NECK PAIN PREVENTION
BY LAKE COUNTY
PHYSICAL THERAPY,
LLC
GET RID OF NECK PAIN
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T ERMS O F U SE A GREEMENT
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T ABLE
OF
C ONTENTS
Chapter One ............................................................................................. 5
What Is Neck Pain? .................................................................................... 5
Chapter Two ............................................................................................. 8
What are The Symptoms?.......................................................................... 8
Chapter Three ........................................................................................ 10
How Is Neck Pain Diagnosed? ................................................................... 10
Chapter Four .......................................................................................... 11
Can You Prevent Neck Pain?..................................................................... 11
Chapter Five ........................................................................................... 12
Stretch Your Neck Muscles ....................................................................... 12
Chapter Six ............................................................................................. 14
Office Ergonomics .................................................................................... 14
Chapter Seven ....................................................................................... 15
Muscle Relaxation Exercises ...................................................................... 15
Chapter Eight ......................................................................................... 17
What Happens With Neck Pain? ................................................................. 17
Chapter Nine .......................................................................................... 18
What Increases Your Risk?........................................................................ 18
Chapter Ten ............................................................................................ 19
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Who Can Diagonose Neck Pain? ................................................................. 19
Chapter Eleven ...................................................................................... 21
How Is It Diagnosed? .............................................................................. 21
Chapter Twelve ...................................................................................... 24
How Is Neck Pain Treated? ....................................................................... 24
Chapter Thirteen ................................................................................... 26
What Other Treatments Are There?............................................................ 26
Chapter Fourteen .................................................................................. 27
What Medicine Will I need? ...................................................................... 27
Chapter Fifteen ..................................................................................... 28
Will I Need Surgery? ............................................................................... 28
Chapter Sixteen ..................................................................................... 30
What Can I Do To Treat Neck Pain At Home? .............................................. 30
Chapter Seventeen ............................................................................... 32
When Should I Call My Doctor? ................................................................. 32
Chapter Eighteen .................................................................................. 34
What Exercise Can Prevent And Treat Neck Pain ? ...................................... 34
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C HAPTER O NE
WHAT IS NECK PAIN?
Neck pain can happen anywhere in your neck, from the bottom of your head to the
top of your shoulders. It can spread to your upper back or arms. It might limit how
much you can move your head and neck.
Neck pain is common, especially in people older than fifty.
hat causes neck pain?
Most neck pain is caused by activities that strain the neck. Slouching, painting a
ceiling, or sleeping with your neck twisted is some things that can cause neck pain.
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These kinds of activities can lead to neck strain, a spasm of the neck muscles, or
swelling of the neck joints.
Neck pain can also be caused by an injury. A fall from a ladder or whiplash from a
car accident can cause neck pain. Some less common medical problems can also
lead to neck pain, such as:
n infection in the neck.
arrowing of the spinal canal in the neck (cervical spinal stenosis).
heumatoid arthritis.
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C HAPTER T WO
WHAT ARE THE SYMPTOMS?
You might feel a knot, stiffness, or severe pain in your neck. The pain might spread
to your shoulders, upper back, or arms. You might get a headache. You might not
be able to move or turn your head and neck easily. If there is pressure on a spinal
nerve root, you might have pain that shoots down your arm. You might also have
numbness, tingling, or weakness in your arm.
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haracteristics of neck pain include:
ain that happens from the bottom of your head to the top of your shoulders.
Pain might spread to the upper back or arms.
ain that worsens with movement.
imited head and neck movement. The neck might be stiff or tender.
eadaches. These are common and might persist for months.
erve-related symptoms caused by pressure on the spinal nerve roots or
spinal cord are:
umbness, weakness or tingling in the arm or hand.
burning feeling when touching the skin of the arm or hand.
pain that feels like a shock and extends into the arm or hand.
eg weakness or numbness, and loss of the ability to control the bladder or
bowel.. This happens when there is considerable pressure or injury to the
spinal cord.
If your neck pain is long-lasting (chronic), it might be difficult to cope with daily life.
Typical side effects of chronic pain are: fatigue, depression, and anxiety.
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C HAPTER T HREE
HOW IS NECK PAIN DIAGNOSED?
Your doctor will question you about your symptoms and do a physical examination.
He or she might also ask you about any injuries, illnesses, or activities that might
have caused your neck pain.
During the physical examination, your doctor will check how well you are able to
move your neck. He or she will also check for tenderness or numbness, tingling, or
weakness in your arms or hands.
If your pain started after an injury, or if it doesn't improve after a few weeks, your
doctor might want to do even more tests. Imaging tests such as an X-ray, an MRI
scan, or a CT scan can show the neck muscles and tissues. These tests might be
done to check the neck bones, spinal discs, spinal nerve roots, and spinal cord.
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C HAPTER F OUR
CAN YOU PREVENT NECK PAIN?
ou can avoid neck pain caused by stress or muscle strain modifying a few
harmful habits. Avoid spending a lot of time in positions that stress your neck.
This includes not sitting at a computer for long periods.
f your neck pain becomes worse by the end of the day, think about how you
often sit during the day. Sit straight up in your chair with feet flat on the floor.
Take short breaks several times each hour.
f your neck pain is at its worse in the morning, check your pillow and your
sleeping position. Use pillows that keep your neck straight. Avoid sleeping on
your tummy with your neck bent or twisted.
hen you read in bed, prop up the book so you do not use your arms to raise it
and bend your neck forward. Think about using wedge-shaped pillows to support
your arms and to keep your neck in a neutral position.
f stress is one cause to your neck pain, practice exercises for muscle relaxation.
Consider having a massage. Protect and strengthen your neck by doing neck
exercises at least once a day.
You can help also to prevent neck pain by keeping at a healthy body weight.
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C HAPTER F IVE
STRETCH YOUR NECK MUSCLES
These exercises should help you feel a gentle stretch, but no pain.
eck stretch
his stretch works the best if you keep your shoulder down as you lean away
from it. To help you to remember this, start by relaxing your shoulders and
lightly holding on to your thighs or your chair.
ilt your head towards your shoulder and hold for fifteen to thirty seconds.
f you would like to do a little added stretch, use your hand to gently and
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steadily pull your head in the direction of your shoulder. For example, keep
your right shoulder down, and lean your head to the left. Allow the weight of
your head to stretch your muscles, or use your left hand to pull gently down
on your head.
epeat two to four times towards each shoulder.
iagonal neck stretch
urn your head slightly towards the direction you will be stretching, and tilt
your head diagonally towards your chest and hold for fifteen to thirty
seconds.
f you would like a little added stretch, use your hand to gently and steadily
pull your head forward on the diagonal.
epeat two to four times towards each side.
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C HAPTER S IX
OFFICE ERGONOMICS
Most injuries that happen at work are caused by physical stress or strain, such as
sitting in the same position for long times, making repetitive movements, and
overuse. These activities can cause stress and strain on your muscles, tendons,
nerves, joints, blood vessels and spine.
ymptoms can include pain in your:
ack.
and, wrist, or arms.
eck and shoulders.
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You might also be at risk for problems such as tendinopathy and bursitis, which are
caused by overuse and repetitive movements. Over time, these kinds of
movements can make you feel bad. They can be the cause of long-term health
problems; also they use up your sick time.
You might be at greater risk for injuries at your work if you have other health
problems, such as arthritis or emotional stress.
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C HAPTER S EVEN
MUSCLE RELAXATION EXERCISES
Certain body muscle relaxation exercises and breathing exercises help to reduce
stress.
Practice relaxation exercises ten to twenty minutes a day.
ell others in your home that you are going to practice your relaxation exercises,
and ask them not to disturb you.
o your exercises in a comfortable place, away from distractions and noise.
ie down on your back or sit up with your back straight.
oncentrate on your breathing. Make it slow and steady.
nhale through your nose. Exhale through either your nose or mouth.
reathe deeply, filling up the area between your navel and your rib cage. Do not
breathe with your chest.
on’t hold your breath.
ontinue this pattern of breathing for five to ten minutes. Notice the calm feeling
throughout your whole body.
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s you continue breathing slowly and deeply, relax by doing the following for
another five to ten minutes:
ighten and then relax each muscle in your body. You can start at your toes and
work your way up to your head.
magine your muscle groups relaxing and becoming heavy.
mpty your mind of all thoughts.
llow yourself to relax more and more deeply.
ecome aware of the state of calmness that surrounds you.
When your time is over, bring yourself back to alertness by moving your fingers
and toes, next your hands and feet, stretching and moving your entire body.
Sometimes people fall asleep during relaxation; but they usually wake up shortly
afterwards.
During relaxation, you could play soothing, relaxing music.
Always give yourself sufficient time to return to full alertness before you drive your
car or do any other activities that might cause accidents if you are not fully alert.
Never play relaxation tapes while driving a car.
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C HAPTER E IGHT
WHAT HAPPENS WITH NECK PAIN?
Most cases of neck pain that are caused by activities, such as computer use or
sleeping position, improve within four to six weeks with treatment that includes
taking steps to relieve pain, modifying activities, and doing exercises or physical
therapy.
Neck pain caused by injuries, such as falls resulting in a herniated disc, usually
improves within 3 months without surgical treatment. Neck pain caused by an
injury such as whiplash might take longer but usually improves within six to twelve
months with only occasional recurring pain.
Neck pain might become long-lasting (chronic) when it happens in combination with
some other health conditions, such as conditions that go with increasing age. These
include narrowing of the spinal canal (cervical spinal stenosis) and arthritis of the
neck (cervical spondylosis). In some cases, chronic neck pain can result from
repeated and prolonged movements, such as very long hours working at a
computer.
Chronic neck pain might result in increased fatigue, irritability, and sleep
disturbances and poor quality of life. If treatment fails, neck pain might lead to
depression, chronic pain syndrome, or drug dependence
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C HAPTER N INE
WHAT INCREASES YOUR RISK?
isk factors for neck pain that you cannot control include:
ge.
People
older
than
fifty
are
more
likely
to
have
a
breakdown
(degeneration) of discs or joints, as well as bone spurs in the neck vertebrae
(cervical spondylosis).
ecent injury or a history of injury. A common injury to the neck is whiplash
caused by a car accident.
onditions that affect the bones and soft tissues of the neck and back, such as
rheumatoid arthritis, a narrowing of the spinal canal (cervical spinal
stenosis), or a severely curved spine (scoliosis).
history of having headaches.
isk factors that you can control include:
wkward positions that put stress on the neck.
tress and poor posture, at home or at work.
eavy physical work.
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oredom at or unhappiness with work.
epression.
moking.
rug abuse.
oor physical condition and lack of exercise.
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C HAPTER T EN
WHO CAN DIAGNOSE NECK PAIN?
ealth professionals who can assess and treat neck pain include:
mergency medicine doctors.
rimary care providers. This includes:
nternists.
amily medicine doctors.
urse practitioners.
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hysician assistants.
f your neck pain is severe or long-lasting, health professionals who can
treat you include:
hysical therapists.
rthopedists.
heumatologists.
eurologists.
steopathic doctors.
hysiatrists.
lternative health professionals who can provide care include:
cupuncturists.
ertified massage therapists.
hiropractors.
We can help you with the above exercises. Contact us to learn more.
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C HAPTER E LEVEN
HOW IS IT DIAGNOSED?
Examinations and Tests
nitial testing
Neck pain is usually assessed by a medical history and physical examination.
Your doctor will ask you about your symptoms, injuries or illnesses, any
previous treatments, and any habits and activities that might be causing your
neck pain. During the physical examination, your doctor will assess your
neck's range of motion and check for pain caused by movement. He or she
will look for areas of tenderness and any nerve-related changes, such as
numbness, weakness or tingling in the arm or hand.
Blood tests might be done to check for an illness or infection.
If you have no signs of a serious condition or recent injury, imaging tests,
such as X-rays, might not be needed at first.
maging, electromyogram, and nerve conduction tests
If, after a period of treatment, your neck pain doesn’t improve, you might
need imaging tests, particularly when:
 You have signs of nerve damage.
 Another, different serious problem is suspected.
 Neck pain is chronic (lasting more than a few weeks) and has not
improved with treatment.
 The cause of your condition cannot be clearly identified.
 Your doctor is asked to provide documentation about your condition, such
as when legal or compensation issues arise from a neck injury.
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In some cases, imaging test results do not agree with symptoms or the findings of
a physical examination. For example, test results might be normal, yet you might
have severe symptoms. But imaging tests usually provide useful information and
are frequently used. Imaging tests that might be used to assess neck pain include:
 X-rays, which help to evaluate the bones and joints of the neck.
 Magnetic resonance imaging (MRI), which helps to evaluate the spinal
cord and nerve roots. MRI is useful for identifying a herniated disc and
nerve root impingement (pinched nerve).
 Computed Tomography (CT) scan, which helps to evaluate the bone and
spinal canal
 Myelogram, which can provide further detail of the spinal canal and nerve
roots.
Tests that are done to check the spinal cord and nerves in the neck include
electromyogram and nerve conduction studies. These tests can help identify the
location and nature of a nerve problem that is causing pain, numbness, or
weakness in the arm or hand.
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C HAPTER T WELVE
HOW IS NECK PAIN TREATED?
Treatment for neck pain is generally by reducing the pain with ice and medicine,
improving neck movement and flexibility with exercises or physical therapy, and by
avoiding further neck injury by changing your activities and body mechanics, such
as how you sit or sleep. The specific treatment might depend on whether your neck
pain is caused by activities, an injury, or another medical condition. Home
treatment is often all that is needed for neck pain.
Because most neck pain is caused by repeated or prolonged movements to the
neck's muscles, ligaments, tendons, bones, or joints, nonsurgical treatment is
usually effective. Most cases of neck pain that are caused by activities are resolved
within four to six weeks.
Acute neck pain
or sudden (acute) neck pain:
ut an ice pack or cold pack over painful muscles for forty eight to seventy
two hours. This will help to reduce any pain, muscle spasm, or swelling. If
the problem is near the shoulder or upper back, apply ice to the back of the
neck. If you prefer, try an ice massage. Massage the painful place with ice for
seven to ten minutes; that should be long enough to numb the pain. Ice
frozen in a paper cup works fine. Make sure you do not damage your skin
(frostbite).
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void anything that might increase swelling, such as hot showers, hot tubs,
hot packs, or alcoholic drinks, for the first forty eight hours after an injury.
After forty eight to seventy two hours, if the swelling has gone, apply heat.
Use a warm pack or a heating pad set on low. Some experts recommend
alternating between heat and cold treatments.
eturn to your normal daily activities as soon as possible. Research suggests
that continuing normal activities after neck-strain injuries helps to end some
symptoms faster than taking time off work and using neck immobilization.
ently massage or rub the place to relieve pain and encourage more blood
flow. Do not massage the injured place if it causes pain. Nonprescription
creams or gels, such as Bengay, should provide pain relief.
ake pain relievers. Acetaminophen (e.g. Tylenol) should help to relieve pain.
Nonsteroidal anti-inflammatory drugs, including aspirin (such as Bayer),
ibuprofen (such as Advil), or naproxen sodium (such as Aleve), should help
to relieve pain and reduce inflammation. Do not give aspirin to anyone
younger than twenty years because of the risk of Reye syndrome (Brain
damage).
or severe pain or muscle spasm, your doctor also might prescribe:
uscle relaxants that treat severe pain spasms when neck pain starts. They
include diazepam (such as Valium), cyclobenzaprine (such as Flexeril), and
carisoprodol (such as Soma).
arcotic pain relievers that are used short-term for severe neck pain. They
include codeine, acetaminophen and hydrocodone (such as Vicodin, Lortab),
aspirin and oxycodone (such as Percodan), and acetaminophen and
oxycodone (such as Percocet).
The treatment that is right for you might be not the same as the treatment for
somebody else with neck pain. Some treatments have been studied more than
others. Many treatments for neck pain haven't been so well researched, even if
they are used a lot. A review of studies shows that exercise and manual therapy,
used either separately or together, are likely to be beneficial in the treatment of
uncomplicated neck pain.
Your doctor might recommend you to wear a cervical collar to support your neck.
Cervical collars might reduce neck pain, but they should only be used for a day or
two.
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Chronic neck pain
For long-lasting (chronic) neck pain, you can use the same treatments used for
acute pain, but you do not have to worry about swelling. Your doctor might
prescribe other medicines, such as antidepressants. These include doxepin (such as
Sinequan) and amitriptyline.
You can help healing and prevent further injury by:
aving physical therapy. For home treatment, you can use heat and massage.
A physical therapist can teach you exercises to do at home. These can keep
your neck flexible and strong and prevent stiffness. Schedule an evaluation
with us so we can help you with these exercises.
hanging or avoiding any activities that might be causing your neck pain, such
as prolonged computer work or overhead work.
aintaining good health habits. If possible, reduce the stress and tension at
work and home. Stop smoking. Smoking slows healing because it decreases
blood supply and delays tissue repair. Exercise regularly, including aerobic
exercise such as walking.
rying manual therapy. A trained practitioner might use slow twisting, pulling,
or pushing movements. When slow, measured movements are used, it is
known as "mobilization." Avoid rapid, forceful movements, which are known
as "manipulation." Talk to your doctor before trying manual therapy.
urgery
Surgery is rarely required for neck pain. It might be considered to treat neck pain
caused by pressure on the nerve roots or spinal cord , a severe injury that has
broken a neck bone (vertebra), a tumor, infection, or a spinal condition such as
narrowing of the spinal canal (cervical spinal stenosis) or arthritis of the neck
(cervical spondylosis). Surgical options include:
iscectomy (with or without fusion)
ervical spinal fusion, in which selected bones in the neck are joined (fused)
together.
pinal decompression, in which pressure is reduced on the spinal cord or
spinal nerve roots by removing part of a bone or disc.
What to Think About
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review of studies, reports that:
xercise-reduced pain is better than medicine for muscle pain or spasm, stress
management, or no exercise.
here is not enough evidence to be sure whether medicines, transcutaneous
electrical nerve stimulation (TENS), ice and heat, soft cervical collars, or
special pillows are helpful for neck pain.
In one small study, women with chronic neck pain were taught and used neck
endurance and strengthening exercises for one year. Compared with people who
had chronic neck pain but were not using the exercises, the exercise group had less
pain and disability.
Keeping your neck moving improves its function and helps it to heal. In general,
cervical collars are only used after surgery or for a day or two after a neck sprain.
People who have chronic pain syndrome and its linked problems, such as
depression or drug dependence, might respond to treatment more slowly.
Counseling in addition to medical treatment might help in recovery.
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C HAPTER T HIRTEEN
WHAT OTHER TREATMENTS ARE THERE?
Other types of treatment for neck pain might help relieve your symptoms, restore
movement, and strengthen the muscles around your spine to help prevent further
injury.
Other Treatment Choices
ther types of treatment are:
hysical therapy. At home, you can use heat and massage to improve blood
flow. A physical therapist can teach you stretching and strengthening
exercises that you can also do at home. Physical therapy can also include
treatments
like
heat
therapy
to
improve
blood
circulation
we can help you with these home exercises.
ervical (neck) collars, which might be used for a short time to help to reduce
pain by restricting neck movement.
raction, a technique used to stretch the neck and relax the spinal nerve root
openings. This might be used if there is no risk of instability in the neck.
omplementary and alternative treatments
Complementary and alternative treatments are sometimes used to relieve pain and
restore neck mobility. They include:
anual therapy, such as that found in massage and physical therapy and in
chiropractic and osteopathic treatments. The goals of manual therapy include
relaxation, decreased pain, and increased flexibility.
oga, a program of exercises to help improve flexibility and breathing,
decrease stress, and maintain health. The basic components of yoga are
proper breathing and posture.
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cupuncture, which is done by inserting very thin needles into the skin.
Acupuncture is used to relieve pain and to treat many health conditions.
hat To Think About
Although the effectiveness of some of these treatments has not been proved, they
seem to be helpful for some people and might relieve stress and improve quality of
life.
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C HAPTER F OURTEEN
WHAT MEDICINE WILL I NEED?
Medicines can relieve neck pain and reduce inflammation of the soft tissues. Pain
relief will allow you to move your neck gently, so you can start easy exercises and
kick off the healing process.
Although pain relievers, muscle relaxants, and antidepressants are frequently used
for neck pain, none of them are well-proven treatments.2
onprescription pain relievers include:
reams or gels, such as Bengay, which are rubbed into the neck.
cetaminophen, such as Tylenol, which reduces pain.
onsteroidal anti-inflammatory drugs, including aspirin (such as Bayer),
ibuprofen (such as Advil), or naproxen sodium (such as Aleve), that can help
relieve pain and reduce inflammation. Do not give aspirin to anyone
younger than twenty years because of the risk of Reye syndrome.(Brain
damage)
rescription pain relievers include:
uscle relaxants, which are used to treat severe neck pain and spasms when
neck pain begins (acute neck pain). They include diazepam (such as Valium),
cyclobenzaprine (such as Flexeril), and carisoprodol (such as Soma).
arcotic pain relievers, which are used to treat severe short-term (acute) neck
pain. They include codeine, acetaminophen and hydrocodone (such as
Vicodin, Lortab), aspirin and oxycodone (such as Percodan), and
acetaminophen and oxycodone (such as Percocet).
ntidepressants, which are used to treat long-lasting (chronic) pain. They
include doxepin (such as Sinequan) and amitriptyline.
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C HAPTER F IFTEEN
WILL I NEED SURGERY?
Surgery is not necessary for most cases of neck pain, which are typically caused by
repeated or prolonged movements to the neck's muscles, ligaments, tendons,
bones, or joints.
urgery might be considered when neck pain is caused by:
raumatic injury to the neck that results in a fracture or abnormal motion
(instability). Surgery might be done to stabilize the spine and prevent a bone
fracture from causing instability and possible paralysis.
ressure on the spinal nerve roots or spinal cord that results in pain,
numbness, or arm, hand, or leg weakness, or that causes severe pain that
persists for months despite treatment, or that causes loss of bladder or
bowel control.
arrowing of the spinal canal (cervical spinal stenosis) or arthritis of the neck
(cervical spondylosis).
urgical options
Surgery is used to treat neck pain caused by pressure on the nerve roots or by
injury or illness include:
iscectomy (with or without fusion)
ervical spinal fusion, in which selected bones in the neck are joined (fused)
together.
pinal decompression, in which pressure is reduced on the spinal cord or
spinal nerve roots by removing part of a bone or disc.
isc replacement with an artificial disc. Some people can consider this surgery
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instead of spinal fusion. Disc replacement surgery removes a spinal disc that
is severely damaged and then replaces it with an artificial disc. This surgery
is currently only for carefully selected patients, and it is done by specially
trained surgeons. Doctors have not yet done long-term studies to know how
well this works over time.
hings to consider
Surgery that is done to relieve neck pain caused by pressure on the nerve roots
(especially from a herniated disc) is successful in relieving pain 80% to 90% of the
time.
A minor surgical technique called percutaneous radiofrequency neurotomy has been
used for some people with chronic facet joint pain. The facet joint is a portion of the
spine in the neck that is sometimes responsible for neck pain after whiplash. One
review suggests that this surgery offers short-term relief for chronic neck pain.
Almost 60% of people with whiplash said they were pain-free more than six months
after treatment. It is a difficult surgery that requires a highly skilled staff. And the
pain will most likely come back over time.
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C HAPTER S IXTEEN
WHAT CAN I DO TO TREAT NECK PAIN AT HOME?
Even if you need medical treatment such as prescription medicines for your neck
pain, the following home treatment measures will help speed your recovery.
or sudden (acute) neck pain:
lace an ice pack or cold pack over painful muscles for forty eight to seventy two
hours. This will help decrease any pain, muscle spasm, or swelling. If the
problem is near the shoulder or upper back, ice the back of the neck. If you
prefer, try ice massage. Massage the painful area with ice for seven to ten
minutes, long enough to numb the pain. Ice frozen in a paper cup works well. Be
sure not to damage your skin (frostbite).
void things that might increase swelling, such as hot showers, hot tubs, hot
packs, or alcoholic beverages, for the first forty eight hours after an injury. After
forty eight to 72 hours, if swelling is gone, apply heat. Use a warm pack or
heating pad set on low. Some experts recommend alternating between heat and
cold treatments.
eturn to your normal daily activities as soon as possible. One study found some
evidence that continuing normal activities after an acute whiplash injury helps
heal some symptoms faster than taking time off from work and using neck
immobilization.
ently massage or rub the area to relieve pain and encourage blood flow. Do not
massage the injured area if it causes pain. Nonprescription creams or gels, such
as Bengay, might provide pain relief.
ake pain relievers. Acetaminophen (such as Tylenol) can help relieve pain.
Nonsteroidal anti-inflammatory drugs, including aspirin (such as Bayer),
ibuprofen (such as Advil), or naproxen sodium (such as Aleve), can help relieve
pain and reduce inflammation. Do not give aspirin to anyone younger than
twenty years because of the risk of Reye syndrome.
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For long-lasting (chronic) pain, you can use the same pain relief measures used for
acute pain, but you do not have to worry about swelling.
ou can aid healing in both acute and chronic neck pain and prevent
further injury by:
oing stretching and strengthening exercises for your neck to keep your neck
flexible and strong and prevent stiffness.
voiding or modifying any activities that might be causing your neck pain, such
as prolonged computer work or overhead work.
aving good health habits. Try to reduce stress and tension at work and home.
Practice muscle relaxation exercises and think about getting a massage. Stop
smoking: smoking slows healing because it decreases blood supply and delays
tissue repair. Exercise regularly, including aerobic exercise such as walking. For
more information, see the topics Stress Management, Quitting Smoking, and
Fitness.
ou can help prevent future neck pain by paying attention to how you
move and hold yourself (body mechanics). This includes:
voiding slouching or a head-forward posture. Sit straight in your chair with your
lower back supported, feet flat on the floor, and shoulders relaxed. Avoid sitting
for long periods without getting up or changing positions. Take short breaks
several times an hour to stretch your neck muscles.
djusting your workstation if you work at the computer. Keep the monitor so that
the top of the screen is at eye level. Use a document holder that puts your work
at the same level as the screen. For more information, see the topic Office
Ergonomics.
sing a headset or speaker phone if you use the telephone a lot. Do not cradle
the phone on your shoulder.
djusting your car seat to a more upright position that supports your head and
lower back. Make sure that you are not reaching for the steering wheel while
driving. Your arms should be in a slightly flexed, comfortable position.
sing a pillow that keeps your neck straight, neither too high nor too flat. Special
neck support pillows called cervical pillows or rolls might relieve neck stress. You
can also fold a towel lengthwise into a pad that is four inches wide, wrap it
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around your neck, and pin it in position for good support. Avoid sleeping on your
stomach with your neck twisted or bent
aving the right posture when reading in bed. Prop the book up so you are not
using your arms to hold it up and bending your neck forward. Consider using a
wedge-shaped pillow to support your arms and keep your neck in a neutral
position.
sing proper lifting techniques. Lifting with your knees, not your back can also
help to prevent neck pain.
Your doctor might recommend that you wear a cervical collar to support your neck.
Cervical collars might reduce neck pain, but they should be used only for a day or
two. When the pain begins to get better, start doing gentle neck exercises.
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C HAPTER S EVENTEEN
WHEN SHOULD I CALL MY DOCTOR?
Call 911or other emergency services immediately if you have been injured and
you have:
severe neck injury, such as an injury caused by a:
erious car accident.
all from a height of fifteen feet or more.
ajor sports-related injury.
ery forceful blow to the head or neck.
igh-energy blow on the top of the head.
enetrating injury, such as a stab or gunshot wound.
igns of a spinal cord injury, such as:
eakness or inability to move the arms or legs.
ontinuous numbness of one or both arms or legs.
oss of bowel or bladder control.
eck pain that comes with chest pain and other symptoms of a heart
attack. These include:
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hest pain that is crushing or squeezing or feels like a heavy weight on the
chest.
hest pain that comes with:
weating, shortness of breath, nausea, or vomiting.
ain that spreads from the chest to the back, neck, or jaw, or one or both
shoulders or arms.
izziness or lightheadedness.
fast or irregular pulse.
all your doctor immediately if you have:
stiff neck and/or severe headache, fever, confusion vomiting, and/or
difficulty staying awake or alert.
eck pain and severe arm pain.
eck pain and suddenly developing numbness, tingling, or weakness in one or
both of your arms.
evere neck pain following an injury.
evere neck pain with no known cause.
new weakness in your arms and legs.
new loss of bladder or bowel control.
all your doctor today if you have:
evere restriction of neck movements.
eck pain or stiffness after starting a new medicine.
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onstant numbness or tingling in one arm or hand.
onstant weakness in one arm.
oderate pain following an injury.
rm weakness, numbness, or tingling that has become worse since you were
evaluated by your doctor.
ngoing (chronic) pain that is getting worse.
bservational Waiting
Observational waiting is a period of time during which you and your doctor observe
your symptoms or condition without using any medical treatment. Most neck pain
does not require medical care. In general, pain relief and neck movement should
get better after a couple of days of home treatment that includes:
imiting the activities that increase neck pain.
aking nonprescription pain relievers together with using ice to reduce pain.
oing gentle exercises to keep the neck flexible.
If you have severe neck pain that has not gone after one or two days and you are
not able to perform your normal daily activities, call your doctor.
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C HAPTER E IGHTEEN
WHAT EXERCISES CAN PREVENT AND TREAT
NECK PAIN?
The following exercises will help to strengthen the muscles in your neck as well as
stopping existing neck pain. You do not need to do every exercise. Do the ones that
help you the most. Discontinue any exercise that increases pain. Do each exercise
slowly. We can help you to learn and practice these exercises
Dorsal glide stretches the back of the neck. If you feel pain, do not glide so far
back. Some people find this exercise easier to do while lying on their backs with an
ice pack on the neck.
 Sit or stand tall and look straight ahead.
 Slowly tuck your chin in as you glide your head backwards over your
body.
 Hold for a count of six, and then relax for up to ten seconds.
 Repeat eight to twelve times.
hest and shoulder stretch
 Sit or stand tall and glide your head backward as in exercise one.
 Raise both arms so that your hands are alongside your ears.
 Take a deep breath, and as you breathe out, lower your elbows
downwards and behind your back. You will feel your shoulder blades
slide down and closer together, and at the same time you will feel a
stretch across your chest and at the front of your shoulders.
 Hold for about six seconds, and then relax for up to ten seconds.
 Repeat eight to twelve times.
houlder lifts
 Lie facedown with your arms beside your body.
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 Lift your head and shoulders straight up from the floor as high as you
can without causing pain. Keep looking at the floor so you do not arch
your neck back. Keep your torso and hips pressed to the floor.
 Hold for about six seconds, and then relax for up to ten seconds.
 Repeat eight to twelve times.
ands on head
 Move your head backwards, forwards, and side to side against gentle
pressure from your hands, holding each position for about six seconds.
 Repeat eight to twelve times.
Lake County Physical Therapy
301 E. Rollins Road, Round Lake Beach, IL 60073
www.lakecountyphysicaltherapy.com
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Appointment line: 847-229-0140
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