Most neck pain can be treated with nonsurgical methods, such as self-care at home and/or with guidance from a medical professional.
Self-Care for Neck Pain
If neck pain is not debilitating and was not caused by trauma, the pain can typically be treated with self-care.
- Short period of rest. While strenuous activities and movements that worsen pain are to be avoided for a few days, some movement is typically encouraged to prevent the neck from becoming weaker and/or stiffer.
- Ice and/or heat. Applying ice can help reduce swelling and pain. Applying heat may help relax muscles and bring more blood flow and healing nutrients to the injured area. For ice or heat therapy, applications are limited to 15 or 20 minutes with at least a 2-hour break in between to give the skin time to recover.
- Gentle stretches. Some forms of neck pain or muscle tightness are alleviated with gentle range-of-motion stretches. If a particular movement or stretch exacerbates pain, stop and try another movement instead.
Other self-care remedies are available for neck pain. In addition, lifestyle changes can play a role in reducing neck pain. Some examples include adopting a more physically active lifestyle, quitting smoking, and using correct posture throughout the day.
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Many treatment plans for persistent neck pain include some form of physical therapy to improve neck strength and flexibility. The physical therapy program’s structure and length can vary depending on the specific diagnosis and situation. Multiple sessions per week with a trained physical therapist may be recommended to start. In time, prescribed exercises may be continued at home.
Over-the-counter (OTC) pain relief medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, are typically tried first for neck pain. If neck pain persists, a doctor may prescribe stronger medications, such as prescription-strength NSAIDs, muscle relaxants, or opioids on a short-term basis. Before taking any medication, read directions carefully and follow doctor’s instructions to reduce the risk for serious complications.
Alternative Treatments for Neck Pain
Alternative or complementary treatments tend to have less rigorous scientific backing, but many people have reported benefiting from them when treating neck pain.
- Massage therapy. A massage can soothe muscle tension and spasms, reducing pain and promoting relaxation. Some people may prefer self-massage or a massage from a willing friend or partner, whereas others may find more relief when massage is performed by a trained professional.
- Manual manipulation. A chiropractor, osteopath, or other health professional may use the hands to adjust the spine for improved range of motion and reduced pain. Spinal manipulation involves a high-velocity manipulation, whereas spinal mobilization involves techniques that are more limited in their range of motion. Before having a high-velocity neck manipulation, it is important to rule out any spinal instability or underlying medical condition to reduce the risk for rare but serious complications, such as stroke.
- Acupuncture. A certified acupuncturist places thin needles into specific points on the skin based on the pain type and/or suspected cause. When treating neck pain, the needles may be placed in the neck and/or elsewhere on the body with the belief that unblocking stagnant energy (qi) can promote healing.
- Mindful meditation. Practicing mindfulness and meditation may help relax the body, reduce pain, or give a sense of more control over the pain. Various methods are available, such as controlled breathing exercises and distraction techniques.
Some people may find alternative treatments to be more tolerable than some medical treatments, such as for people who experience serious side effects from medication.
Therapeutic Injection Procedures
Some cervical spine injections may help provide neck pain relief.
- Cervical epidural steroid injection. Using contrast-enhanced fluoroscopy (x-ray guidance), cortisone steroid solution is injected into the cervical epidural space, which is the outer layer of the spinal canal. The goal is to reduce inflammation of nearby nerve roots and tissues, most commonly caused by a disc herniation or other spinal degeneration.
- Radiofrequency ablation (RFA). If a facet joint is the confirmed pain source, RFA may be considered. Using fluoroscopy, a special needle is placed near the facet joint’s sensory nerve to create a heat lesion that prevents pain signals from reaching the brain. RFA typically provides longer-lasting relief. One study found about 30% of patients still experienced relief 3 years after RFA treatment. 1 Van Eerd M, de Meij N, Dortangs E. Long-term follow-up of cervical facet medial branch radiofrequency treatment with the single posterior-lateral approach: an exploratory study. Pain Pract. 2014; 14(1):8-15. doi: 10.1111/papr.12043. Epub 2013 Mar 18.
- Trigger point injection. These injections are usually done with no solution injected and use a very thin needle, such as an acupuncture needle. In some cases, a very small amount of local anesthetic may be used to help calm an irritated muscle bundle or trigger point.
Other injection options may be available. Injections tend to provide temporary relief because they reduce inflammation or block pain, rather than address the underlying cause. If an injection helps lessen neck pain, it is still important to use that time period to continue therapeutic exercises and lifestyle modifications that may provide more long-term relief.
While the risk is relatively low, injections carry the risk for serious side effects. Injections are typically one of the last treatments to try before considering surgery.
Read more about Injections for Neck and Back Pain Relief
- 1 Van Eerd M, de Meij N, Dortangs E. Long-term follow-up of cervical facet medial branch radiofrequency treatment with the single posterior-lateral approach: an exploratory study. Pain Pract. 2014; 14(1):8-15. doi: 10.1111/papr.12043. Epub 2013 Mar 18.