Neck pain, also known as cervical pain, is one of the most common musculoskeletal disorders in the United States, affecting people in their daily activities, work, and leisure activities.
Treatments of musculoskeletal conditions are listed in our article on musculoskeletal disorders, including:
- Physical therapy (PT) and occupational therapy (OT)
- Chiropractic care
- Hot and cold therapy
- Steroid injections
- Lifestyle changes
For the purposes of this article, we will recommend treatments specifically for people with neck pain.
However, before using the many methods listed above and below, it is essential to determine the cause of the pain by first seeking medical attention.
A physician or medical provider will examine the area, checking for signs and symptoms of more serious disease. Diagnostic tests should be done, including laboratory tests, x-rays, ultrasound, computed tomography (CT or CAT) scans, or magnetic resonance imaging (MRI) scans.
One of the most serious conditions that cause neck pain is meningitis and ruled out before muscular treatment begins. Meningitis causes neck pain and additional symptoms, including fever, nausea, vomiting, confusion, irritability, dizziness, seizures, poor appetite, or photophobia (sensitivity to light).
1. Cervical collars
The use of cervical collars for neck pain remains an issue of debate; however, many people report symptom relief using soft cervical collars. In addition, studies have shown if immobilization of the neck is needed, a firm cervical collar is more beneficial than a soft one.
The overall conclusion is that even though soft cervical collars are not recommended for all people with cervical pain, using the collars for ten days or less has not been shown to cause any adverse effects.
2. Cervical pillows
Numerous cervical pillows are available on the market, as seen with all the advertising. You may ask which one is best, and which one you should buy. The answer is simple; it depends on the person.
We know that every person with neck pain has a different etiology (cause) for the pain, as far as the musculoskeletal structures are concerned. In addition, every person has a slightly different anatomy and will respond differently to various pillows.
People with neck pain caused by poor neck posture during sleep usually have pain that is worse in the morning and alleviates during the day; it can effectively be relieved with the correct cervical pillow.
3. Travel pillows (neck pillows for travel)
For people that travel much, a travel pillow can be beneficial. Even though the seats of planes, trains, automobiles, and certain buses have headrests, they tend to place the neck in a hyperextended state (too far back).
The modern travel pillows are "C" or “U” shaped, providing support to the back and sides of the neck. Some are inflatable, while others are manufactured with material filling.
One study, published in the Journal of Rheumatology, found that neck support pillows significantly reduced neck pain, but only if used for six weeks or more; thus, travel pillows are recommended for the frequent traveler.
4. Postural exercises
One of the more common problems causing neck pain is when the head is tilted forward (see image below) from poor posture. Usually, the head moves forward, or the shoulders rotate forward. Many weightlifters, especially men, spend significantly more time developing their chest muscles than the back muscles, leading to this shoulder rotation.
5. Cervical traction
Cervical traction has shown to be very effective for stretching the neck muscles and improving the disc space between the vertebrae.
Old-fashioned cervical traction devices involved a rope pulley system. Some used a bag filled with water on the opposite side of a house door, while others used a solid weight. These devices were found dangerous for home use since the user could injure themselves with excess force applied.
The more modern cervical traction devices involve the person using a squeezable air pump to achieve the desired traction force, with deflation available to correct to a tolerable amount. These devices are much safer and more accurate in attaining a therapeutic but safe traction force. Different models exist for use with an upright posture or laying down.
6. Telephone headset
Nowadays, people spend much time holding their cell phones against their ears or using the handset on their work phones, and both are bad for the neck muscles. Some people even tilt their necks to keep the handset or cell phone in place, which is very bad for your neck muscles.
A telephone headset can significantly reduce neck pain for people who spend a lot of time on the phone. Earbuds, with or without wires, can also be helpful in the avoidance of neck pain but can lead to ear infections. If using earbuds, clean them often since dirt and dust can accumulate on the surface, be placed into the ear, and lead to infections; thus, we recommend over-the-ear headsets.
7. Neck stretching
We specifically mention neck stretching since it needs to be done differently from stretches on the rest of the body. The neck muscles are very short compared to those in the back and extremities; thus, they are more prone to overstretching injuries.
Neck stretches are best done once the muscles have warmed up, like from exercise, and must be done very gently. Overstretching the neck muscles can cause spasms, leading to severe neck stiffness and pain.
Barati, Kourosh, Mokhtar Arazpour, Roshanak Vameghi, Ali Abdoli, and Farzad Farmani, ‘The Effect of Soft and Rigid Cervical Collars on Head and Neck Immobilization in Healthy Subjects’, Asian Spine Journal, 11.3 (2017), 390–95 <https://doi.org/10.4184/asj.2017.11.3.390>
Hersi, Kenadeed, Francisco J. Gonzalez, and Noah P. Kondamudi, ‘Meningitis’, in StatPearls (Treasure Island (FL): StatPearls Publishing, 2022) <http://www.ncbi.nlm.nih.gov/books/NBK459360/> [accessed 30 August 2022]
Jamal, Alisha N., Brian M. Feldman, and Eleanor Pullenayegum, ‘The Use of Neck Support Pillows and Postural Exercises in the Management of Chronic Neck Pain’, The Journal of Rheumatology, 43.10 (2016), 1871–73 <https://doi.org/10.3899/jrheum.151368>
Muzin, Stefan, Zacharia Isaac, Joseph Walker, Omar El Abd, and Jennifer Baima, ‘When Should a Cervical Collar Be Used to Treat Neck Pain?’, Current Reviews in Musculoskeletal Medicine, 1.2 (2007), 114–19 <https://doi.org/10.1007/s12178-007-9017-9>