Neck: Painful Neck

It was a quiet Sunday morning, and I found myself seated at my desk, catching up on some paperwork when a familiar message popped up on my phone. It was Sam, my neighbor, who always enjoyed weekend DIY projects. “Dr. Priya, I think I’ve hurt my neck,” the text read. I replied immediately, suggesting we meet for a quick chat.

Later that day, Sam walked in with a visible tilt to his head. “I’ve been painting the ceiling for hours, and now my neck is stuck like this!” he chuckled, trying to mask the discomfort.

As a doctor, neck pain is something I encounter frequently, and Sam’s case was no different from many others I’ve seen.

What Causes Neck Pain?

Neck pain is commonly the result of an injury such as a sharp, sudden jerk of the neck, as in a motor vehicle accident. Other causes include blows to the head (such as in boxing and wrestling), striking the head on an overhead object, or even simple falls. People often wake up with severe neck pain and blame it on a cold draught, but it is caused by an unusual twist in the neck for a long period during sleep. The pain mainly arises from minor injury to the many small swivel joints in the neck (called facet joints) and less often to injury of one of the discs between the vertebrae. In older people, arthritis can develop in these joints.

Studies published in the Journal of Orthopaedic & Sports Physical Therapy reveal that improper posture and sudden jerks are leading causes of neck pain in adults.

What Are the Symptoms?

The main symptom is pain and stiffness in the neck, but the pain can travel to the head, around the eye and ear, or to the shoulder and arm. Problems from the cervical spine (the first seven vertebrae in the spine) can also cause ‘pins and needles’ in the neck or down the arm.

Sam nodded as he listened. “I did feel a bit of tingling down my arm,” he admitted.

What is the Outlook?

Neck pain, which is a very severe problem, can clear up very quickly and usually responds very well to physical treatment such as exercises, massage, and mobilisation. However, it can be persistent or recurrent, and for that reason, regular exercise of your neck is advisable.

A study in the British Medical Journal found that consistent neck exercises and proper ergonomics at work reduce the recurrence of neck pain by up to 60%.

What About Cervical Collars?

Collars are very helpful for a short period for acutely painful necks but should not be worn for any longer than 7 to 10 days at a time and not at night. Your neck needs to be mobile and exercised naturally.

I handed Sam a soft cervical collar. “This is for temporary support, but remember, mobility is key.”

Dos and Don’ts

To avoid bouts of further neck pain, the following rules are helpful.

Don’t:

• Look up in a strained position for long periods of time (e.g., as when painting a ceiling)
• Twist your head often towards the painful side
• Lift or tug with your neck bent forwards
• Work, read, or study with your neck bent for long periods
• Sleep on too many pillows

Do:

• Keep your neck upright in a vertical position for reading, typing, and so on
• Keep a good posture: remember to keep the chin tucked in
• Sleep on a low, firm pillow
• Sleep with your painful side on the pillow
• Use heat and massage—massage your neck firmly three times a day using an analgesic ointment

Professional Help

Your doctor may prescribe mild painkillers such as aspirin or paracetamol or other medicine for a short period, especially if arthritis is developing.

A course of exercises to mobilise stiff joints in the neck and strengthen the supporting muscles is probably the best treatment.

A clinical trial published in The Spine Journal emphasized that professional physiotherapy for neck pain reduces recovery time by up to 30%.

Neck Exercises to Relieve Pain

Exercises can be a game-changer for those suffering from neck pain. These exercises focus on loosening stiff joints and strengthening muscles.

1. Neck Rotation

Lie on your back on a firm surface such as a floor or bed. Turn your head firmly (but not quickly) to the side by turning your chin towards your shoulders as far as you can. Hold for 3 seconds and then turn to the opposite side. Repeat 5 times.

2. Hand Press

While lying on your back, lock your fingers behind your head and press your forearms against the sides of your head. Press your head down into the locked fingers. Relax. Repeat 5 times. This can be done while lying on the bed or floor.

3. Bird Exercise

Sit upright, tuck your chin in, and then thrust it forwards and backwards in a bird-like manner. Repeat this 5 times.

4. Resisted Side Bending

Lie on your side with your head resting on a small, firm pillow. Your head and neck should be in a straight line. Take a deep breath in, hold it, and push down hard on the pillow for 7 seconds, then breathe out as you relax. Repeat 3 times. Repeat on the opposite side if this side is tender.

5. Resisted Side Bending (Seated)

Sit upright in a chair, tuck your chin in, and keep your head straight. Place your right hand over the top of your head to grasp the head just above the ear (a left-sided problem is demonstrated) and reach behind your back with the other hand. Pull your head down until it first begins to feel uncomfortable. Take a deep breath in, hold it, and press firmly against your hand for 7 seconds (you will be pushing to the left). Breathe out, relax, and repeat.

6. Resisted Rotation

Sit upright in a chair, tuck your chin in, and turn it to the left side to the point of discomfort. Then place your right hand on the back of your head and your left on the chin as shown (a left-sided problem is demonstrated). Take a deep breath in—now try to turn your head to the right but hold it in place by resistance from your hands. As you relax and breathe out, rotate your head firmly but gently towards the left. Repeat 3 to 5 times. (Reverse sides for a right-sided problem.)

Sam was already trying out some of the stretches. “This feels better already,” he smiled.

“Good to hear. But remember, take it slow. Consistency over intensity,” I advised.

FAQs About Painful Neck