Neck pain: common causes and what helps

What neck pain usually is

Neck pain is very common and, like back pain, most of it is non-specific. That means it comes from the joints, muscles and other tissues of the neck being irritated or sensitised, without a single serious structural problem behind it. You might wake with a stiff neck that will not turn, or notice a nagging ache after a long week at a laptop.

A smaller group of people have nerve root irritation in the neck, called cervical radiculopathy. This sends pain, pins and needles or numbness into the arm and hand, and it needs a more careful assessment.

Common causes and who gets it

• Long periods in one position, such as desk work, driving or looking down at a phone
• Sleeping awkwardly or on a pillow that does not suit you
• Stress and poor sleep, which increase muscle tension and pain sensitivity
• Sudden increases in training, especially heavy shrugs, lots of overhead work or high-volume pulling
• Minor strains from sport, carrying a heavy bag on one shoulder or overhead DIY
• Age-related changes in the neck joints, which are common and often cause no pain

Posture gets blamed for almost all neck pain, but the evidence for a single ideal posture is weak. The bigger issue is staying in any one position for too long. A neck that moves often and is reasonably strong tends to tolerate a desk day far better than one held rigidly upright. Our guide on training around a desk job has practical ideas, and our page on postural pain explains the posture question in more depth.

Typical symptoms

Non-specific neck pain is usually an ache or stiffness in the neck that can spread into the top of the shoulders, between the shoulder blades or up into the back of the head. Turning to check a blind spot or looking up at a shelf may be sore. Some people get a headache that starts at the base of the skull.

Nerve root irritation feels different: sharp, burning or electric pain running into the arm, often with pins and needles in particular fingers, and sometimes weakness when gripping or lifting. Pain can be worse when looking up or tilting the head towards the painful side.

What a physio assessment looks at

Your physio will ask how it started, what makes it better and worse, and screen for signs that need medical attention, such as trauma, dizziness, visual changes or general illness. Then they will look at how the neck and upper back move, test the strength and endurance of the neck and shoulder muscles, and check nerve function in the arms if you have arm symptoms.

They will also look beyond the neck: your workstation, your sleep, your stress levels and your training programme. Heavy upper-body sessions stacked on top of long desk days are a very common pattern in people who lift.

What usually helps

Exercise has the best support for neck pain that has lasted more than a few weeks, particularly strengthening for the deep neck muscles, upper back and shoulders. Manual therapy, such as joint mobilisation or soft tissue work, can ease pain and stiffness in the short term and works best combined with exercise. Soft collars and prolonged rest are not recommended for ordinary neck pain.

For lifters, the plan usually involves reducing whatever loads the neck most for a while, such as heavy shrugs or overhead pressing, while keeping the rest of training going. Upper back work like the face pull and rows often feels good and can be progressed as symptoms settle.

What you can start with at home

1. Gentle range of movement: slowly turn, tilt and nod the head within a comfortable range, 5 to 10 times each direction, a few times a day.
2. Chin tucks: sit tall and gently draw the chin back as if making a double chin, hold for 5 seconds, repeat 10 times.
3. Shoulder blade squeezes: draw the shoulder blades back and down, hold for 5 seconds, repeat 10 times.
4. Walk daily. General activity eases stiffness and helps with sleep and stress.
5. Try a pillow height that keeps your neck roughly level with your body when you lie on your side.

Heat can ease muscle tension and many people find a warm shower first thing helps. Aim to keep discomfort mild during exercises and make sure it settles afterwards.

As the neck settles, build strength and endurance. Rows, band pull-aparts and holding the head steady against light hand pressure in each direction are good places to start. Add a little each week rather than jumping straight back to your old training loads.

Recovery and when to get urgent help

Many people find a new episode of neck pain eases within a few days to a couple of weeks, and most improve within about six weeks. Arm pain from a nerve root often takes longer, commonly several weeks to a few months. If symptoms keep returning, the on-site physio at Lycan Strength can assess you, with 20% off for members, and you can book a physio appointment online.

• Call 999 if neck pain comes with a high temperature, severe headache, stiff neck, sensitivity to light or a rash, as these can be signs of meningitis.
• Call 999 for a sudden, severe headache, or neck pain with dizziness, double vision, slurred speech, difficulty swallowing or weakness on one side.
• Go to A&E after a fall, collision or sports impact if you have significant neck pain, numbness or tingling, or cannot move your neck.
• See your GP urgently for clumsy hands, problems with balance or walking, or arm weakness that is getting worse.
• See your GP if you have unexplained weight loss, a history of cancer or constant severe night pain.

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