Your Neck Changes With Age
The top portion of your spine ,along with supporting structures, makes up the neck. The spine is a stack ofbones separated by cushioning disks made of cartilage. A hollow columnrunning through the middle contains the spinal cord. Small joints behind eachvertebra called facet joints connect each vertebral body to the vertebrae aboveand below.
The vertebrae are connected by ligaments and supported bymuscles. At each level of the spine, nerves leave the spinal cord throughopenings. From the cervical spine, they extend to the arms.
Over time, degenerative changes happen to these neckstructures in just about everyone. The disks between vertebrae can becomethinner. The facet joints can develop osteoarthritis, meaning the cartilagecovering the ends of the bones at the joints wears down. Bone spurs can form atthe edges of the vertebrae and ligaments can thicken.
These changes will be visible on an X-ray, but just becausewe can see them doesnt mean people feel them, Dr. DeMicco says.
These changes dont always cause symptoms, but sometimesthey do. In addition, an injury or added stress from poor posture or strainscan make you more likely to have symptoms than before you had thesedegenerative changes. This means its especially important to do the thingsthat will reduce stress on the neck.
Therapeutic Exercise For Neck Pain
Exercises to stretch and strengthen the neck, shoulder, and upper back muscles can speed recovery from a painful neck condition and possibly reduce flare-ups, although the evidence for this is not ironclad. Dr. Shmerling encourages his patients to see a physical therapist for guided therapeutic exercise. Here is what the therapist can offer:
- Therapy will likely combine isometric and range-of-motion exercises. In isometric exercise, you tighten the neck muscles against an opposing forcesuch as your own hand, which you “push against” with your neck muscles. Range-of-motion stretches attempt to progressively relax and lengthen the neck muscles.
- Physical therapists can offer other therapies that, while not proven in research trials, seem to offer some people ease and comfort. One option is ultrasound treatment of the sore tissues with high-frequency sound waves.
- A physical therapist can also perform traction, using the hands or special equipment to gently stretch the neck muscles. You can also get equipment by prescription to perform neck traction at home but follow the therapist’s instructions carefully.
Finally, take inventory of your posture or daily habits that could trigger neck pain, like sitting for extended periods in positions that strain the neck during reading, TV watching, computer work, or sleeping. Attending to the cause may stop some flare-ups of neck pain at the source.
What Are The Most Common Nonsurgical Treatments For Neck Pain
If you are experiencing chronic pain , it is important to seek medical attention for further evaluation and treatment. Treatments for neck pain vary, depending on the cause and duration of the neck pain you are experiencing. Many neck pain patients find relief in using one or a combination of these therapies. The most common treatments include:
Medications: Both over-the-counter and prescription medications may help manage neck pain, reduce inflammation, and decrease muscle spasm and sleep disturbance. The first line of treatment when it comes to neck pain medication is typically non-steroidal anti-inflammatory medications , such as ibuprofen and naproxen, and acetaminophen . Some NSAIDS can be applied topically to the skin, such as Voltaren Gel and Aspercreme other topical treatments include Icy-Hot, lidocaine based patches, and CBD creams/ointments.
Prescription medications such as muscle relaxers and nerve pain medications are sometimes considered, says Dr. Bonte. Muscle relaxants are used more often for acute pain rather than chronic pain.
For those with neuropathic neck pain, injections including a steroid and pain reliever may be effective, especially if done in conjunction with physical therapy. Ablation of the nerves near the neck joints may improve mobility and reduce pain, too.
Complementary therapies:Alternative treatments may be helpful in managing neck pain. Some of the more popular complementary therapies for treating neck pain include:
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When To Contact A Medical Professional
Seek medical help right away if you have:
- A fever and headache, and your neck is so stiff that you cannot touch your chin to your chest. This may be meningitis. Call 911 or the local emergency number or get to a hospital.
- Symptoms of a heart attack, such as shortness of breath, sweating, nausea, vomiting, or arm or jaw pain.
- Symptoms do not go away in 1 week with self-care
- You have numbness, tingling, or weakness in your arm or hand
- Your neck pain was caused by a fall, blow, or injury — if you cannot move your arm or hand, have someone call 911 or the local emergency number
- You have swollen glands or a lump in your neck
- Your pain does not go away with regular doses of over-the-counter pain medicine
- You have difficulty swallowing or breathing along with the neck pain
- The pain gets worse when you lie down or wakes you up at night
- Your pain is so severe that you cannot get comfortable
- You lose control over urination or bowel movements
- You have trouble walking and balancing
Don’t Wait For The Pain To Go Away
If you develop neck pain, you may feel that if you simply wait, the pain will disappear just as suddenly as it appeared. While this may occasionally be true, there are some things that you should to do help make the pain go away when neck pain strikes.
Check-in with your healthcare provider to get an accurate diagnosis and get started on treatment. Most neck pain requires little more than postural correction and exercises, so no need to worry about invasive procedures like injections or surgery
A visit to your physical therapist to learn the proper exercises to initiate can help you rapidly return to your previous pain-free lifestyle. Your physical therapist will also teach you strategies to keep the pain from coming back so you maintain control.
What Is Neck Pain
Neck pain is pain in or around the spine beneath your head, known as the cervical spine. Neck pain is a common symptom of many different injuries and medical conditions.
You might have axial neck pain or radicular neck pain . It can be acute or chronic .
Neck pain can interfere with daily activities and reduce your quality of life if left untreated.
Other Causes Of Neck Pain When You Wake Up
There are certainly other causes that can also contribute to you waking up with neck pain. In some cases, you may develop a sore neck during the day, too. Some common causes of neck pain include:
- poor posture during the day
- working too long at a computer, or watching television for too long without changing positions
- osteoarthritis in one of the upper spinal joints
- nerve compression caused by a herniated disk or bone spur in your neck
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Using Heat And Ice Packs
Applying a heat pack to your neck can help to ease pain. You can use a microwavable wheat bag, a hot-water bottle or a reusable heat pad which you can buy from chemists and sports shops. An ice pack, or even a bag of frozen peas, can also be helpful.
Make sure you wrap heat or ice packs in a towel and dont put them directly onto your neck to avoid burning or irritating your skin. You might want to consider applying a heat pack to your neck before and after exercise to help soothe the muscles.
When To See Your Doctor
See your doctor if you have neck pain that is not relieved by the self-care tips above, or if it continues or worsens after exercising.
Some conditions, such as arthritis, nerve or disc problems, lymph node inflammation or bone disorders require assessment and treatment by a doctor.
Call Healthline if you are unsure what you should do.
If you have flu-like symptoms along with a stiff painful neck and difficulty bending your head forward, call your doctor immediately.
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Is It Something More Serious
If neck pain is severe, lasts for weeks or months, drastically limits your ability to move your head, radiates into the shoulders, or feels worse in the morning, consider seeing a doctor. Fever or weakness or numbness in the arms are other “red flags” that warrant additional evaluation. In some cases, an underlying physical problem, such as arthritis, an infection, or a compressed nerve, may be the cause. Depending on the diagnosis, you may need additional treatments or even surgery to relieve the pain and get back to your normal activities.
Simple neck stretch
Look straight ahead. Tuck your chin in slightly and move your head backward, slowly and smoothly. Be sure to keep your head level you should be gliding your head backward, not bending or tipping it. Hold for five seconds. Repeat five times.
Additional exercises for neck pain are available in Neck Pain: A troubleshooting guide to help you find relief, a Special Health Report from Harvard Medical School. /NK
Illustrations: Alayna Paquette
Exercises To Help Neck Pain
The goal of exercises for neck pain is to relieve tense muscles and improve your range of motion. A stiff and sore neck can make it hard to turn your head or engage in physical activity. These exercises focus on deliberate stretches and motions to reduce pain and tension without injury.
One of the simplest motions you can do to relieve neck pain is nodding. The goal for this stretch is to keep your shoulders straight. This helps you actually stretch your neck muscles instead of compensating with other muscles.
Step 1: Sit or stand with an upright posture, and your shoulders relaxed. Look straight ahead.
Step 2: Slowly look down, lowering your chin towards your chest. Stop when you feel a gentle stretch in your neck and hold the position for up to thirty seconds.
Step 3: Slowly return your head to a neutral position.
Repeat this three to five times a day, or whenever you feel neck tension.
Side to Side Tilts
This exercise helps stretch the muscles on the sides of your neck, relieving muscle tension, and helping reduce pain.
Step 1: Sit or stand with good posture and look straight ahead.
Step 2: Gently lean your head to the left, aiming your left ear at your shoulder. Hold this position for up to thirty seconds, then return your head to neutral.
Step 3: Repeat on your right side.
Side to Side Rotations
If your neck is stiff and it’s difficult to look to the side, this is a useful exercise to regain your range of motion.
Step 3: Return to a neutral position.
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Efficacy Of Physical Therapy
Many studies have examined whether or not physical therapy can help reduce spine-related pain, such as in the lower back or neck.1 Current medical literature suggests moderate to strong evidence supporting the benefits of physical therapys role in reducing neck pain and improving range of motion.2–5 Some studies have found even more benefits from physical therapy when combined with other treatment methods, such as aerobic activity.6
One of the challenges with collecting good data about physical therapys effectiveness or lack thereof is that it is hard to measure how well a person follows the prescribed program. For example, a person may do exercises with poor form or not as often as directed, which can reduce the chances of the treatment working.
Signs And Symptoms Of Neck Pain
Neck pain may be characterized by the following symptoms:
- Persistent aching
- Tenderness or sensitivity to mild pressure
- Pain that gets worse when you hold your head in one place for a while
- Muscle tightness or spasms
Neck pain can be axial or radicular . It may be accompanied by a headache, or by numbness or tingling in one or both arms.
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What Are The Common Symptoms
Occipital neuralgia can cause intense pain that feels like a sharp, jabbing, electric shock in the back of the head and neck. Other symptoms include:
Aching, burning, and throbbing pain that typically starts at the base of the head and goes to the scalp
Pain on one or both sides of the head
Crick in neck.
Pain when you move your neck
What Treatments Are Available
Healing begins with self-care and nonsurgical strategies . The goal is to correct the problem, restore function, and prevent re-injury.
Self care: Neck pain often resolves with rest, ice or heat, massage, pain relievers, and gentle stretches. Reduce muscle inflammation and pain using an ice pack for 20 minutes several times a day during the first 48 to 72 hours. Thereafter, a warm shower or heating pad on low setting may be added to relax the muscles. A short period of bed rest is okay, but more than a couple of days does more harm than good. If self-care treatments aren’t working within the first couple of days, see your doctor.
Medications: Many people get pain relief with over-the-counter nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen or naproxen. A muscle relaxant may be prescribed for spasms. If pain is severe, an analgesic may be prescribed that can be taken with the NSAID or muscle relaxant.
Steroids can reduce the swelling and inflammation of the nerves. They are taken orally as a Medrol dose pack tapered over a five-day period or by an injection directly into the pain source . Steroids may provide immediate pain relief within 24-hours.
Surgery: Surgery is rarely needed unless you have muscle weakness, a proven disc herniation, cervical cord compression, problems with balance and coordination, or severe pain that does not resolve after a reasonable course of nonsurgical treatment.
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Dont Drive For Long Periods At A Time
Just like sitting at your desk all day, sitting behind the wheel of your car can affect your neck. If you have to drive for long periods, here are some tips for preventing a stiff neck:
- Take breaks to stand up and stretch.
- Set an alarm to remind you to check your posture while driving.
- Set your seat in a position that provides you the most support and puts you in good posture.
- Dont text and drive. Its illegal, dangerous, and bad for your neck to be repetitively looking up and down from your phone to the road.
Key Points About Back And Neck Pain
- Back and neck problems range from minor aches to severe, disabling pain.
- Often, the reason for your pain can’t be found.
- See a healthcare provider if you have numbness or tingling, severe pain that does not improve with medicine and rest, trouble urinating, weakness, pain, or numbness in your legs, fever, unintentional weight loss, or pain after a fall.
- Often, back and neck pain will improve over time. See your healthcare provider if your pain is not decreasing.
- Use prevention strategies to keep yourself healthy and injury-free.
- For severe, disabling, or chronic back pain, consider an individualized rehabilitation program.
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Give Gua Sha A Chance
Gua sha typically involves having a trained practitioner use a spoon to apply short strokes down the skin of the painful area. Gua sha is from Chinese Traditional Medicine, and its applied to areas of the body where blood circulation is believed to be stagnant and blocking energy . While there is no scientific evidence for qi, some people have reported neck pain relief from gua sha. One small study found gua sha to relieve neck pain more than heat therapy,3 but not all studies agree and more research is needed.4
When performed by a trained professional who uses sterile equipment, gua sha is generally considered safe. This treatment should not be applied to damaged or thinning skin. Also, as part of normal gua sha strokes across the skin, tiny capillaries break and cause petechiae to form, which might be misinterpreted by others as a rash or bruising from abuse. The petechiae typically clear up within a few days.
Swimming is a great low-impact exercise for many people who have neck or back pain. Being in the water adds buoyancy, which means less stress on the spine. Depending on the cause of your neck pain, consult with your doctor or physical therapist regarding which swim strokes may need to be avoided or modified.
Be Careful When Managing Pain
The natural painkillers described above may only be effective for specific causes of pain. Its possible that not all of the suggestions on this list will work for you. However, these natural alternatives to prescription or OTC medications may at least give you some decent options to try before you turn to pharmacological solutions.
Remember, pain is the bodys signal that something is wrong. It may be temporary, as with a strained muscle. But pain can also mean you have a serious health problem that needs professional medical evaluation. Dont hesitate to seek out a healthcare provider to diagnose the source of your pain, and discuss some natural options for treating it.
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Sleep On Your Back If You Can
In general, sleeping on your back is the best position to let your entire spine rest comfortably. Some people with neck problems find it helps to sleep on their back and place a pillow under each arm, with the idea that supporting each arm takes strain off the neck.
Some people with spinal arthritis or stenosis may find that sleeping at a slight incline is easier, so they add a foam wedge pillow to their bed and/or switch to an adjustable bed.