WHAT SHOULD I DO IF I EXPERIENCE NECK PAIN?
The following exercises are designed to abolish neck pain and to restore full mobility. You should perform these exercises within a pain free range of motion, never exercise into a pain, only to the “edge” of pain. If exercising to relieve stiffness, use your hands to apply overpressure and achieve maximum range of motion.
Observe for three effects when performing these exercises:
Symptoms may disappear
Pain intensity may increase or decrease
Pain may move to another location in your body
Your neck pain may be confined to the neck only, or it might spread as far as your shoulders and arm. When performing these exercises, observe closely the changes in location of your pain. To determine if the exercises are good for you, widespread pain should start to localise to the neck. The effects should be fairly rapid, within ten to twelve repetitions.
Note that on performing these exercises, pain intensity may initially increase yet it should start to diminish with practice, at least to the original intensity. If the pain continues to increase in intensity or spreads to other regions of your body, stop exercising. Do not continue with the exercises if your symptoms are much worse immediately after exercising and remain worse the next day – seek professional advice.
Exercise 1 – head retraction in sitting
Sit down, look straight ahead, allowing your head to relax. Notice your head will protrude slightly. Keeping your chin tucked down and in, move your head back as far as you can. Ensure your focus stays straight ahead and that you don’t extend your neck such that you are looking at the ceiling.
Maintain this position for two seconds then relax back to the starting position. Perform ten repetitions, six to eight times per day. You can also add overpressure by placing both hands on the chin and firmly pushing the head back even further.
If this exercise causes pain, replace it with exercise 3.
Exercise 2 – Neck extension in sitting
Remain seated with your head in the retracted position. Lift your chin up and tilt your head backwards as in looking up at the ceiling. Whilst your head is tilted backwards, turn your head left and right so that your nose moves 2cm from the midline, all the time attempting to move the head and neck further backwards. Repeat the movement rhythmically and not too slowly.
Perform ten repetitions, six to eight times per day. If this exercise causes pain, replace it with exercise 3.
Exercise 3 – Head retraction in lying
Lying flat on the floor, push your head into the floor and at the same time tucking your chin in. The overall effect should be that your head and neck move backwards as far as possible while you keep facing the ceiling.
Maintain this position for two seconds then relax back to the starting position. Perform ten repetitions, six to eight times per day.
After performing this exercise, evaluate its effects on the pain. If the pain has localised or decreased in intensity, you can safely continue the procedure. If the pain has increased or extends further away from the spine, or you develop pins and needles or numbness in the fingers, stop the exercise and seek advice.
Exercise 4 – Neck extension in lying
Lying face up on a bed, place one hand behind your head, then move up the bed until the head, neck and top of your shoulders are extended over the edge of the bed. While supporting your head with your hand, lower it slowly towards the floor.
Now remove your hand, tilt your head and neck as far backwards as you can and try to see as much of the floor as possible. In this position, turn your head left and right so that your nose moves 2cm from the midline, all the time attempting to move the head and neck further backwards. Repeat the movement rhythmically and not too slowly.
Once you have reached the maximum amount of extension, try to relax in this position for 30 seconds. On returning to the starting position, ensure you use one hand behind your head to assist your head back to the horizontal position. Do not rise immediately after performing this exercise, rest for a few minutes with your head flat on the bed.
As for exercise 3, this exercise is for the treatment of severe neck pain. This exercise should follow exercise 3 and should be done only once per session. Once you no longer have severe pain, replace these two exercises with exercises 1 and 2.
Exercise 5 – Side bending of the neck
Sit on a chair, holding your head in the retracted position. Bend your neck sideways and move your head towards the side on which you feel the most pain. Note, do not turn the head so that your nose moves towards your shoulder. Rather, ensure you keep looking straight ahead by attempting to touch your shoulder with your ear. Keep the head retracted throughout the movement.
Increase the effectiveness of the exercise by placing the hand of your more painful side on top of your head, then gently but firmly pulling your head further towards the painful side. Maintain this position for two seconds then relax back to the starting position.
This exercise is specifically for the treatment of pain felt on one side of your neck, or more to one side than the other, that does not improve with exercises 1 and 2. Until symptoms have localised, perform ten repetitions, six to eight times per day.
Exercise 6 – Neck rotation
Sit in a chair, holding your head in the retracted position. Turn your head as far to the left then to the right whilst keeping your head retracted at all times. If you experience more pain on turning to one side, continue turning to this side repetitively.
The pain should localise to a smaller area or decrease in intensity. If it does not, continue to exercise by turning your head to the least painful side. Once you have the same amount of pain or no pain, and only stiffness when turning to either side, continue to exercise by turning to both sides.
Increase the effectiveness of the exercise by using both hands and gently but firmly pushing your head further into rotation. Once you have maintained the position of maximum rotation for two seconds, return your head to the starting position.
Perform ten repetitions, six to eight times per day. Always follow exercise 6 with exercises 1 and 2.
Exercise 7 – Neck flexion in sitting
Sit down looking straight ahead. Drop your head forwards and let it rest with the chin as close as possible to the chest. Place your hands behind the back of your head and interlock your fingers. Let your arms relax so that your elbows point towards the floor. The weight of your arms will pull your head down further, bringing your chin closer to your chest.
Maintain the position for two seconds then return to the starting position. Perform three repetitions, six to eight times per day.
This exercise is specifically for the treatment of headaches but can also be used for residual neck pain and stiffness once acute symptoms have subsided. Always follow this exercise with exercises 1 and 2. These neck exercises have been adapted from the Robin McKenzie protocol for self treatment of neck pain.
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