Neck Pain Relief Without Pills

Four ways to reduce and manage your neck pain.

posture 2My approach to helping people with chronic neck pain – daily neck pain that is not due to a recent injury surgery etc. – involves doing a number of things and NOT doing a number of things. Each change will help perhaps 5-10% over time (yes, it takes time), doing the steps below could add up to 50% improvement or more, and often help basic neck aching and stiffness related to day-to-day muscular strain, and perhaps a bit of disc arthritis (called degenerative cervical disc disease). You might also use medications sometimes, but they are only one part of treatment and may not be necessary (especially daily) if you keep in mind some general principles. If would like to explore possible causes of your neck pain, go to PainSpot.com. (The principles below are general educational advice, and not meant to be specific or individual medical advice, so of course please review them with your health provider before starting them or any physical therapy program.)

1. The proper position of your head and neck on your shoulders in the day is crucial to relieving pain.

When you are sitting especially, it’s important to picture the idea of your head balancing over your tailbone; if it is in a forward position (I call it first gear position) then the head holder-upper muscles have to work overtime to keep your head up! Your ear lobes should be centered over the middle of your shoulders, where the crease in a shirt usually is. These muscles behind your neck and over the tops of your shoulders are the ones that often hurt and feel stiff. If you allow your shoulders to settle back, and pretend you have a puppet string attached to the top of your head pulling up and back, these muscles will relax.

(picture, courtesy dreamwellnesspacificbeach.com)

(courtesy dream wellness pacific beach.com)

Picture a twelve pound ball balancing on a stick, where the ball is your head and the stick is your spine. If you lean the ball forward, your head feels almost four times heavier with poor neck posture.

When you slouch forward your spine becomes “C-shaped”. This is guaranteed to cause pain over time; your head-ball is not balanced. Because we can’t actually straighten the spine, a useful mental picture is to make your C-shape spine into an “S-shape” with the lower part of your back going in as though you had a pillow behind your back. If you correct your head posture over your shoulders and lower spine, you should feel the upper shoulder muscles relax immediately.

2. At night, your neck and head position are just as important!

Never sleep this way

Wrong way to use a neck pillow!

Never sleep on your stomach! Your neck should be straight, and your head not turned at all. Most neck pain sufferers already know this, but it is worth repeating. Even for 10 minutes, which can cause the neck muscles to go into spasm. Throw out any foam pillows. They don’t allow your neck to be in the right position. If you can sleep on your back, a thin towel folded up behind your neck will feel good. Side sleepers will often bunch up their pillows which is the right idea, but it never lasts – better to use a cervical roll BUT the position is key. It should angle down under your chin so you can feel it on the front of your chest. Remember this neck roll/pillow secret: tilt the pillow down so it lies along your chest.

3. Stretch and strengthen

Right before going to sleep, lie on your back and lift your head off the pillow like you are doing sit ups with your head. Don’t do this if it’s too painful. Strengthening the core muscles in the front of your neck is the same idea as strengthening your low back core muscles for back pain. Then stretch the neck from side to side. A brisk walk or jog may loosen up your neck and shoulder muscles, and a massage from time to time will do the same.

4. Things not to do.

napping on couch

Guaranteed neck pain

No TV in bed. No napping on the couch. No cradling the phone. If you fall asleep sitting up, put on a soft foam collar, or better yet just go to bed! If you have a couch with deep cushions, it is almost impossible not to slouch, and putting an extra pillow behind your low back will help to regain the ‘S-shape’ in your lower spine, and position your head over your tailbone.

Remember to run these ideas by your health provider. Don’t do anything that is too painful, and if you’ve had neck surgery only follow the advice of your surgeon and therapist.

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About Doug Roberts MD

Board certified practicing rheumatologist and founder of PainSpot.com
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