Neck Pain Exercises
From a clinical research perspective, the studies that examine the effectiveness of neck pain exercises are confusing. We know very clearly that neck pain exercises control neck pain better than inactivity and rest. We also know that neck pain exercises are most effective when they are tailored to the precise cause of the neck pain. Unfortunately no single exercise regimen has emerged in the medical literature as being the "best" neck pain treatment. However we do know that some general categories of neck pain exercises that are more effective than others.
Strength and endurance is better than stretching and the status quo
Researchers have not yet pinned down the exercise regimen that will improve the symptoms of neck pain in all people. However, they have determined that certain types of neck pain exercises are better than others. For example, resting the neck muscles is detrimental to therapy and relative rest is only modestly effective in neck pain treatment. Therefore the recommendation is that activity is better than rest. The question remains: What type of activity? If we consider other types of pain like those that occur in the neck or shoulder, stretching is a good initial exercise. Based on clinical studies, though, stretching neck pain exercises are not terribly helpful. To date, the best neck pain exercises seem to be those that improve strength and endurance in the neck muscles.
Neck pain exercises to increase strength and endurance
Again, no one neck strengthening exercise is better than others but a stronger neck is clearly better than a weak one. One of the neck pain exercises that has emerged slightly ahead of the pack is progressive resistance exercise or PRE. There are three basic principles to progressive resistance exercise:
- Keep the number of repetitions of neck pain exercises to a minimum and stop when the muscle fatigues,
- Rest sufficiently between sets of neck pain exercises, and
- Increase the resistance of the neck pain exercises as soon as the muscle can tolerate it.
You may recognize that these are the same principles that body builders use when they are trying to build core or limb muscles. The additional benefit of these exercises when applied to neck muscles is that they tend to reduce neck pain and increase function. The resistance can be applied to the neck with bands, machines, or simply the weight of the head (at first); the means of providing resistance is not as important as following the above three principles.
Maintaining the effect and (possibly) preventing neck pain
The scientific reviews of neck pain exercises aimed at increasing strength and force-generating ability indicate that the benefit only lasts as long as the muscle remains strong. Even under best case circumstances it seems that the benefits of these neck pain exercises only last about 9 to 12 months after neck pain treatment concludes. One obvious way of keeping the benefits going is to continue some sort of neck pain exercises. As opposed to strength training, the goal here is to maintain neck muscle endurance for the long-term. Since we know that strong and conditioned necks are less prone to injury, it seems quite reasonable that that keeping one's neck "in shape" is not only an effective way to treat neck pain, but also a way to prevent neck pain from occurring in the first place (even in people that have not had neck pain!).
neck pain exercises references
Oldervoll LM, Ro M, Zwart JA, Svebak S. Comparison of two physical exercise programs for the early intervention of pain in the neck, shoulders and lower back in female hospital staff. J Rehabil Med 2001;33:156-161.
Sarig-Bahat H. Evidence for exercise therapy in mechanical neck disorders. Man Ther 2003;8:10-20.
Taylor NF, Dodd KJ, Damiano DL. Progressive resistance exercise in physical therapy: a summary of systematic reviews. Phys Ther 2005;85:1208-1223.
Ylinen J, Takala EP, Nykanen M et al. Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial. JAMA 2003;289:2509-2516.
Ylinen J. Physical exercises and functional rehabilitation for the management of chronic neck pain. Eura Medicophys 2007;43:119-132.
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