Neck pain: How to manage your neck injury

- Physiotherapist

Neck pain has become a common issue in our life. It can occur at any age. Because now more or less everyone is using mobile computers. Leaning for a long time can cause neck pain. Neck ache is caused by muscle tension, bone disease in the spine, arthritis, cervical spondylosis, etc.

Like other pains, neck pain is quite uncomfortable. When neck pain occurs, it becomes difficult to concentrate on any other work. According to experts, the main techniques for treating neck pain are exercise, meditation, and proper posture. If all this does not work, then it is important to take the advice of a doctor.

Causes of Neck pain

Many suffer from neck pain. There is no end to people’s worries about neck pain; most people think that the main reason is high blood pressure. High blood pressure means excess pressure on the blood vessels in the body. Do we think high BP is the only reason being neck ache? Let’s see what causes neck pain.

1. One of the causes of neck pain is upper back pain. By posture, we mean the position and position of different parts of the body during any work. The position in which we sit, where we work by keeping the neck muscles active, is the posture. If we have a problem with this postural adjustment, we are more likely to get neck pain.

2. People who sleep a little abnormally may have neck pain 

3. In children, pain can be caused by torticollis or sudden pulling of the neck muscles.

4. In many cases, due to cervical ribs or extra bones in the neck.

5. Cervical stenosis is one of the major reasons for having neck pain. Stenosis means narrowing cervical foramen becomes narrow in which the spinal cord and spinal nerve emerge through it. Stenosis occurs due to disc slipping or herniation and bone spurs.

6. Mechanical causes :

  • Operating the computer or laptop for a long time. This is called Browse Syndrome
  • Long time work leaning forward
  • Write for a long time at same posture
  • Prolonged sitting then puts too much pressure on the neck and causes pain in the neck
  • When household chores are long and leaning forward

7. Very familiar disease in the elderly such as followings

Cervical spondylosis (decreases the space between the bones of the spine)

Cervical spondylolisthesis( forward slippage of one vertebra upon another)

Cervical canal narrowing 

Cervical disc prolapse or herniation

Osteoporosis or bone loss and brittleness

Cervical osteoarthritis

Inflammation of the disc

8. Neck injury: There may be neck pain after the accident, called ‘Whiplash.’ Its symptoms last for many years. Besides, neck injury occurs due to intervertebral disc inflammation or damage, repetitive tasks such as contact and non-contact sports, vertebral fractures, and spinal cord lesions. Neck injury is the commonest cause of neck pain.

9. Diseases condition 

Infection or bacterial infection

Many other infections, including tuberculosis of the neck bones, can cause neck pain.

Rheumatoid arthritis:

It is a rheumatic disease, which is caused by the body’s immune system working against itself. It usually causes pain in the joints of the hands or feet, swelling, and neck pain.


Inflammation of the bones of the spine is called spondylitis. This condition is caused by arthritis called seronegative arthritis. It also causes neck pain along with back pain.

Blood cancer

Blood cancers called lymphoma, and myeloma can cause neck pain.


When cancer of another organ has spread to a distant organ, it is called metastasis. In this case, if it spreads to the neck, there may be a pain in the neck.

Tumors of the nervous system

Tumors of the neck or cervical nervous system can cause neck pain.


This disease causes pain all over the body, but there is no visible cause of the pain. The incidence of this disease in girls is ten times higher than in boys. It causes neck pain along with pain all over the body.

Other causes of Neck pain

Some diseases of the outside of the neck can also cause neck pain.

1. Inflammation of the Larynx or Pharynx.

2. Due to Inflammation of the lymph nodes or lymph nodes.

3. Dental problems.

4. Chest angina or heart pain.

5. Aortic aneurysm or abnormal dilation of the aorta.

6. Pancreatic tumors or apex or superficial tumors of the lungs.

7. Diaphragm, which separates the chest from the abdomen, can also cause neck pain.

8. Ear Infection by bacteria or virus.

What is Neck structure / Anatomy that helps to deal with Neck Pain

The neck structure is very elaborate and complex. We can manage Neck pain easily if we have basic anatomical knowledge of the Neck. In general, Some important structures in the Neck are given briefly which as following :

 Neck Bones (Cervical Vertebrae) 

There are seven vertebrae in the neck region. Each vertebra of this region is called cervical vertebrae. The cervical Vertebrae can rotate, bend forward, side to side flex. Each cervical vertebrae moves small degrees, and as a whole, it can move the neck 90 degrees of flexion and rotation and 45 degrees of side bending. The cervical vertebra has a hole or foramen by which arteries pass out to the brain.

The cervical spine has a concave shape naturally, which is called lordosis. Cervical vertebrae protect arteries, spinal cord, and intervertebral discs from any damage.

structure of neck bones
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Intervertebral disc structure,spinal nerve
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Image courtesy: science abc, new heights physical therapy

Spinal Cord

The spinal cord is a long tubular form of nerve tissue bundle that extends from the skull base up to the lumbar two vertebrae level. In the Neck region, the spinal cord is attached to the skull. The spinal cord transmits different sensory and motor signals from the brain to other body areas via the spinal nerve.

Spinal Nerves

At the cervical region, nerve roots look like a pole that emerges from the spinal cord. It extends to the arms and upper cervical region. The nerve is like a wire that carries various sensations from the brain to the neck through both arms. 

Intervertebral Discs 

An Intervertebral disc is the soft sac-like substance that stays between two vertebrae. The discs are responsible for absorbing pressure/jerk. The disc also provides the flexibility of neck movement in all directions. Its outer layer is thick fibrous band-like tissues called Annulus fibrosus, and the inner layer is gel-like soft sac material named Annulus pulposus.

Symptoms of Neck Ache

1. Neck pain and this pain can spread to the shoulders, arms, hands, and fingers.

2. Abnormal sensations or numbness in the shoulders, arms, hands, and fingers.

3. Arms, hands, and fingers may be weak.

4. stiffness in the neck, and it grows slowly.

5. Neck movement and standing can trigger neck aches.

. Lowering the neck and lifting something heavy or overwork can provoke severe neck aches.

. Sneezing, coughing, or leaning forward may elicit pain.

. The body becomes unbearably weak, sleep disturbances and inability to work may occur.

 6. Neck pain at night, or you may wake up due to pain.

What are other symptoms that are associated with neck pain?

  • Post covid-19 symptoms
  • Trigeminal neuralgia- a neurological condition 
  • Migraine
  • Sinusitis
  • Thoracic outlet syndrome- extra formation of bone on the neck region
  • High blood pressure
  • Diabetic neuropathy 
  • Hypothyroidism
  • Advance stage in pregnancy
  • Severe gastritis elicits pain in the neck and upper back
  • Fever, 
  • Stiff neck,
  • Throat pain,
  • Dental problem
  • Eye diseases or visual power decrease 
  • Weakness of the arms.

What are the different types of Neck Ache?

Neck pain has not found a verifiable root always, although some cases can trace out to general causes like muscle strain, disc slip or leakage, or narrowing of spinal foramen. However, pain can classify as follows:


Acute pain occurs when the sudden muscle pulls or cramp due to working time or pulling heavy lifting. MuscleS, ligaments are the main causes of acute neck pain. Wake up in the morning with a neck is the classical sign of acute neck injury.

Besides, road traffic injury or sports injury causes an acute ache in your neck. Acute pain lasts for three days to weeks. The intensity of pain can be mild, moderate, and severe depending on how badly the neck surrounding structures have been injured.


Chronic pain happens when your repetitive posture at the office, house cores works can not properly identify or modify. When the root cause of neck injury persists, your neck pain will come and go temporarily, which causes chronic aches.

Chronic neck ache lasts from months to a year or more. Chronic pain must be supervised by specialist doctors like an orthopedic, neurologist, physical therapist, osteopath.

Localize pain 

When pain is a specific area of the neck, such as the right side or left side, spasm and tenderness of that area are easily findable while putting pressure or doing neck movement. This kind of neck injury may be found while waking up in the morning. 

If this localized pain persists for more than five days, then you should visit your doctor. Muscle spasm or muscle strain causes localized pain. Mental stress also leads to neck muscle spasm that causes neck pain.

Cervicogenic ache

Pain in the back of your head and upper portion of the neck area is particularly detectable while palpating on the lateral side of the neck. In addition, the rotating head and neck become awful, and movement becomes restricted to an extent. A dull or throbbing type of sensation occurs in cervicogenic pain.

Facet joint pain

The facet joint is when two vertebrae are attached to their articular superior and inferior articular process—the roughness of smooth articular surface or ligament injury due to accident or degenerative changes with aging. 

Patients feel sharp, deep pain while there is facet joint pain of the cervical region. Neck pain occurs on the site of injured facet joints, either left or right side. Patients often mark as right side pain while moving the neck on the right side flexion or rotation.


Cervical means neck spine, and gia means pain or injury. Cervicalgia means generalized pain that happens in our neck region. Pain felt at the bottom of the head or top shoulder levels. Pain might also shift from the neck to the arms. Spasms and pain may limit your neck movement. 

Road traffic accidents or sports injuries, even bad sleeping positions, are the most common causes of cervicalgia. If cervicalgia persists for more than a week, you should consult with your specialized doctor regarding this issue.

Referred pain

When neck pain moves from the neck region to the upper back or arms, the disc is pushing corresponding spinal nerve roots. Nerve roots compression causes traveling pain from one area to another. Numbness or sharp, aching sensation is felt in this referring pain or radicular pain.

Risk Factors for Neck pain

  • Desk job employees especially work on the computer at office 
  • Mentally disturbed or tensed 
  • Poor posture maintenance at home and office 
  • Aging people or Osteoarthritis 
  • Degeneration of disc by age or diseases
  • Fibromyalgia 
  • Spinal canal stenosis 
  • Whiplash injury or neck injury. 
  • Ankylosis Arthritis
  • Uncontrolled Diabetes
  • Obesity
  • Vitamin D deficiency
  • Tumors or Cancer(rarely)

How do health care professionals diagnose neck pain?

  • Before starting any treatment protocol, diagnosis is mandatory, right. To ascertain the extent of damage on the neck region, your healthcare specialist will  undergo some physical and diagnostic tests, such as the following:
  • Details history taking of your neck pain
  • Physical examination of the neck region and associated part of the body.
  • Basic Blood tests like Total Blood Count, Blood sugar level, Hemoglobin, Creatinine Phosphokinase(CPK), etc.
  • X-Ray: To screen out any problem in the neck bones and its surrounding.
  • Magnetic resonance imaging (MRI): It shows all the soft tissue structures like a muscle, disc, ligaments, spinal cord of the neck spine.
  • Computed tomography scan (CT scan): CT scan shows any bony lesions with some more sophisticated features of the neck area more clearly than X-ray.
  • Myelogram: It is a radiological investigation of the neck spine, some medicine inserts of your body to see the hard and soft tissue structure distinctly.
  • Electromyogram (EMG): This reveals which neck muscles have gone completely degeneration or partially damaged.
  • Nerve Conduction Study(NCs): Any nerve injury to the neck area can be tested through this NCS test.

When to see your Doctor for Neck pain

  • Consult with the Doctor if you have neck pain that:
  • Persistent neck pain for more than one week and getting worse gradually although taking self-care.
  • If neck pain becomes continuous and you can’t sleep at night more than three days after taking over-the-counter drugs like paracetamol, Ibuprofen.
  • Radiating pain down to your arms, and your muscle becomes atrophied or numb.

What specialties of doctors treat neck pain?

First of all, your house Physician, a General Practitioner(GP), will prescribe and advise you on the necessary drugs and pain management. Later on, you can consult with the Orthopedic or Neurologist to reduce or stop your neck ache. A licensed Physical Therapist will also help you a lot regarding treating your neck injury.

How is Neck ache treated? (Treatment )

Treatment of neck pain usually depends on various factors. Most of the time, neck pain is cured within a week. If all other options fail, then only surgery will be considered. Multiple strategies are taken at once for chronic neck pain, including exercise, muscle strengthening training, meditation, and lifestyle changes.

1. You can take a hot or cold bath on the Neck to relieve the pain.

2. You can use painkillers, such as paracetamol or ibuprofen to get rid of the pain. Remember, self-medication can be dangerous and can worsen the situation. Consult your doctor if your pain does not subside within a week

3. People who suffer from neck pain due to reduced disc space in the cervical spine will use a neck collar when traveling. So that the shaking of the car does not further reduce the disk space

4. Physiotherapy treatment

There are some manual techniques or methods of physiotherapy treatment called manual therapy, through which it is possible to relax or normalize the muscles easily.

  • Such as:
  • MFR / Myofascial Release
  • MWM (Movement with Mobilization)
  • Manipulation Technique
  • Active release technique
  • McKenzie method
  • Dry needling
  • Retraction Technique
  • Neck muscle stretching
  • Neck muscle strengthening
  • Cervical Traction increases the strength of the neck muscles in some exercises or exercises so that the space does not decrease again later.


  • Cervical Traction (Auto & Manual)
  • Ultrasound therapy
  • Transcutaneous nerve stimulation(TENS)
  • Infrared radiation therapy(IRR)
  • Interferential therapy (IFT)
  • LASER Therapy
  • Shock Wave therapy
  • Short Wave Therapy(SWD)

How to ease neck pain at home

Hot and Cold therapy: If your neck pain is acute, ice therapy is undoubtedly beneficial for releasing muscle spasms and movement restriction. Ice has a great impact on reducing any inflammation of soft tissue structures such as muscles, ligaments, and joint capsules.

But when your neck ache becomes chronic, hot therapy is very supportive of reducing your neck injury. It will increase your blood circulation to the neck area that washed away all your toxic pain material around the painful area. Moreover, cold and hot can be given alternatively, which sometimes found the best effect to alleviate your neck ache.

Salt Bath: If you have neck pain due to muscle tension, you can take a bath by mixing Epsom salt in hot water. The sulfate magnesium in this Epsom salt helps relax muscles and reduce swelling and pain. It reduces stress as well as keeps blood circulation active.

Turmeric: Turmeric is an excellent ingredient to reduce shoulder pain. These include antioxidants; Contains anti-inflammatory ingredients. It works to reduce swelling and pain.

Apple cider vinegar: Apple cider has powerful antioxidant and anti-inflammatory properties that can relieve any pain in the body. Mix vinegar in hot water and massage it on the sore spot or soak a towel in this vinegar and put it on the sore spot. The benefits will match.

Ginger: Ginger contains anti-inflammatory ingredients and antioxidants. It reduces pain, helps increase blood circulation. Cut the ginger. Then boil two / three pieces of ginger in two cups of water. Add honey to it.

Massage: Massage is another excellent home remedy to reduce shoulder pain. Light massage helps reduce anxiety and stress. Gently Massage like this for 10 minutes.

Exercises to help your neck pain

Different exercises are better than taking painkillers. Appropriate exercise should be done based on whether the pain is just on the neck or spreading to the hands. Here are some simple exercises:

1. First, keep your neck straight and sit comfortably. Hold both shoulders high for 10 seconds. Then return to normal. You can do the exercise three to four or five times a day. Breathing exercises will be more effective while doing this exercise.

In this case, keep the neck straight and take a deep breath while sitting comfortably. Hold your breath while raising your shoulders. Although there is a pain in the hands with the neck, this exercise will be very useful.

2. Keep your head straight. Keep your hands on your forehead and try to press your hands with your head. In the same way, put your hands on the right side, left side, and back of the head and apply pressure with the help of the head. In this way, you can do this exercise several times in a row.

3. For those who have neck pain and difficulty in moving the neck, they can do the first relaxation exercise. Later you can do exercises by slowly shaking the neck in different ways. Bend the neck backward as much as possible. Similarly, try to bend the neck to the right and the left. 

Moving the neck as far as possible will gradually increase the range or distance. You can also do this exercise several times in two or three days.

Yoga for neck pain


Doing Triconasan Yoga stretches the spine horizontally, keeps the spine flexible and supple, and increases blood flow to the spine. It helps in relaxing the upper back muscles. As a result, there can be no upper back or neck pain.

Stand up straight to do this yoga. Keep a three-foot distance between your two legs. Then raise both hands along the shoulders on both sides of the body. Keep the palms of the hands facing downwards.

Then keep the body straight from the legs to the waist and try to touch the soles of the feet by gently turning to the right without leaning forward or backward. Gently raise your hand to your comfort level. e. If you practice for a while, you will do the seat in the right posture. Do this first to the right and then to the left.

Fishing position

Fishing position yoga results in a gentle massage of the abdominal organs. The muscles and nerves on both sides of the neck, shoulders, and spine are very good exercises. 

First, lie down on your back. Both legs will keep in touch at this time. The palms of the hands will stick to the floor. Place buttocks on the floor, keeping palms of hand on the floor and lifting the chest with the weight on both hands. 

The breath will remain normal. Stay like this for 10-15 minutes. If you are accustomed, you can stay for 1-2 minutes.

Balasan or baby-like posture

Doing this yoga relaxes the neck and shoulders and helps to get rid of drowsiness and headaches. Perform this exercise in a calmful mind.

Sit on your knees first. Then bend your head forward and touch the floor in front of your knees. In this position, place both hands straight forward on the floor.

Camel-like posture

Doing this yoga stretches the chest, shoulders, and neck. It also causes excellent expansion of the lower part of the body.

First, stand with the mass on both knees. The knees and legs will stick together. The spine will remain straight. Now hold your ankles with both hands while keeping your breath normal. Bend the chest and abdomen as far forward as possible and the neck and head backward like a bow. Return from this position for 10-15 seconds.

If you can’t put your feet together initially, you can do it easily by spreading your legs. If you can’t keep both hands together, hold it with one hand and hold it against the wall with the other hand. If you do this for a while, you will do the seat in the right posture. This seat is called Ustrasan because the middle part of the body is as high as a camel.

However, before starting yoga, it should be done with the advice of a Yoga expert.

What’s the outlook for people with neck pain?

Neck pain usually cures or recovers without surgery. Most cases of neck ache occur from a sedentary lifestyle and occupational hazard.

 In America, ninety percent of neck injuries are associated while doing work at computers.  

Neck pain due to bone fracture, tumor, spinal cord injury might have needed surgery. Major causes of neck ache are responding well by non-surgical treatment within a month.

How to prevent Neck pain?

Those who have not yet suffered from neck pain can prevent neck pain if they follow some rules.

1. Do not work long hours leaning forward. Take some time off between work.

2. Keep computer monitors at eye level for those who work on computers. As if not to lean too much.

3. Use a medium-sized pillow at bedtime, half facing the head and the other half facing the neck.

4. Above all, exercise according to the advice of a physiotherapist to maintain the strength of the neck muscles.

5. Change your lifestyle

. Change eating habits such as controlling or avoiding alcohol, quitting smoking, etc.

. Avoid stress or anxiety.

6. It is important to consult a doctor before starting any exercise, especially in cases of neck pain. If there is a situation that worsens when you exercise, the doctor will advise you to stop exercising.

Consult your doctor if you have had neck pain for several months.

Will I Need Surgery for Neck Pain?

Surgery for neck ache is not usually required for 90 percent of cases around the world. Proper diagnosis with treatment can recover neck pain within a month. Numbness, muscle wasting, and neck bone fracture require surgery.

When do you Seeking Medical emergency Care for neck pain

cute trauma of neck injury

Road Traffic Accident(RTA) induced injury or Contact sports injury. For example, car collisions, motorbike accidents, or twisting fall while playing soccer. 

Neck Muscle weakness/Paralysis

Sudden onset of muscle weakness in an arm or leg. Even sometimes, trouble for walking could be an early sign of medical emergency care.

Neck ache associated with High fever 

If you have an unbearable spontaneous neck ache with a high fever, there is a chance of suffering from spinal nerve lesions like meningitis. A bacterial invasion on the covering of the spinal cord or spinal nerve might cause life-threatening conditions. Immediate call for emergency medical care.


To prevent your neck pain, always have a break every hour at work time. A healthy lifestyle and early discussion with a doctor can refrain from your Neck injury.

Neck pain related FAQs (Frequently Asked Questions)

1. Can neck pain happen due to COVID-19?

The answer is no. There is no such research finding that COVID-19 has a direct link to neck pain. Survivors from coronavirus often suffer for a long time as a general weakness. Neck pain can trigger because of the muscular weakness of the neck region or long time watching tv or mobile.

2. What is the best for neck pain, heat, or cold?

First 72 hours, ice wrapped by a towel is the best treatment approach for neck pain. After three days, a hot pack can apply to reduce neck injury. In chronic neck ache, cold followed by heat can apply to get the best results. This is called the contrast method. Lastly, ask your Healthcare Expert before applying heat or cold for a disease-associated neck injury.

3. Can neck pain heal on its own?

Neck pain that occurs suddenly waking up in the morning. This kind of neck ache usually disappears within three days. But repetitive tasks like sitting for a long time on a chair using a computer must get attention to this issue to heal neck injury.

4. Should you message pulled neck muscles?

Doing massage on pulled or cramping muscles is strictly prohibited. Massage on injured muscle can further increase muscular irritation or pain.

5. Can stress cause neck pain?

Mental stress particularly makes neck muscles stiff and painful, causing neck pain. There is a strong association between mental stress and neck pain in many research studies.

6. How do I loosen up my neck muscles?

A physical therapist will help you reduce the tightness of neck muscles through heat. Different manual techniques like active muscle release will also loosen your muscle spasm. Muscle relaxant drugs might relax your stiff neck muscles.

Dr. Abid Kabir
Dr. Abid Kabir
Mohammad Abid Kabir is a licensed Physical Therapist in Bangladesh. He has vast clinical experience in treating critical patients on Orthopedic, Neurological, Geriatric, Pediatric, and Sports injuries. He is also a Public Health specialist with an emphasis on Disability issues and healthcare management. His post-graduate thesis was a KAP study on “Disability. “ Recently, he involves in Respiratory rehabilitation for Post-Covid-19 patients. He has been consulting on Medical, Health & Fitness issues for 14 years. Being passionate about Professional Blogging, Content Writing, and SEO works, he has been consulting for around ten years on Global media and the International market places.


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