Neck Program



sunset2Neck pain is a very common occurrence, and for some it is an everyday experience. Many of the symptoms felt can be prevented, decreased, or even eliminated through proper stretching, strengthening, and alignment of the cervical spine. The cervical spine has a “C” shaped curve which opens in the back.



  1. Muscular: tightness or spasm in the muscles in, and around your neck – rhomboids, trapezius, scalenes, as well as the erector spinae groups.
  2. Facet joints: each pair of vertebrae has 2 facet joints which allow for motion to occur between them. Nerve roots sprout between these facets. Pain can occur when these facets rub or grind together. Osteophytes can also develop within the facet and encroach onto the nerve.
  3. Intervertebral disk: between the vertebrae are disks made of fibrocartilage. They absorb the shock form walking, running, jumping, turning, and twisting. Sometimes these disks protrude out of their normal space, and can cause pain by putting pressure on nerves or the spinal cord.
  4. Ligaments: another structure which keeps the vertebrae in place are ligaments. Extreme acceleration and then deceleration of the neck can cause a whiplash injury, thus leading to injury to these ligaments and a resulting pain. Another result of a whiplash injury could be a strain or sprain of the muscles surrounding and supporting the cervical spine, also leading to pain.
  5. Posture: having your head rest too far forward can cause the “C” shaped curve in your neck to decrease, and keeping your head too far back can accentuate it. These positions can increase the amount of stress placed on the muscles, ligaments, facets, and disks in and around your neck. This undue stress can cause you to feel pain in your neck.



  1. Heat: take a nice hot shower and let the water run on your neck. Or place a heating pad or hot water bottle on your neck. Keep it on long enough to allow your skin to turn a little red and warm up.
  2. Medicine: try an over the counter anti-inflammatory drug. Follow the instructions on the package, and stick with it for a couple of days.
  3. Rest: try to avoid movements which aggravate your symptoms.
  4. Pillows: try an orthopedic pillow if you normally sleep with more than one pillow. Sleeping with too many pillows can cause an increased amount of stress placed on the muscles, ligaments and facets which can cause neck pain. The pillow will keep the curve in your spine in its proper position while you sleep, and hopefully help with your pain.



  1. Let your neck bend to the side, and with your hand apply a little pressure to your head to help bring it into the same direction. Go until you feel a nice stretch and hold it for 6 seconds. Do this three times and repeat with the opposite side.
  2. Let your head hang forward, as if you are touching your chin to your chest. Lace your fingers behind your head to apply a little pressure to bring your chin further down. Stop when you feel a good stretch and hold for 6 seconds. Do this three times.
  3. With your shoulders relaxed, turn your head to side as if you were looking over your shoulder. Go until you feel a stretch and hold it there for 6 seconds. Do this three times and repeat with the opposite side.



  1. Place one hand on the side of your head, and hold it there. Press your head into your hand, trying to bend it to the side, but don’t let your head move. Hold that contraction for 10 seconds. Do this three times, and repeat with the opposite side.
  2. Place both of your hands on your forehead. Push your head into your hands, again not letting it move, and hold the contraction for 10 seconds. Do this three times, and repeat with the opposite side.
  3. Place one hand onto the side of your head, and hold it there. Turn your head into your hand as if you were going to look over your shoulder, only don’t let your head move. Hold this contraction for 10 seconds. Do this three times, and repeat with the opposite side.
  4. Stand with your back flat against a wall. Tuck your chin and press your head into the wall, and hold for 10 seconds. Repeat this three times.



To help relieve your back pain, you may have to go to physical therapy. There, a physical therapist will work with you to restore movement and help your body heal. The therapist may also teach you about ways to minimize pain in the future.

Physical therapy includes both passive and active treatments. Passive treatments help to relax you and your body. They’re called passive because you don’t have to actively participate. Your physical therapy program may start with passive treatments as your body heals, but the goal is to get into active treatments. These are therapeutic exercises that strengthen your body and help prevent a recurrence of your back pain.



Your physical therapist may give you passive treatments such as:

  1. Deep Tissue Massage: This technique targets spasms and chronic muscle tension that perhaps builds up through daily life stress. You could also have spasms or muscle tension because of strains or sprains. The therapist uses direct pressure and friction to try to release the tension in your soft tissues (ligaments, tendons, muscles).
  2. Hot and Cold Therapies: Your physical therapist will alternate between hot and cold therapies. By using heat, the physical therapist seeks to get more blood to the target area because an increased blood flow brings more oxygen and nutrients to that area. Blood is also needed to remove waste byproducts created by muscle spasms, and it also helps healing.
  3. Cold therapy, also called cryotherapy, slows circulation, helping to reduce inflammation, muscle spasms, and pain. You may have a cold pack placed upon the target area, or even be given an ice massage. Another cryotherapy option is a spray called fluoromethane that cools the tissues. After cold therapy, your therapist may work with you to stretch the affected muscles.
  4. TENS (transcutaneous electrical nerve stimulation): A TENS machine stimulates your muscles through variable (but safe) intensities of electrical current. TENS helps reduce muscle spasms, and it may increase your body’s production of endorphins, your natural pain killers. The TENS equipment your physical therapist uses is relatively large. However, a smaller machine for at “at home” use is also available. Whether large or small, a TENS unit can be a helpful therapy.
  5. Ultrasound: By increasing blood circulation, an ultrasound helps reduce muscle spasms, cramping, swelling, stiffness, and pain. It does this by sending sound waves deep into your muscle tissues, creating a gentle heat that enhances circulation and healing.



In the active part of physical therapy, your therapist will teach you various exercises to improve your flexibility, strength, core stability, and range of motion (how easily your joints move). Your physical therapy program is individualized, taking into consideration your health and history. Your exercises may not be suitable for another person with back pain, especially since your pain might not even be caused by the same condition.

If needed, you will learn how to correct your posture and incorporate ergonomic principles into your daily activities. This is all part of the “self-care” or “self-treatment” aspect of physical therapy: through physical therapy, you learn good habits and principles that enable you to take better care of your body.

Your physical therapist may also suggest a personalized exercise program for you. This can help reduce the likelihood of your back pain recurring and can also improve your overall health.

We have close working relationship with Proactive Physical Therapy, Body Central, & Athlon Physical Therapy. Please contract their respective offices for more information on how to get started on your low back program.


Adopted in part from Vert Mooney, MD November 20, 2006

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