Massage therapy · Kitchener–WaterlooNeck Pain

Muscle:

Muscle pain in the neck is very common, and poor posture is one of the common causes (NHS, 2023). Our heads are heavy, and the neck muscles that support them are fairly small. When the head is kept in line with the body (imagine a golf ball sitting on a tee), its weight is easily supported by the neck. However, we live in a forward-facing world with computers, cars, TVs, smartphones and tablets that encourage us to poke our heads forwards. When the head and neck sit forwards, known as forward head posture, the neck muscles have to work harder to hold the head up, which over time can lead to muscle fatigue, aching and neck pain. Keeping the neck in the same position for a long time can also cause pain (NHS, 2023).

Facet joint:

Facet joints are small pairs of joints at the back of each vertebra that allow the neck to bend and twist (Cleveland Clinic, 2022). They can be strained or injured, or simply become stiff and painful. The neck can become locked in an awkward position while sleeping (NHS, 2023), so people typically wake up with the pain; sometimes a small movement during the day locks the neck. It can be very painful, and the person may be unable to turn the neck without sharp pain.

Disc:

The intervertebral discs are shock-absorbing cushions that sit between the vertebrae (Cleveland Clinic, 2022). They can bulge or prolapse, known as a “slipped disc” in lay terms, where the disc protrudes backwards and can pinch a nerve in the neck, causing pain to travel down the arm. A pinched nerve is one of the common causes of neck pain (NHS, 2023).

Vertebrae:

The discs and facet joints are susceptible to age-related wear and tear, known as cervical spondylosis or neck arthritis (American Academy of Orthopaedic Surgeons, n.d.). It is very common in middle-aged and older people, and can simply be part of the normal ageing process (American Academy of Orthopaedic Surgeons, n.d.). Sometimes it causes neck pain and stiffness, and some people have a particularly stiff neck. A family history of neck pain and spondylosis increases your risk, as do smoking, jobs with lots of repetitive neck movement or overhead work, and previous neck injury (American Academy of Orthopaedic Surgeons, n.d.).

Ligaments:

Ligaments are less commonly injured, but can be damaged by forceful movement of the neck, such as in whiplash injuries.

1. Medication

The NHS says you can take paracetamol or ibuprofen, or use ibuprofen gel on your neck, to ease neck pain (NHS, 2023). (This medicine information comes from the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.) Medication can help with short-term neck pain, but if you find yourself relying on it, let me know: I can assess what may be behind your neck pain and help you manage it, and point you to a physiotherapist, osteopath or chiropractor if you need one. See your family doctor or nurse practitioner if painkillers like paracetamol or ibuprofen have not worked (NHS, 2023).

2. Keep Your Neck Moving

Do not wear a neck collar; it's better to keep your neck moving, unless a doctor tells you otherwise (NHS, 2023). Keeping the neck still (immobilisation) is not recommended for this type of neck pain (El-Allawy et al., 2025).

Options outside my scope

• Spinal manipulation: a hands-on technique, given by trained practitioners such as chiropractors, osteopaths and some physiotherapists, that moves a joint quickly; it can be offered for longer-lasting neck pain alongside exercise (El-Allawy et al., 2025).

How I can help (see the My Approach tab)

• Stay active: Gradually increasing your normal daily activity can help to reduce stiffness and pain and improve physical function (El-Allawy et al., 2025). Gentle neck movement will help to relieve pain and stiffness.
• Heat: Applying heat yourself is recommended for neck pain (El-Allawy et al., 2025). Use a hot water bottle wrapped in a tea towel for 20 minutes, 2 to 3 times a day (NHS, 2023).
• Cold: Alternatively, use a pack of frozen peas wrapped in a tea towel for 5 minutes, 3 times a day (NHS, 2023).
• Posture: Change activities and position frequently. Do not keep your neck in the same position for a long time, for example when sitting at a desk (NHS, 2023). Sit upright, roll your shoulders back gently and bring your neck back (NHS, 2023).
• Sleep: You may have difficulty sleeping. Use a low, firm pillow, and make sure your head is the same height as the rest of your body. Have a firm mattress, do not sleep on your front, and do not twist your neck when you're in bed (NHS, 2023).
• Regular exercise and physical activity: This helps to keep your neck fit and healthy. Walking, swimming and yoga are popular, but it is important to do an enjoyable activity that you can benefit from without making your pain worse.
• Taking a warm shower can help to relax sore muscles in the neck.
• Ask your employer for a workplace ergonomic assessment. Making small changes to the set-up of your computer can make a big difference over a period of weeks and months.
• Be careful with long periods of laptop and tablet use, which encourage you to bend your neck forwards.
• Do not do anything that could be dangerous because you cannot move your neck properly, such as driving or cycling (NHS, 2023).

If it hasn't eased after a few weeks, I'll suggest checking in with your family doctor or nurse practitioner too. If you have weakness that's getting worse, clumsy hands, trouble walking or changes in bladder or bowel control, call 911 or go to the emergency room.