Exercise for Cervical Pain – Neck Exercise

Neck pain, often referred to as cervical pain, is a prevalent medical issue causing discomfort or soreness in the neck region. Understanding the nuances of neck pain and its treatment options is vital to address this common yet bothersome health concern. In this blog, we will explore the various aspects of neck pain, bad posture and its management through Exercise for Cervical Pain

Exercise for Cervical Pain – Neck Exercise

Neck pain, also known as cervical pain, is a common medical condition characterized by discomfort or soreness in the region of the neck. The neck is composed of vertebrae, muscles, ligaments, and tendons that support the head and allow for its movement. Treatment for neck pain depends on its underlying cause but may include rest, physiotherapy, pain medications, muscle relaxants, and in severe cases, surgical intervention.

Common causes of neck pain include:

Muscle Strain:

Overuse or excessive strain on neck muscles, often due to poor posture, repetitive motions, or sleeping in an awkward position, can lead to muscle tension and pain.

Neck Injuries:

Trauma or injury to the neck, such as whiplash from a car accident or a fall, can cause neck pain.

Herniated Discs:

The discs between the vertebrae in the neck can bulge or herniate, pressing on nearby nerves and causing pain.

Arthritis:

Osteoarthritis or rheumatoid arthritis can affect the neck joints and cause pain and stiffness.

Nerve Compression:

Conditions like cervical radiculopathy or a pinched nerve can lead to pain, tingling, or numbness in the neck and down the arms.

Poor Posture:

Maintaining poor posture over time, such as slouching at a desk or using electronic devices with the head tilted forward, can strain the neck and lead to pain.

Stress and Tension:

Emotional stress can lead to muscle tension in the neck and shoulders, resulting in pain.

Infections and Inflammation:

Conditions like meningitis, neck abscesses, or inflammatory disorders can cause neck pain.

Tumors:

Rarely but tumors or growths in the neck region can lead to pain and discomfort.

Neck pain may present with following variation :

• Neck pain left side
• Neck pain right side
• Pinched neck nerve
• Neck muscle spasm
• Stiff neck
• Suboccipital neuralgia

Symptoms of neck pain can vary from person to person but may include the following:

Aching, throbbing, piercing, scalding or dull discomfort in the cervical spine.

Discomfort extending into the upper back, shoulders, arms, forearms, or hands.

Discomfort extending into the occiput or skull (the base of the skull).

Sensations of numbness or tingling in the arms, forearms, or hands.

Discomfort or rigidity when moving the neck.

Neck pain can vary and may include stiffness, limited range of motion, headaches, and radiating pain down the arms or into the shoulders.

Classification of Neck Pain

The ICD-10 code for neck pain is utilized when a patient exhibits discomfort or pain, typically located in the posterior or lateral area of the cervical spine. This pain can persist for either over three months, classifying it as chronic, or less than three months, categorizing it as acute. Therefore, neck pain can range from mild to severe and may be acute (short-term) or chronic (long-lasting).

Principles /Basic of neck exercise

Precaution for Neck Exercises

Before starting the neck exercises consult to the physiotherapist

• If neck pain due to accident or pain, numbness, tingling or weakness in the arm is worsening due to exercise. An indicator that neck issue may be worsening is when symptoms extend beyond the neck itself, radiating into shoulder or down to the arm. This can occur during specific exercises or common daily activities like driving, reading, or prolonged computer use.
• If persistent or severe neck pain, it is important to consult a healthcare professional for a proper diagnosis and appropriate treatment.

Physical activity should continue   

Physical activity is crucial for individuals dealing with neck pain. This article will illustrate how to remain active while minimizing the exacerbation of neck discomfort. Staying active can even lead to a reduction in neck pain and act as a preventive measure against its recurrence in the future.

The exercises protocol for neck provides rapid and significant relief, expediting recovery and guarding against the return of pain. Once pain diminishes or disappears altogether, additional exercises can assist in restoring neck mobility and strengthening muscles. These exercises play a vital role in achieving a full recovery and reducing the risk of future episodes.

Many Physiotherapy professionals believe that returning to regular activities is worth considering if it is challenging to alleviate neck pain. Even if there is a temporary increase in pain during the activity, it is generally deemed acceptable if the pain subsides once the activity concludes. Therefore, it is advisable to strive for continued physical activity.

Choosing the right exercise for centralization of the symptoms

Choosing the right exercises is crucial to prevent exacerbating neck pain. The encouraging news for reversal of symptoms may include that pain can shift from arm or shoulder closer to the center or midline of neck, a phenomenon referred to as “symptom centralization.”

When this occurs, it signifies improvement and progress toward recovery. Subject might even be able to identify exercises and positions that intentionally facilitate this centralization. In such cases, as all symptoms return to the center of the neck, they often diminish and eventually disappear with continued exercise. If pain is confined to your neck without symptoms spreading, these same exercises frequently alleviate that pain. Numbness or tingling typically improves as well, though it may sometimes take longer than pain relief.

There are some straightforward exercises approaches that are often effective in centralizing and reducing neck-related symptoms. While performing these exercises, as well as any other activities, closely monitor your pain, numbness, and tingling. Ensure that they are moving toward the middle of the neck, becoming less intense, or at least remaining stable.

If these symptoms are moving away from the neck, discontinue the exercise. Persist with the exercises that provide the most pain relief and avoid those that worsen discomfort

Role of Physiotherapy in neck pain

Physiotherapy plays a crucial role in the management and treatment of neck pain. Here are several key reasons highlighting the importance of physiotherapy in addressing neck pain:

Pain Relief:

Physiotherapists are trained to use various techniques and modalities to alleviate pain. Through manual therapy, exercises, heat/cold therapy, and other interventions, they can help reduce the intensity and frequency of neck pain.

Improved Mobility:

Neck pain often leads to stiffness and restricted range of motion. Physiotherapy focuses on improving neck flexibility and mobility through targeted exercises and stretching routines.

Posture Correction:

Poor posture is a common contributor to neck pain. Physiotherapists can assess your posture and provide guidance on how to maintain proper alignment, reducing the risk of future pain.

Muscle Strength and Endurance:

Weak or imbalanced neck muscles can contribute to pain. Physiotherapists design exercise programs to strengthen the neck and shoulder muscles, which can help prevent pain recurrence.

Education:

Patients often benefit from understanding the causes of their neck pain and learning techniques to manage and prevent it. Physiotherapists educate patients about ergonomics, body mechanics, and lifestyle modifications to reduce the risk of pain.

Manual Therapy:

Hands-on techniques such as joint mobilization and soft tissue massage can be highly effective in relieving neck pain by reducing muscle tension, improving circulation, and restoring joint function.

Tailored Treatment Plans:

Physiotherapists create individualized treatment plans based on a patient’s specific condition and needs. This personalized approach ensures that the treatment is focused on addressing the root causes of the neck pain.

Preventing Recurrence:

Physiotherapy not only aims to relieve current pain but also works to prevent future episodes. By addressing underlying issues and providing patients with tools and exercises for self-management, physiotherapy helps reduce the likelihood of recurrent neck pain.

Avoiding Medication and Surgery:

In many cases, physiotherapy can be a conservative and non-invasive alternative to medication or surgery. It can help individuals manage their neck pain effectively without resorting to more aggressive interventions.

Enhanced Quality of Life:

Chronic neck pain can significantly impact an individual’s quality of life, affecting daily activities and overall well-being. Physiotherapy can help restore function and improve the overall quality of life for people suffering from neck pain.

In conclusion physiotherapy is essential in the comprehensive management of neck pain. It offers a holistic approach that addresses pain relief, functional improvement, and prevention, allowing individuals to regain their comfort and mobility while minimizing the risk of future issues. If anyone experiencing neck pain, consulting with a physiotherapist can be an important step in recovery.

Physical therapy for neck pain

 

 

Neck pain treatment / neck pain relief exercises

1. Neck Posture awareness and correction
2. Neck strengthening exercises
3. Neck Range of Motion Exercises
4. Neck stretches for pinched nerve

Posture correction exercises:

Posture awareness is very Important in neck pain management

Bad neck posture

Many of us tend to slouch and allow our head to just forward. This forward head position, particularly when sustained for extended periods, frequently leads to the development and exacerbation of painful neck conditions. Symptoms worsening while sitting, which means they are becoming more intense or spreading away from neck, possibly into shoulder or down arm, it is likely due to bad posture. In essence, the effect of a forward head position on painful lower neck is comparable to the strain caused by bending forward at the waist, a behavior often associated with exacerbating low back pain.

Good neck posture

Proper neck posture involves correctly positioning and consistently maintaining head in a neutral alignment. This means that when viewed from the side, ears should align directly above shoulders, . Initially, this posture might feel somewhat unfamiliar, akin to tucking your chin slightly. However, this new position effectively centers the weight of head directly over supporting spine. This alignment minimizes stress on the discs and supporting ligaments in neck. It is advisable to maintain this posture while sitting consistently.

Cultivating the habit of sitting more erectly with head in a neutral position, helps prevent the protruded head position.

This is not only frequently essential but also highly beneficial for achieving lasting comfort in the long run. 

Fig: -1 Bad & Good neck posture with neck retraction

 

 

Neck posture corrector techniques

 

1.2 Postural correction

• Day time postural correction (DTPC)
• Night time postural correction (NTPC)

Day time postural correction (DTPC)

• Good neck posture

• Neck retraction

All these exercises should be

practices in the following position

• Walking
• Standing
• Sitting
• Lying supine

Good neck posture: -Upright posture in a neutral head alignment is essential. Strive to maintain a posture of stand tall with chest up, shoulders pulled back and ears align directly over shoulders. Ensure to avoid allowing head to slouch forward, as this is a detrimental habit that frequently leads to neck discomfort and extends the recovery process. Initially, it may require conscious effort to consistently keep head in the correct alignment by drawing it backward. However, with time, this neutral head position will become new, corrected natural habit.

Devote 5-10 minutes to this position, and consider repeating it every couple of hours if necessary. This practice often reduces or even eliminates neck discomfort, facilitating head’s gradual adjustment towards the ideal alignment.

Use of Pillow for neck pain

Night time postural correction (NTPC)

Sleeping position:

Supine positioning sleeping:

Neutral head position is a simple way to establish and maintain a with minimal effort with lie on r back with a thin pillow (½ -1 inch), or ideally, no pillow at all, gently allow head to recline backward. This action helps align ears more closely with shoulders and hips, achieving a more comfortable posture.

Side line positioning sleeping:

Neutral head & neck position is established and maintain a with a thick pillow (4 -5 inch). This action helps align the all-spinal vertebrae spine & achieving a more comfortable posture. 

Fig: 2 Supine & side line sleeping position

 

 

Isometric neck exercise/ Isometric strengthening

 Many individuals experiencing neck pain often have weakened muscles in their neck, upper back, and core. By engaging in exercises that strengthen and stretch these muscles, neck pain can be improved. This, in turn, enhances ability to perform daily activities. Strengthened muscles offer greater support to your neck and trunk, promoting good posture and improved overall body movement. Building strength also serves as a protective measure against potential future issues. Moderate strength training ranks among the most valuable steps for overall well-being.

Home exercise are effective, low-tech, and cost-efficient methods to bolster the muscles in r neck and upper back.

Isometric neck exercise/ Isometric strengthening

Sit in a chair with back straight or supported, head in the neutral position.

Neck Extension Resistance: Place the hand against the back of the head and push the head backward while resisting with the hand. Push hold for 10 seconds, then relax, and repeat 8-10 times.

Neck Flexion Resistance: Place hand against forehead and push the head forward while resisting with the hand. Push hold for 10 seconds, then relax, and repeat 8-10 times.

Lateral Neck Resistance: Place the hand against the side of the head and push the head to the side while resisting with the hand. Push hold for 10 seconds, then relax, and repeat 8-10 times. Do the same by bending neck to other side also.

Fig: 3   Isometric cervical strengthening exercises

Isotonic strengthening exercise:

Supine Head Lifts:

Lying on back on a firm surface, raise head fully off the surface, taking chin toward the chest and hold for 10 seconds before returning to starting position. Repeat that lift 8-10 times, twice a day

Prone Head Lifts:

Lying face down on a firm surface, raise the chest, shoulders, and head up by resting on elbows. Let the head hang fully downward so chin is near chest. Lift the head upward with retracted head (tuck chin). Then continue lifting the head upward and backward as far as it will go to look skyward. Hold that position for 10 seconds before slowly returning through that head-neutral position to the original downward position. Repeat that exercise 8-10times, twice a day.

Fig: 4 Supine & prone Head Lifts

Shoulder Blade Squeezes/Scapular Retraction: Stand with arms at sides. Keep the head and neck in neutral position. With chest lifted, gently but firmly pull both shoulders backward while squeezing both shoulder blades together. Hold for 10 seconds and repeat that exercise 8-10times, twice a day. Some resistance can be added by stretching a towel or using an elastic band across chest during shoulders retraction.

Scapular Retraction with resistance: Some resistance can be added by stretching a towel or using an elastic band across chest during shoulders retraction.

Fig: 5 Shoulder Blade Squeezes or Scapular Retraction       

Shoulder shrugging:

It is a simple yet effective exercise that targets the trapezius muscles and can help improve posture and alleviate neck and shoulder tension. Stand or sit up with back straight, inhale and lift both shoulders straight up toward the ears as high as can. Hold for 10 seconds, exhale slowly lower the shoulders back down to the starting position. And repeat that exercise 8-10times, twice a day.

Dumbbell Shrugs:

It can be progress with a light weight using dumbbells gradually as become more comfortable with the exercise. Hold a dumbbell in each hand and perform the shrugging motion as describad above.

Shoulder rotation :

Shoulder rotation exercise typically refers to exercises aimed at improving or preventing a common postural issue of upper back. These exercises focus on strengthening the muscles that support good posture and opening the chest to counteract the forward slumping of the shoulders by reliving the muscle spasm.

Fig-6 Shoulder shrugging exercise  Fig: 7 Shoulder rotation exercise

Chin Tucks:

Sit or stand with head in a neutral position. Gently place fingers on chin and apply downward pressure to tuck the chin toward the chest. Ensure that feel a gentle stretch at the back of neck and a sensation of mild crowding in the front of neck. then release. Hold that retracted stretching position for 8-10 seconds and then release, allowing head to return to neutral. Repeat that movement 8-10 times and perform 2 such sessions each day.

Cervical Retraction:       

Sit up straight and gently draw the head backward as if trying to make a double chin. Hold that retracted stretching position for 8-10 seconds and then release, Hold that retracted stretching position for 10 seconds and then release, allowing head to return to neutral. Repeat that movement 8-10 times and perform 2 such sessions each day.

Repeat this stretch while paying close attention to any changes in discomfort levels. If any improvement in pain, continue the exercise. However, if pain worsens as a result of the exercise, it is important to stop immediately.  

Neck Range of Motion Exercises:

Neck Tilts:

Gently tilt the head to the left and right, then forward and backward. Hold each position for 10 seconds. Repeat that exercise 8-10times, twice a day.

Neck Turns/ Neck Rotation:

While sitting or standing with head and neck in neutral position slowly turn head to the left as far as comfortably can (trying to look over shoulder) and hold for 10 seconds. Similarly, slowly turn the head to the right and hold for 10 seconds. Repeat that exercise 8-10times, twice a day.

Neck Stretching Exercises

Neck Stretch:

Tilt the head to one side and gently apply pressure with the hand to increase the stretch. Hold for 15-30 seconds and repeat on the other side. Repeat that exercise 5-8times, twice a day.

Chin to Chest Stretch:

Slowly bring chin down toward your chest and hold for 15-30 seconds. Repeat that exercise 5-8times, twice a day.

Behind-the-Back Stretch:

Clasp hands behind the back and gently lift arms while pulling shoulder blades together to stretch the neck. Hold for 15-30 seconds. Repeat that exercise 5-8times, twice a day.

Fig: 9 Neck Stretching Exercises

 Summary

Good neck care with neck exercises are very good managing tools for pain and  to restore full neck movement. These techniques can help to recover and provide a good defense against future symptoms.

Cervical exercises can be beneficial for managing neck pain and promoting neck strength, flexibility, and overall comfort. However, it’s important to consult with a healthcare professional or physiotherapist before starting any exercise regimen, especially with an existing neck condition or injury, to ensure that the exercises are safe and appropriate for specific situation.

Remember to perform these exercises slowly and gently and stop immediately if any pain or discomfort experience. Consistency and proper form are key to benefiting from cervical exercises for neck pain relief.

It is advisable to reach out to a physiotherapist if you are experiencing persistent pain that doesn’t improve with home exercises. They can provide you with treatments such as mobilization, manipulation, electrotherapy, or advice on optimizing your workstation ergonomics, among other options. Additionally, it is essential to seek guidance from a physiotherapist to create a customized exercise plan tailored to your specific needs and limitations.

Frequently asked questions (FAQs)

1. What is neck pain or cervical pain?

Neck pain, medically referred to as cervical pain, is a prevalent condition characterized by discomfort or soreness in the neck region. The neck consists of vertebrae, muscles, ligaments, and tendons that provide support to the head and enable its movement.

2.  What are the common causes of neck pain?

Common factors contributing to neck pain include poor posture, muscle strain, neck injuries, herniated discs, arthritis, nerve compression, stress, tension, infections, inflammation, and, rarely, the presence of tumors or growths in the neck area.

3. What are the symptoms of neck pain?

Symptoms of neck pain can vary from person to person and may encompass aching, dull pain, discomfort that extends into the upper back, shoulders, arms, or hands, sensations of numbness or tingling in the arms, discomfort or stiffness when moving the neck, and more.

4. How is neck pain classified?

Neck pain can be categorized as acute (short-term) less than 6 weeks, subacute less than 12 weeks or chronic (long-lasting) extends beyond 12 weeks, respectively.

5. What are the principles and  precautions for neck exercises?

Before initiating neck exercises, it is essential to seek advice from a physiotherapist, particularly when dealing with persistent or severe neck pain. Vigilance is required during exercise to monitor any exacerbation of symptoms or their extension beyond the neck.

6. What role does physiotherapy play in managing neck pain?

Physiotherapy plays a pivotal role in the comprehensive management of neck pain. It encompasses pain relief, enhanced mobility, posture correction, muscle strengthening, patient education, manual therapy, personalized treatment plans, and a focus on prevention to minimize the likelihood of recurrent neck pain.

7. What are some neck exercises for      pain relief and strengthening?     

Neck exercises aimed at pain relief and strengthening of the neck. It includes isometric and isotonic neck strengthening exercises, various stretching routines to promote awareness and correction of neck posture. Neck exercises are also beneficial for improving neck flexibility and mobility enhance neck range of motion, and relieve discomfort associated with pinched nerves.                                               Please be mindful that it is crucial to consult with a healthcare professional or physiotherapist before embarking on any exercise regimen, especially if you have an existing neck condition or injury, to ensure that the exercises are safe and appropriate for your specific circumstances.