do Neck Circles:  Relax your neck muscles and drop your head forward.  Slowly move your head in a clockwise direction.  Let the weight of your head stretch your neck muscles as you rotate.  Do ten clockwise, then reverse directions and do ten more.  Do once in the morning.

Sit in a chair, back straight.  Grasp the bottom left side of the chair with your left hand, and with your other hand gently pull down your head to the right side, to end range.  Hold for 5 seconds, relax and return to neutral.  Repeat 3 times; then switch sides.

Next, grasp the crown of your head and pull down in a 45 degree angle, forward, stretching the back of your neck.

Do the following stretch if you feel tightness on one side of your neck, limiting your ability to turn your neck to the opposite side. 

Here, we’ll demonstrate the stretch for problems turning your neck to the right. 

Recruit a partner.  Sit up straight in a chair, with your partner directly behind you.  Your partner holds the sides of your head with his hands as shown. 

Attempt to turn your neck to the right as your partner prevents you from doing it, but keep trying your hardest.  This is an isometric contraction of the neck muscles.  Maintain the contraction for 5 seconds, then relax. 

Your partner then does a few seconds of ice massage over the tight muscles, then passively stretches your neck to its maximum end range and holds for 5 seconds.

Next, turn your neck again to the right.  This time, your partner allows you to turn 20 degrees, then prevents you from turning any further.  Keep trying to turn your neck against the resistance for 5 seconds, then relax.

Your partner then does the brief ice massage and passively stretches your neck to its maximum end range, which should be greater at this point, and holds for 5 seconds.

Next, turn your neck to the right once again.  This time your partner allows you to turn 40 degrees before offering resistance.  Keep trying to turn your neck against the resistance for 5 seconds, then relax.

 Your partner does the ice massage and passively stretches your neck to its maximum end range, which should be increasing, and holds for 5 seconds.

 Lastly, repeat the procedure starting at 60 degrees rotation.  After this stretch you should have more range of motion to the problem side since starting.

Lie prone on a massage table.  Your partner applies massage cream or baby oil to the back of your neck.  Using one or both thumbs, press gently at the right side of the base of the skull at the hairline and slowly run thumb down along the spinous processes, staying close the spine as shown.  At the base of the neck, turn to the top of the shoulder, pressing deeper, until you to the end of the shoulder.  Do ten strokes; then do the left side.

Lie face up on a massage table, or bed.  Your partner is at your head.  He slides both hands underneath your head and neck until his fingertips are at the base of your neck.  Make sure fingernails are trimmed to avoid poking.  Using the tips of his index fingers, he presses firmly upwards with the right fingertip, then the left, repeating this pattern as he moves his hands segment by segment in the direction towards the head.  The force should be enough to raise the neck upwards.  When he gets to the hairline, return to the base of the neck and repeat.  Do 3 repetitions.

Next, your partner cradles your occiput by cupping his hands.   Fingertips should be at around the hairline.  Flex the wrist, pushing the neck upwards and causing head to arch backwards.  Hold this position for 10 seconds, then lower and rest for 10 seconds, then repeat 2 more times.

Next, cradle the back of the head and mobilize the cervical spine as shown.

Your partner then gets a hand towel and folds it length-wise until it is about 6 inches wide.  He wraps it around your neck with some slack, grips the sides and brings his hands closer together causing the towel to grip the back of your skull.  He then uses the towel to pull your head towards him.  This is traction and should feel like your neck is being decompressed.  Remember to leave enough slack so as to avoid choking. 

If it causes any pain, tell your partner immediately to release.  If not, hold the stretch for about 5 seconds.  Do just once per day.

Stand up erect.  Tuck your chin.  Focus on contracting your posterior neck muscles so that they pull your neck straight back as you maintain the chin tuck.  Do not arch back your neck; the top of your head should remain level.   Go back as far as you can, then hold the position for 3 seconds; return to neutral and repeat 10 times.

For stronger results, use the Amalgia 1 or OMI PowerBand to apply pulsed EMF to your neck muscles.  Pulsed EMF will help any areas of injury or dysfunction heal faster, whether you have a sprain strain, abnormal muscle spasm, or disc bulge.  Do 30 minutes at max setting, 2 to 3 times a day.

The PosturePump™ is a device that helps restore the natural curvature of your neck and helps rehydrate discs by separating them, lowering intradiscal pressure and drawing in fluids.  Start out with zero to 1 pump the first few days for 15 minutes twice a day.  Then, increase by 1-2 pumps each successive day until you get up to 8 pumps.  Do daily for 2 weeks, then twice a week for maintenance.