Treating neck pain with a dose of exercise

Do your neck and shoulders ache? Not long ago, you would have been told to rest, maybe use a neck brace, and wait until the pain had ebbed away. Doctors have changed their song about the best treatment for neck and shoulder pain. They now recommend movement instead of rest.

As described in Neck and Shoulder Pain, a newly updated Special Health Report from Harvard Health Publishing, there is mounting scientific evidence for the role of stretching and muscle strengthening in treating people with neck and shoulder pain. After a whiplash injury, for example, people heal sooner and are less likely to develop chronic pain if they start gentle exercise as soon as possible. For those with long-term pain (called chronic pain), results from controlled studies show that exercise provides some relief.

One review of the research found that exercise programs to stretch and strengthen either the neck alone or the neck plus the shoulders and the trunk improve pain in the short and long term compared with standard treatment with pain relief medication. Other studies support strengthening, stretching, and general physical activity. But exactly how much exercise to do, what types are best, and how often it should be done have yet to be determined. That uncertainty might explain why, despite the evidence favoring the role of exercise in relieving neck and shoulder pain, fewer than half of people who see a health professional for these problems are prescribed exercise as part of their treatment plan.

Taking steps

If you’re interested in using exercise to help relieve neck or shoulder pain, make sure to see your doctor for evaluation. Ask if you can get help from a physical therapist or other professional who can create an individualized exercise program based on your pain severity, limitation of movement, and current strength. The program should have clearly stated goals and include stretching and strengthening exercises, as well as exercises to improve how you use your neck muscles.

Ideally, if you are working with a therapist, he or she will guide you through appropriate exercises, motivating you to work hard enough to see results but not so hard as to cause further injury. At some point, you will be given exercises to do at home. Before you exercise independently, make sure you understand which exercises to do and how to do them safely. Ask for written instructions and illustrations if you are still unsure.

For more information, take a look at Neck and Shoulder Pain, which is available at /NK. There you can see a description of the report, its table of contents, and a free excerpt that covers causes of neck pain and common types of it.