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Neck Pain

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What Is Neck Pain? 

Neck pain is pain or discomfort felt around the neck.

It can be a common problem that usually gets better after a few days or weeks. It’s rarely a sign of anything serious.

There are several structures in the neck, such as joints, ligaments, muscles, nerves and discs, which can all be strained or irritated and have an effect on our comfort. Also, pain can arise as part of the normal and natural ageing process.

Neck pain can be categorised into 3 types of neck pain:

  • Simple/non-specific neck pain is pain or discomfort in the neck and can sometimes be felt around the shoulders.
  • Neck pain with nerve pain is pain coming from the neck that is felt in the shoulder, down the arm and sometimes into the fingers. It can present as burning pain, paraesthesia (pins and needles) or anaesthesia (numbness).
  •  Whiplash related neck pain is pain in the neck following an acceleration-deceleration injury to the neck such as in a road traffic accident. For more information on whiplash, please look for the NHS Lanarkshire Whiplash information leaflet
person rubbing the back of their neck

What Are The Symptoms Of Neck Pain?

Symptoms of neck pain can include:

  • Pain or stiffness or sometimes both together, pain with movements, posture or activities
  • Intermittent Headaches
  • Dizziness (For further information on Dizziness visit our Vestibular Physiotherapy page)
  • Muscle spasms
  • Pins and needles/numbness or burning sensation.

How Common Is Neck Pain?

Neck pain is a very common condition, two out of three of us will experience it during our lives. It’s not usually serious and most often eases on its own or with simple treatment within a few days.

In patients who present to Physiotherapy, almost ½ will have some neuropathic factors (pins and needles/ numbness or arm pain)

What Causes Neck Pain?

There is no one cause of non -specific neck pain. This means that in simple neck pain, it is not possible to identify one particular fault for the pain. Neck pain can be due to poor posture, normal ageing process, strain, sporting and occupational activities, anxiety, and even depression. The symptoms can also vary over time. It is important to note that normal ageing processes does not necessarily translate into pain.

You can have:

  • Acute neck pain. This is an episode of pain that resolves on its own between a few days to a few weeks.
  • Chronic neck pain. This is mild and/or intermittent pain for up to a year or more.

What Can Help With Neck Pain

Remember that neck pain is a common problem and will usually resolve between a few days to a few weeks. There are a few things you can do to help with your pain:

  • Try and remain active including staying at work and continuing with sports
  • Using heat around your neck and shoulders can help
  • Speak to your GP or pharmacist for simple analgesia in the acute phase (in the early phase when pain starts)
  • Neck pain that may be caused by work, consider asking for a referral to occupational health for a work-based assessment if your work has access to this service.
  • Pay attention to your posture in both sitting and standing; avoid lengthy periods in the one position. Try to avoid lengthy periods sitting or standing in one position. Change your position and move regularly. Getting up for a short walk can help if you work at a desk
  • Wearing a neck collar is not recommended as it stops you from moving your neck and may prolong your pain

Can physiotherapy help?

Physiotherapists are qualified and skilled therapists in managing musculoskeletal conditions such as neck pain. Each patient is assessed and treated individually. It is therefore important when you speak to the physiotherapist to tell them about all your symptoms to help them make the appropriate decision regarding your particular neck pain. Physiotherapists use special physical examination techniques and special tests to assess your problem. Thereafter, they will use treatment and management strategies with the best evidence to help with your neck pain. Those strategies include:

  • exercise: can consist of stretches, movements, strength
  • advice and education
  • manual therapy techniques
  • acupuncture ( Although this may not be suitable for everyone and should only be used in conjunction with a suitable exercise programme for a short period of time)
    *Neck manipulations are not recommended*

Physiotherapy/advice

ENCOURAGE

  • regularly change your position throughout the day particularly if you sit for a long time during work
  • ensure work surfaces /desk/seating is at a comfortable position for you and risk assessment has been completed if necessary.
  • maintaining a healthy weight

STAY ACTIVE 

General exercise is important to maintain fitness, protect joints and promote general mental and physical wellbeing.

person sitting slouched on a chair

Try to avoid sitting in a slumped position for long periods of time

person sitting correctly on a chair

Exercises

The following exercises are designed to help improve your neck range of movement and strength and may in turn help to reduce pain. The exercises are divided into early, middle and late stages. Your physiotherapist will help guide you. You should start doing the early exercises first and should find them easy before you progress to the middle exercises. Again you should begin to find the middle exercises easy before you progress to the late exercises.

Lifestyle Adaptations

With any ongoing conditions, you may need to make some changes to your regular activities to make life easier.

We have given some suggestions below, and more information can be found at:

Washing and Dressing

Non-slip bath mats, rails, bath boards or seats may make getting washed easier. If you struggle to get on and off the toilet a raised toilet seat or grab rail may be of use. Consider the layout of your toiletries and avoid having to stretch to reach items.

When drying hair you could try supporting your arm on a table if you are bothered with overhead activity and struggle to hold the weight of the hairdryer.

Sleep and Posture

If you have one side that is painful try to avoid sleeping on the affected side especially with neck, shoulder or hip pain. You might find it helpful to use extra pillows to support your arms or legs.

If sitting try not to spend too long in one position. We recommend moving every 20 minutes. Consider the height of your chair and sit in a higher chair if you struggle to get up from sitting. Armchairs may be better than a sofa as you will have arm support.

Housework and Garden

Try not to attempt too many tasks in one day.  Avoid spending too long doing repetitive activities such as cleaning windows and hoovering. You could try sitting down to iron.  

In the garden try to vary the jobs so you don’t spend too long in one position.    

Shopping and Driving

If appropriate to you take a trolley rather than a basket even if you are only needing a few items as this will give you more support and avoid you having to carry heavy objects.

Try to break up longer journeys, get out and stretch your legs regularly.  

When To Speak To A Health Professional

Please contact your GP or 111 if your start to experience:

  • persistent or worsening headaches, dizziness, nausea or double vision,
  • severe neck tenderness (pain that is getting much worse)
  • lack of coordination – for example, trouble with tasks like buttoning a shirt
  • heaviness or weakness in your arms or legs
  • pins and needles in both arms which is worsening
  • unsteadiness (feeling weak, losing your balance or falling over) when you walk
  • loss of bladder or bowel control

These can be signs of a condition that may require early assessment and potential orthopaedic involvement.

Help And Support

If after following the above advice, your symptoms have not improved within 6 to 12 weeks, a referral to a physiotherapist may be beneficial.

You can access physiotherapy by any of the following:

Additional information

Acute Injury Management

POLICE is an acronym (Protection, Optimal Loading, Ice, Compression and Elevation) that is used as a management strategy for many injuries and conditions for the first 24 to 72 hours.

  • Protection and relative rest are advised immediately after injury for the first 24 to 72 hours.
  • Optimal Loading refers to having a balanced rehabilitation program which encourages early and gradual activity to improve recovery. How you progress will vary from person to person depending on the injury. It is about finding the injured areas happy place and increasing slowly and gradually.
  • Ice may be used for reducing pain and swelling. There are safety points to follow when you use ice:
    • Don't ice over a numb area or open wound. If the skin is numb you won't notice if you're developing an ice burn and ice on an open wound can increase the risk of infection.
    • Be wary of ice burns – don't apply ice directly to the skin, wrap an ice pack in a clean, damp tea towel before applying. Avoid prolonged exposure to ice, 10-20 minutes is usually adequate.
    • Apply crushed ice/frozen peas wrapped in a damp towel for 10-20 minutes, 2-3 times per day for the first 5-7 days post injury/ flare up of pain.
    • Stop applying ice if there are any negative effects such as increase in pain or swelling or skin soreness.
  • Compression and Elevation are helpful for reducing inflammation. This can be done by keeping your joint raised on a pillow and compressed by wrapping a bandage around it.
    Do not make the bandage too tight and do not wear tubi-grip or any compression bandage in bed at night.
  • Heat: After 2-3 days, you may find that heat is more relaxing.

You could use a heat pad or a hot water bottle with an insulated cover on it. Make sure this is not too hot and is not directly touching your skin.

You should do this for 10 to 15 minutes, 3 to 4 times a day.

What do I do if my symptoms flare up?

Flare ups of pain are common. Some people have recurrent flare ups of pain so it is important to know how best to manage these flare ups. In most cases a pain flare-up will settle within 6 weeks.

Top Tips

  • You will likely find it helpful to rest a bit more but it is still important to keep active. This will help to avoid becoming stiff and your muscles becoming weak.
  • If you aim to get a balance between rest and activity it should help your pain to settle down. You may be sore at first, however, start slowly and gradually increase the amount you do.
  • Reduce movements or tasks that aggravate your symptoms. This can help especially in the early days.
  • Adopting positions or movements that reduce your pain can be useful.

Pain Relief

Analgesia

  • Analgesia also known as pain relief can be an important part in helping you manage your symptoms and allow you to stay active.
  • Taking suitable pain relief regularly allows you to move more normally and continue your usual activities without causing any damage. It is unlikely that medication alone will resolve your pain totally. For this reason we are using the term pain relief (A 30-50% reduction in pain would be deemed to be a good success).

Paracetamol

  • Paracetamol is a good general pain management medication. It is used to help manage lots of different types of pain.
  • Sometimes people believe they need something ‘stronger’ than paracetamol when in fact, taking a regular dose rather than a one-off dose is more effective.
  • Spreading the doses of the paracetamol evenly out over a day will help you control your pain. Visit NHS Inform for more detailed information on paracetamol.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

  • NSAIDs are medications that can reduce swelling around joints and nerve endings to give pain relief. They are particularly useful
    in treating inflammatory type pain. Two commonly prescribed NSAIDs are ibuprofen and naproxen.
  • Although NSAIDs can be very useful they are not suitable for everyone. Visit NHS inform for further information related to NSAIDs.

There are other forms of pain relievers available. If you feel your current pain relievers are not helping your pain or you are
experiencing any side effects from your medication, please seek advice from your GP or pharmacist.

For general information on medication visit NHS Inform.

Staying in work and returning to work

We know that staying in work or returning to work as soon as possible is good for your mental and physical health.

If you have problems with activities at work, it may be helpful to ask for a workstation/workplace assessment or talk with your manager or Occupational Health Department. This can help with alterations or provision of equipment or altering your working day or tasks.

There are organisations which can support you at work or help you return to work. You can visit Knowledge Scotland for further information.

Weight Management

Weight Reduction – People who are overweight tend to have more prolonged pain and poorer tissue healing due to increased levels of inflammation in the body. Reducing your weight can generally help improve the healing process.

A good indicator of whether you need to lose weight is your body mass index (BMI), which you can calculate with the NHS BMI calculator.

If your BMI states you are overweight or obese it is likely that losing weight will reduce your symptoms. Carrying extra fat also increases your risk of heart disease, stroke, type 2 diabetes, and some cancers. Reducing your portion sizes and eating a balanced diet can be helpful in reducing weight. NHS informs provides a free online 12-week weight management programme to get you started right away.

If you need a little more help and feel that you would benefit from working with others in group sessions NHS Lanarkshire’s Weigh to Go programme, groups in North and South Lanarkshire, will help you become more active, eat well and lead a healthier lifestyle.

Smoking

Smoking can affect how your body recovers from musculoskeletal problems. If you smoke then the good news is that by stopping smoking it can improve your health in many different ways. Giving up smoking is not something you have to do on your own. You’re twice as likely to stop smoking successfully if you get the right support from the NHS. There is a free NHS stop smoking service available in Lanarkshire to help you succeed.

Chronic Pain

Some people will have pain which persists beyond the expected time frame for their condition. For further information on this and how best to manage it please visit our Chronic Pain webpage.

Pain Association Scotland is a national charity that delivers professionally led self-management pain education in the community.

Active Health Programme

South Lanarkshire

Active Health is a programme for residents of South Lanarkshire living with long term conditions. Residents are referred via Acute, Physio & specialist nurses to a 10-week programme and then signposted onto a wide variety of mainstream physical activity, sport & outdoor opportunities.

South Lanarkshire Leisure and Culture have many active community opportunities as well as specialised referral programmes. Full details of the 20 leisure centres can be found on the SLL website. Contact details across South Lanarkshire or call 01698 476262 to find out the number of your local leisure centre.

Please contact your health professional to discuss this referral or contact SLLC on 01698 476262.

Contact details

North Lanarkshire

North Lanarkshire Leisure’s Active Health Programme in partnership with NHS Lanarkshire provides a range of supported programmes to help individuals realise the benefits of becoming more physically active whilst also assisting those who are recovering from minor or even more serious illness.

The Active Health Programme has both a General Programme where individuals can access the mainstream health and fitness programmes running within NL Leisure Venues including swimming, jogging, golf and more!

A Specialised Health Class Programme which requires a referral from a health professional, this option is available to individuals who require additional specialised support in taking part in physical activity and classes include Strength and Balance, Cardio I, Cardio II, Back Care and Macmillan Move More classes.

A health and social care professional can make a referral by using the Active Health referral form found at the bottom of the page in the link below.

Contact Details - Health & Wellbeing Information

Mental Wellbeing

It is very important to look after your own mental wellbeing. This can have an influence on your recovery or management of your Musculoskeletal problem. Visit our mental wellbeing page for more information.

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