When neck pain flares up, body movements and concentration levels are reduced, which can severely limit the ability to participate in activities. This cycle can lead to feelings of sadness and depression, which may cause more pain and even less activity.

Mind-body therapy focuses on training the mind to become more in tune with its surroundings and experiences, and how they may be affecting the body’s pain levels. Most mind-body therapies aim to reduce stress levels, such as by practicing relaxation or becoming aware of stressors in order to better manage them. Three examples discussed in this article are controlled breathing, guided imagery, and journaling.


Controlled Breathing Exercises

Breathing tends to quicken with stress and anxiety. Becoming aware of one’s own respiration and concentrating on slowly breathing in and out can have a calming effect.

Numerous controlled breathing exercises exist. For beginners looking to do something more advanced than slow breathing, the following is a simple one to try:

  • Find a quiet place and take a slow, deep breath in through the nose. While breathing in and counting to 10, concentrate on feeling the upper abdominal muscles air pull air into the lungs.
  • After reaching the number 10, switch to slowly exhaling through the mouth and count to 10 again.

This exercise can be repeated until it starts to feel more relaxing. Once simple exercises such as this one become routine, more complicated breathing exercises can be tried. If it does not feel relaxing or is difficult, it is OK to stop and try again later, or consult a trained health professional for guidance.

Controlled breathing can be combined with many other activities and/or treatments, such as mindful meditation, guided imagery, yoga, listening to relaxing music, or while taking a break in the middle of a work day.

Guided Imagery

Guided imagery is a therapy to help the mind focus on images, metaphors, or stories that may bring the patient a sense of control and/or a calming effect. Many types of guided imagery are performed—or at least started—in an office setting with a therapist or other trained health professional.

Some examples of guided imagery include:

  • Imagine a serene setting. In order to reach a calm state, it may help to picture a relaxing place. For example, a paradise island with clear water and a cool breeze, or a familiar porch and rocking chair in a childhood neighborhood may provide comfort.
  • Respond to a self-described image of the pain. When prompted to say the first word or image that comes to mind when thinking about the pain, a patient may be surprised by his or her own answer. When exploring this answer further with the therapist, the patient may discover a previously hidden memory, thought, and/or belief that the mind associates with this physical pain.
  • Picture the pain going away. Some patients have found some relief, even if only temporary, by imagining their pain healing or going away. For example, neck pain could be visualized as a throbbing red ball over the neck. Then the ball can be mentally visualized as moving down to the shoulder, elbow, hand, and finally leaving the finger tips and flying away.

See Chronic Pain Coping Techniques - Pain Management

Numerous other guided imagery techniques exist. Some techniques may be performed at home, such as by watching guided imagery videos, listening to recordings, or using a phone app.


Research indicates that expressing and articulating emotions can help reduce stress and may also contribute to improved thinking. Some people may achieve these same benefits by regularly writing thoughts and feelings in a private journal. 1 Klein K, Boals A Expressive writing can increase working memory capacity. J Exp Psychol Gen. 2001; 130(2): 520-33. , 2 Langens TA, Schuler J. Effects of written emotional expression: the role of positive expectancies. Health Psychol. 2007; 26(2): 174-82.

For people who might have a hard time sitting or writing due to neck pain, another possibility would be to record an audio journal. The important part is expressing the emotions and having something to refer back to if desired.

Sharing the journal with someone else is not necessary.

Efficacy of Mind-Body Therapy

There are currently no large random controlled trial (RCT) studies with strong evidence showing mind-body therapies specifically reducing chronic neck pain. However, there is mounting evidence that mind-body therapies can reduce stress and inflammation, and many people have reported various pain-relief benefits from these treatments. 3 Mind-body medicine practices in complementary and alternative medicine. U.S. Department of Health & Human Services Web site. Updated March 29, 2013. Accessed February 6, 2018.

See Chronic Pain As a Disease: Why Does It Still Hurt?

For chronic neck pain that has yet to respond well to any type of treatment, mind-body therapy may offer an opportunity to feel more in control of the treatment plan, reduce stress, and possibly experience more pain relief.


Risks of Mind-Body Therapy

While mind-body therapies tend to be safe to try, it is important to have chronic or severe neck pain evaluated by a doctor first. It should also be noted that some forms of mind-body therapy, such as guided imagery or journaling, may bring back especially hurtful or traumatic memories. For a patient who struggles with emotions or mental illness, some forms of mind-body therapy may not be advised. A trained professional can help find the best mind-body therapies for the patient if this is the case.

Dr. Susan Blum is a functional medicine practitioner specializing in the prevention and treatment of chronic disease. She is the Founder and Director of the Blum Center for Health and has nearly two decades of experience practicing functional and integrative medicine.

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