Physical Therapy Exercises for Neck Pain
Neck pain is a common complaint that brings people to physical therapy. Not only are the causes of neck pain difficult to understand, but just how to get rid of this nagging pain is even more confusing. In this post, I share 4 exercises to reduce neck pain. The biggest perk, they can all be done sitting at your desk!
What causes neck pain?
There are many structures in your neck (also called your cervical spine). Muscles, vertebrae, and peripheral nerves are all important structures that can become injured and cause pain. However, simple stiffness in your neck and even in your upper back can cause neck pain and contribute to headaches. That’s why a few simple exercises may be enough to reduce your neck pain and allow you to go through your day without this nagging injury.
Physical Therapy Exercise 1: Thoracic Extension
Your thoracic spine (upper back) is like the middle child (sorry kids), it often gets overlooked. People don’t usually come into the clinic complaining about pain in their upper back. Instead they have neck or low back pain, but a stiff upper back is usually present. Thoracic extension sitting in a chair is one of the easiest ways to stretch your upper back. If you sit at a desk, performing this stretch throughout the day can reduce your neck pain and improve your posture.
How to perform: sit in a chair with a shorter backrest. Sit your bottom all the way back in the chair so you are upright and your low back is touching the back of the chair. With your hands supporting your head, bend over the back of the chair until you feel a gentle stretch in your upper back. Note: do NOT perform this exercise in a chair that is on wheels or a chair that is not extremely sturdy. Safety first!
Parameters: 10-20 reps 3 times per day.
Physical Therapy Exercise 2: North, South, East, West
This exercise allows you to gently improve your neck motion in 4 different directions. As you work into each direction think about going far enough to “kiss” the tightness you feel. Don’t force into each direction as hard a possible, but also don’t move so little that you don’t work into the tightness at all. As you do repetitions, you should be able to move further in each direction.
How to perform: Look down toward your toes. Look up toward the ceiling. Look right toward the tip of your right shoulder. Look left toward the tip of your left shoulder.
Parameters: 10 reps in each direction 3 times per day.
Physical Therapy Exercise 3: Cervical Extension
Cervical extension, or looking up toward the ceiling, is a movement that is often limited. That’s why I recommend doing this movement during the previous exercise and giving it extra attention by performing this exercise. My test for my neck extension is washing my hair. If I rinse my hair in the shower and the back of my neck hurts, I know I haven’t been stretching enough or I’ve been hunching over my computer. Often I find that when this movement is restored, moving in the other directions becomes easier or less painful.
How to perform: tuck your chin back slightly (see next exercise), then look up toward the ceiling as far as you can. If you feel stiff as you look up, hold your head up and gently rock from side to side. This gentle movement will help you ease into the stretch a little more. But don’t forget to just “kiss” the tightness.
Parameters: 10-20 reps 3 times per day.
Physical Therapy Exercise 4: Double Chin Stretch
The form for this is tough, but it’s well worth the effort to learn! This exercise mobilizes the joints and stretches the muscles at the base of your skull and is part of the McKenzie treatment method. So if you feel a gentle stretch at the base of of your skull, you’re doing it correctly. The need for this stretch again comes from our tendency to round our shoulders and push our head froward. Performing this exercise (and all of these exercises) can help you avoid the upper back “hump” that is often seen in elderly people.
How to perform: sit tall. Gently tuck your chin straight back like you are giving yourself a double chin. But go straight back more than down. Remember if you feel a stretch at the base of your skull, you are doing the stretch correctly.
Parameters: 10-20 reps 3 times per day.
Top Tips for these physical therapy exercises
Remember to kiss the tightness. With repetition how far you can move in each direction should increase. Safety first! Do not aggressively push into restriction.
Why 3 times per day? If you’re like me, you are either working on your computer, cooking, or staring down at your phone. Our tendency to get into this forward posture means we need to work into other directions often, especially if we are trying to get rid of neck pain.
Why 10-20 reps? If you are doing these exercises often and have relatively good movement in your neck, 10 repetitions is probably enough. But if you are very tight and/or experience neck pain, you will likely need more repetitions to improve your movement and your pain.
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Disclaimer: These exercises are not a substitute for full medical evaluation. You should consult your doctor if you are experiencing any new pain especially if you have tingling or weakness in your arm. If any of these exercises sound especially helpful for you, be sure to discuss with your doctor the best way to implement them into your health plan and ask for a referral to a physical therapist for a full musculoskeletal evaluation.