Neck pain is an extremely common problem that affects millions of people. While some cases of neck pain resolve on their own, many people deal with chronic or recurring pain that interferes with daily life. Before resorting to medication or surgery, there are several physical therapy techniques that can provide relief from neck pain. Physical therapy aims to reduce pain and improve mobility by strengthening muscles, improving flexibility, and promoting proper alignment and posture. Here are some of the most effective physical therapies for managing neck pain.
Simple stretching exercises are often one of the first recommendations for reducing neck stiffness and pain. Neck stretches help improve range of motion and flexibility of the muscles and joints. This can alleviate pinched nerves and loosen tight muscles that may be contributing to pain. Some helpful stretches include chin tucks to stretch the back of the neck, side-to-side neck rotations to target the trapezius muscles, and upper trapezius stretches in which you tilt your head to the side while lightly pulling the opposite ear down. For best results, stretches should be done slowly and held for at least 30 seconds. Doing stretches two to three times a day can help maintain flexibility.
Poor posture habits are a very common source of neck discomfort. Slumping forward or craning the neck can put strain on the cervical vertebrae and muscles. Physical therapists often work on posture training to help realign the neck and reinforce proper position. This may involve simple cues like pulling the shoulders back or lifting the chest. Special equipment like posture braces or monitors may also help increase body awareness. Practicing exercises that strengthen the upper back can further assist with improving posture. Maintaining good posture throughout the day can take pressure off the neck.
Manual Therapy Techniques
Hands-on techniques applied by physical therapists are effective for loosening tight neck muscles and mobilizing the cervical joints. Manual therapy includes soft tissue massage, joint mobilization, and spine manipulation. Massage helps improve circulation and relax muscle tightness that contributes to pain and reduced mobility. Mobilization and manipulation gently move the joints and vertebrae to improve alignment and restore normal range of motion. Studies show that manual therapy provides immediate improvements in neck pain and dysfunction when combined with exercise. It must be performed by qualified physical therapists to ensure safe and proper application of these techniques.
Transcutaneous Electrical Nerve Stimulation
Transcutaneous electrical nerve stimulation (TENS) utilizes a small device to deliver mild electrical impulses through electrodes placed on the skin. This stimulation helps block pain signals and release endorphins which act as natural pain relievers in the body. TENS therapy may also relax muscle spasms. Electrodes are often positioned along the affected area of the neck as well as down the back, shoulder, and arm to target the nerves contributing to pain. The stimulation intensity is adjusted for comfort. Many patients report a reduction in neck pain following TENS treatment. The effect is temporary, but the therapy can be repeated as needed for pain relief.
Specific strengthening and stabilization exercises for the neck are often a core component of physical therapy for managing pain. Isometric exercises that contract the neck muscles without moving the head are helpful for building strength. Chin tucks against resistance train the deep neck flexors critical for proper head and neck alignment. Low resistance band exercises also allow strengthening with minimal strain. As pain decreases, therapists may incorporate gentle stretches and range-of-motion exercises to improve flexibility. A strong, flexible neck is less susceptible to irritation that can lead to pain.
Applying gentle, prolonged traction to the neck can alleviate pressure on compressed nerves and relax tense muscles. Manual traction involves the therapist manually pulling on the head to provide a decompressing effect. Mechanical traction uses a special device where the head is pulled by weights and pulleys. This allows the neck to be distracted for up to 20 minutes. Heat and ice are sometimes applied in conjunction with traction for increased benefits. For patients with herniated discs, pinched nerves, or headache pain, traction can offer symptom relief by taking pressure off the cervical spine. It is important to be monitored by a therapist trained in appropriate application of neck traction.
The Alexander technique is a postural training method that helps people unlearn poor posture habits that contribute to unnecessary muscle tension. Through greater self-awareness and mindful movement, patients can correct unbalanced head, neck and shoulder alignment. Physical therapists certified in the Alexander technique coach patients through posture and movement modification and provide gentle guidance during activities. Many patients notice reduced neck pain as proper alignment is restored. The training allows patients to become aware of and inhibit tendencies to slump or tilt the neck that can exacerbate pain.
Physical therapists often provide guidance on lifestyle adjustments that can help manage neck discomfort. Recommendations may include using proper ergonomics for workstations and driving positions, quitting smoking, trying yoga or pilates, and modifying activities that aggravate neck pain. Sleep positioning may also need improvement to keep the neck aligned neutrally. Stress management and relaxation techniques are also important since mental and emotional tension often manifests physically as muscle tension in the neck and shoulders. By making positive lifestyle changes, patients can help control neck pain.
Neck pain can be difficult to treat, especially when the cause is not clear. Consulting a physical therapist allows patients to try a variety of non-invasive therapies that have proven effective for the treatment of neck pain. The expertise of a physical therapist can ensure therapies are tailored appropriately for each patient’s condition and tolerance. When performed correctly, the physical therapy methods discussed above can provide significant and lasting relief from neck pain.