Treatment of neck pain

Neck pain (or cervicalgia) is a very common complaint, most people deal with it once in a lifetime.


Treatment of neck pain

Muscle or posture-related neck pain usually subsides after a few days or weeks.
Conservative (non-surgical) treatment includes the application of cold (cryotherapy) or heat packs (thermotherapy), the use of medication, physical applications, chiropractic or osteopathic manipulations.

Whatever the cause of neck pain or a stiff neck, the behavioral measures are usually always the same: normal life should continue, the patient should remain active and painkillers should be taken to relieve the discomfort.

Therapies for neck pain

There are numerous treatment options that the doctor may recommend:

Physiotherapy for neck pain

As part of physiotherapy, there are various treatment techniques.

Some examples: traction treatment, heat, cold, manipulations, etc. The effectiveness of these applications has not been proven.

Heat should be applied if the pain lasts longer than 48 hours.
I am often asked by my patients whether heat or cold is the better remedy; the cervical region should not be cooled, but heat can relieve symptoms.
In the search for the best form of treatment, research shows conflicting results.

The family doctor usually advises gentle movement exercises for the neck and taking painkillers.
If the symptoms have not subsided after about a week, the doctor may prescribe a visit to a therapist who will use pain-relieving massage and therapy techniques and also show the patient special exercises for his neck complaints.


In traction and pull treatment, weights and pulleys are used to gently stretch the neck and maintain the extension.
Under the supervision of a doctor or physiotherapist, this treatment can relieve the symptoms, especially if they occur in connection with inflammation of a cervical nerve or cervicobrachialgia.


A natural remedy is a warming neck brace to relieve pain and muscle spasms.
Posture must be controlled because certain positions require constant tension of the muscles, which would aggravate the pain.

A necktie should not be worn, there is no evidence that it effectively supports healing, on the contrary, it can increase stiffness; it is better to keep the cervical spine in motion.
If a collar needs to be worn to keep the neck in a more comfortable position, they should not be worn for more than 48 hours.
You should only get behind the wheel of a car when the pain and stiffness have subsided, so that the head can be moved freely again to control the traffic.

If the neck is stiff, you should try to do some simple exercises without causing pain, because that would make the situation worse.
You can turn your head left and right, tilt to the side, bend forward and backward.
These exercises strengthen the neck muscles and increase the range of motion.
An acute crooked neck usually responds well to McKenzie treatment; it is initially carried out passively by the physiotherapist and later actively at home.

Exercises and stretching for neck pain

An important part of therapy is to keep the cervical spine moving.
Normal sports activities must be interrupted as long as the neck pain persists; during this period, neck-specific exercises should be performed.

Gradual movements of the cervical spine in all directions help to stretch the tense and shortened muscles.
Hot shower: a quarter of an hour under the hot water jet can be very effective.
Some patients feel relief when they apply cold compresses to the painful area in the first 48 hours after the onset of pain (for about 5-10 minutes).
This can relieve the pain, as well as muscle-relaxing heat applications.

The doctor may prescribe physiokinesitherapy (exercise therapy) for stretching and strengthening the neck muscles; he may also recommend the McKenzie method to return the disc to its natural position so that the pressure on the nerves eases.
The physiotherapist performs the exercises together with the patient, first in his practice, which must then be repeated daily at home; or you visit a sports hall, then the training will not be forgotten so quickly.
The exercises can help relieve the pain and improve the functioning of the neck; through an optimized posture, an overload of the muscles can be avoided, while muscle strength, endurance and resilience are strengthened.

While yoga and Pilates improve cervical spine posture, there are numerous doubts about the effectiveness of these disciplines in treating neck pain.
Swimming can aggravate the symptoms because in this sport the neck is often turned; therefore, it should not be exercised as long as the pain persists.

Medication for neck pain

Over-the-counter medications such as paracetamol (e.g. Ben-u-ron) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as dolormin or alrheumatism, are usually sufficient to relieve neck pain.
Muscle relaxants can help patients with secondary, tension-related movement restrictions.

The doctor may also prescribe stronger painkillers.
For pain control, paracetamol (e.g. Ben-u-ron or paracetamol), ibuprofen (e.g. Dolormin) or both can be taken regularly.
As an alternative to the tablets, ibuprofen-based ointments can be applied to the neck. For the dosage, the package leaflet must always be observed.

To relieve neck pain, specialists recommend taking nonsteroidal anti-inflammatory drugs (aspirin, dolormin, alrheumatism), muscle relaxants (Mydocalm, Sirdalud, etc.) or antidepressants (Valium, Lexotanil, etc.) to relax the muscles.
You can also apply a cream or gel directly to the neck, Voltaren is the most commonly used.

Alternative methods of treatment for neck pain should be discussed with the doctor, he can explain benefits and risks.

Surgical intervention for neck pain

Only in rare cases, the cervical spine needs surgery for neck pain; usually when the pain radiates into the arm or hand.
In case of herniated disc or protrusion, the surgeon may insert an artificial disc. This device made of metal or plastic is the most useful treatment for patients with intervertebral disc problems who have no further injuries or deformations of the cervical spine.

Natural healing methods


In acupuncture, thin needles are inserted into different points of the body. Scientific studies have shown that acupuncture can help with many types of pain. For an optimal treatment result, several acupuncture sessions may be necessary.
Acupuncture is commonly considered safe when performed by professionals and with sterile needles.


This manual therapy technique is particularly used on the spine.
Chiropractic manipulation consists of the passive, controlled and sudden rotation of a joint.
Movement near the limit of movement affects nerves and muscles. Chiropractic treatment of the cervical spine increases the risk of stroke.
This form of therapy is also used for pain at the level of the thoracic and lumbar spine.


During high stress, muscle-related neck pain may occur.
Massage therapy has shown good results in chronic neck pain because it releases the tension and adhesions between the soft tissue structures.
A trained masseur or therapist manipulates the muscles in the neck area with his hands.
There is some scientific evidence of the effectiveness of massage therapy for neck pain, especially when done together with the other treatments recommended by the doctor.
Tension of the deep neck muscles (suboccipital muscles) can cause dizziness; Massage therapy can reduce dizziness.

Kinesio Taping

Neuromuscular tapes, which are elastic patches that are often used in sports medicine, have a great effect; they are applied over the entire muscle course and are intended to relieve the discomfort and relax the muscles.
Depending on the appropriate tensile stress, the tension of the muscles on one side of the neck or shoulder can be reduced, whereby the muscles on the opposite side are activated.

Transcutaneous electrical nerve stimulation (TENS)

At the painful areas, electrodes are attached to the skin and small electrical impulses are emitted, which can temporarily relieve the pain.

Living together with neck pain

The best way to cope with neck pain is prevention.
If you sit at the computer for hours, you should take a break every now and then, get up and stretch your neck and back.
It is recommended to relieve the neck muscles of daily stress with physiotherapy exercises.
Anyone who smokes should stop. Smoking is a risk factor for neck pain. Overweight helps weight loss.
General tips: control of body and body movements, healthy eating and a healthy lifestyle.
How long does neck pain last? There is no universal standard answer: in some cases, the pain has completely disappeared after the therapy applications, but if poor posture continues to be taken daily, relapses are possible.

Prevention of neck pain

In most cases, poor posture or age-related joint wear are the cause of neck pain.
As a preventive measure, the head should always be kept straight so that its weight is optimally discharged to the spine without causing muscle tension.
Sometimes even simple changes in everyday habits can help.

Practical tips:
If you sit at the wheel of a car or in front of a PC for a long time, you should often take small breaks.
Keep the head back at the level of the spine so that the neck muscles do not tire. Nocturnal teeth grinding should be avoided, here a bite splint can help.

Set up the desk, office chair and computer so that the screen is about at eye level.
The knees should be higher than the hips.
The elbows rest on the armrests.
The phone should not be trapped between the ear and shoulder when making a call. If you spend a lot of time on the phone, you can use headphones.

While working at the desk, you should often incorporate stretching exercises. Pull the shoulders up and drop again, bring the shoulder blades backwards and then let the shoulders loose.
Tilt the head alternately on both sides to loosen the neck muscles.

If possible, do not sleep in the prone position. In this position, the neck muscles remain tense.
A pillow should be used that supports the natural curvature of the cervical spine.

Postural errors

With a good posture, the shoulders are pulled back, the head is straight, the chest is slightly arched forward, and the pelvis is in line with the spine; in this way, the body weight is optimally distributed from the back muscles to the body.
If the head is bent even slightly forward, the weight of the head, which weighs on the cervical spine, increases by at least half a kilo. This extra pressure is held by the tension of the muscles and can lead to muscle contractures and chronic neck pain.

Physical activities

Anyone who is physically engaged in heavy physical work and has to lift large loads or performs repetitive activities, especially when the working environment is cold, should provide adequate protection, such as protective clothing and appropriate support aids.
You can discuss the problem with the employer, who may not be aware of it.
Frequent breaks help the muscles relax.
It is important to have strong abdominal and lumbar muscles to prevent complaints caused by sudden overexertion.
If possible, the loads should be distributed on both arms in order to avoid a one-sided load on the neck and back.

Sleeping and neck pain

Unfortunately, an incorrect sleeping position can also be responsible for the neck pain. If you notice that you are lying in an uncomfortable position while sleeping and wake up with discomfort and stiffness in your neck, a new pillow of good quality should be purchased.
The worst position for the neck is the prone position, because in this case the neck is twisted and some muscles always remain tense.
Ideally, the head is neither bent up nor down.
The pillow is intended to “fill” the empty space that naturally forms between the bed and the head.
Good pillows consist of a higher part on which the neck rests and a flatter part for the head.
It is important to sleep on a flat pillow at night.
The use of two pillows must be avoided in any case, because this will bend the neck in an unnatural way.

Sofa and posture Poor posture
while watching TV can cause neck pain, especially if you’re very focused on the show. At the end of the program, when you get up, you notice that your arm has fallen asleep and your neck hurts a lot.
If this sounds familiar, you might consider using a travel pillow that keeps the spine in the correct position or prefer sitting on a chair, as the spine is better supported there.
Soft and comfortable sofas, while very inviting, usually offer little support and are a common cause of neck and back discomfort.

Other incorrect postures, in which the neck is bent down or stretched forward, can be seen when driving, reading, using a smartphone, on a PC and when writing a text message.

How can the sitting posture be corrected on the computer?

The following factors can make a difference: screen size, height and number of screens used at the same time, as well as wrist rests that relieve the shoulders.
Usually only one screen is used, but the portable computers have a screen size of only 13-15 inches, insufficient for comfortable use; therefore, some people connect the notebook to an external display.


The mouse should be moved on an ergonomic mousepad that has an elevation for the wrist.
These mousepads are more expensive, you can buy them in computer shops.
It is important to support the forearms on the table when using a keyboard or mouse.

The keyboard of a fixed PC should have a soft stripe (usually a gel strip) on which the fingertips rest when typing.
The keyboard of a notebook is more convenient to use because the wrists are already at the level of the keyboard and thus at the level of the fingers.

The screen must be slightly at eye level and easily adjustable; large and legible characters (font) should be used.
The movement made with the neck to approach the screen is called protrusion of the cervical spine and is typical of myopia. This posture should be avoided in any case, it is one of the worst positions for the cervical spine.
So that the eyes do not tire, white or light gray letters on a dark background (gray or black) should be used; in this way, an easy-to-read contrast is created.
The screen should not reflect light, you should check if there are reflections when the PC is switched off.

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