Simple self-help treatments and a day or two's rest are often enough to clear up a spell of neck pain. If you do have a more complex or persistent neck problem, your doctor will be able to recommend other treatments and therapies.
Simple painkillers such as paracetamol will often help. It’s best to take them before the pain becomes very bad but you shouldn’t take them more often than every four hours.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can also help. You can use them for a short course of treatment of about 5–10 days. If they haven’t helped after this time then they’re unlikely to. If they help but the pain returns when you stop taking the tablets, you can try another short course. As an alternative to tablets, you can rub anti-inflammatory gels or creams onto tender areas.
If you're pregnant, or if you have asthma, indigestion or an ulcer, you shouldn't take ibuprofen or aspirin without speaking to a doctor or pharmacist.
You may find a short period of rest is helpful initially, but to prevent your neck muscles weakening and your joints stiffening, you should rest for as short a time as possible and certainly no more than a day or two. As soon as possible, start some gentle stretches and neck movements as these can help the muscles and ligaments to relax and ease your pain and stiffness.
Try simple stretching and strengthening exercises. If you do these every day, they’ll increase the strength of your muscles, ease stiffness, and help to restore your range of movement. Start by exercising very gently and gradually build up.
As with any physical activity, you’ll need to use some common sense when doing these. You should expect some normal aches or discomfort during or following the exercises, but if a particular one makes your symptoms significantly worse you should stop doing it.
It's also important to find some form of exercise that you enjoy and to keep doing it. Walking, swimming, and exercise classes such as yoga or Pilates are all popular and will help with your general health and fitness.
Read more about exercise and arthritis.
Stress can make neck pain worse. One way of reducing the effects of stress is to learn how to relax the neck muscles. You can sometimes get audiotapes to help with relaxation from your doctor or physiotherapist. They're also available to buy online or from high-street shops.
Heat or ice packs
Applying a heat pack to your neck can help to ease pain. You can use a reusable heat pad (which you can buy from chemists and sports shops), a microwavable wheat bag or a hot-water bottle. An ice pack (for example a bag of frozen peas) can also be helpful. Make sure you don’t put heat or ice packs directly onto your neck to avoid burning or irritating your skin.
Gentle massage of the neck muscles, particularly with aromatic oils, often helps. However, some oils can be poisonous (toxic) in large quantities and can be harmful if you're pregnant or have a condition such as epilepsy.
Rubbing the area with liniments can also help – these produce a feeling of warmth and reduce pain. Some liniments available over-the-counter contain capsaicin (an extract of the capsicum, or pepper, plant), and a similar but a stronger preparation is available on prescription.
Pain and stiffness can be caused by a number of factors:
- poor standing posture
- staying in the same position for too long
- a bed that’s too soft
- a pillow that's uncomfortably hard or soft
- poor posture at work.
When you’re sitting, your hips and knees should be at right angles, and you should have good support for your lower back. Hardback, upright chairs or straight-backed rocking chairs are better for your posture than low, soft, upholstered chairs or sofas. Using back supports can help your posture when sitting at home, at work or in the car.
If your desk is too low, so that your head is bent forward for long periods, then your neck may be stretched and you may develop muscle pain. Check the height of your desk and the design of your chair at work and at home. Many employers have occupational health specialists who can check that workstations are set up according to your needs.
If you do a lot of reading, having the book or papers on a reading frame will often help to correct your posture.
For more information on preventing pain at work, read occupational therapy and arthritis and work and arthritis.
If your pillow is too firm or thick, it can make neck pain worse. Changing the number or position of pillows may be helpful – ideally, you should use only one so that your head isn’t pushed too far forward or to the side. Your head and neck should be supported so your head is level with your body in a neutral position. The pillow should fill in the natural hollow between the neck and shoulders – a soft or moulded pillow may be useful, or a supportive roll inside your pillow case can support the hollow of your neck.
If your mattress doesn't give your back proper support, it can also make neck pain worse. You may want to consider replacing it if it's old or uncomfortable.
If night-time pain is making it difficult for you to get to sleep, you can take a painkiller such as paracetamol before you go to bed. It's unlikely to last through the night but should ease the pain for long enough for you to get to sleep.
Talk to your doctor if you're having problems getting a good night's sleep.
Read more about sleep and arthritis.