All of us have woken up with a sore, stiff neck at one time or another.

It is not how we want to start our day, and the severity of the pain can range from a mild annoying twinge to an excruciating spasm that can completely ruin your life for the next couple of days!

The pain is greatest when you attempt to turn your head to one side, causing great discomfort when you try to force the movement.

When I get neck pain (which happens more often than not), I find that I have to turn my whole body instead of my neck when I want to look at something off to the side. 

Sometimes, your sore neck is accompanied by a headache or pain that extends down to your shoulder and the interscapular space (the area between your shoulder blades). 

In most instances, the cause of a sore neck can be attributed to your sleeping position or the wrong type of pillow.

In this article, I will explore the causes of neck pain, review non-pharmacological and pharmacological management of neck pain, and discuss when you should seek a higher level of care.

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Common Causes of neck pain

There are several causes of neck pain. Some of the common ones are:

Lifting heavy objects

Your neck muscles can become strained when you exert too much force on them, especially if your muscles have not been stretched and warmed up.

For example, I once strained my neck when attempting to do dumbbell shrugs with very heavy weights in the gym.

The pain lasted a full 2 weeks before I was healed enough to turn my head to the side.

Injury, collision, sudden movements, or accident causing whiplash injury to neck

In these types of injuries, the cervical vertebrae are moved too quickly and forcefully in relation to the attached muscles.

The result is a strain injury. These injuries are typically seen in auto accidents or sports injuries.

 

Repetitive movement

Doing repetitive movements, even under normal load, can strain your neck muscles. 

 

Poor posture or head position

“Tech Neck Pain”

This problem is especially common in our modern, digital age –  Hunched over a computer for an extended period, staring at your phone with your neck held forward for hours watching Youtube or TikTok videos, or holding your phone between your ear and shoulder can all contribute to neck strain. 

“Sleeping Wrong”

Another very common cause of neck pain, especially the type you feel when you wake up in the morning, is sleeping in an uncomfortable position or using a pillow that offers very poor cervical spine support.

Personally, most of my neck pain is due to this last reason.  

What muscles are involved in neck strain?

When the contractile fibers within muscles are torn due to injury or overexertion, inflammation results, causing a sore neck. 

The two common muscles that are at increased risk for strain are the Levator scapulae and the Trapezius muscles:

Levator scapulae

The two muscles located on each side of the neck originate from the skull’s base and inserting into the scapulae or shoulder blades.

See the image below for a visual depiction of the muscles:

Trapezius

This is the large trapezoidal or kite-shaped muscle that extends from the base of the neck all the way to the mid-back, covering the area between the shoulder blades.

The image below shows you what it looks like:

 

How long does a strain in your neck take to heal?

Most sore necks take two to three weeks to heal with home management. 

Sometimes, the pain is felt immediately after the injury. 

Other times, the pain comes on gradually as the inflammation sets in over time. 

Usually, the pain worsens during the first day or two of the muscle strain and gradually gets better as time passes.

 

How to treat neck pain

 

Non-medication management of neck pain:

Alternating cold and warm compresses

To lessen inflammation, start with a cold compress using an ice pack, ice wrapped in a towel, or a bag of frozen vegetables and apply it to the affected area on your neck.

You can do this several times a day, up to 20 minutes each time.

A word of caution for diabetics and those with circulatory problems: limit your treatment to 10 minutes at a time. 

Alternate your cold compresses with warm ones.

The heat helps ease the muscle fibers’ tension and relax them.

The pain is also typically relieved.

You can do this by taking a warm shower or applying a heat pack or hot water bottle to the painful area.

However, be very careful to avoid burns, especially using electric corded ones.

Just as with cold therapy, you can treat yourself for 20 minutes at a time and 10 minutes if you are diabetic or have circulatory issues.

 

Stretch

You can also stretch your neck muscles several times a day. Be gentle and take your time with these self-treatments.

Don’t yank on your neck!

The three videos below show you how to do these gentle stretching and pain relief techniques safely and effectively:

How to stretch your Levator scapulae muscles

Relieving trapezius and shoulder pain

Yoga poses to relieve “Tech Neck” pain 

 

Sleep Posture and Cervical Pillows

With “sleeping wrong,” one or two issues are causing your neck pain: You are either using the wrong pillow, or your sleeping position is causing and worsening it.

The two best positions to prevent neck aches and ensure proper spinal alignment are on your side and back.

With these positions, you maintain good posture, prevent acute and chronic neck pain, and prevent sleep issues.

Sleeping on a firm mattress helps prevent muscle spasms, back pain, and neck stiffness.

A soft pillow is usually the culprit because it is not offering your head the support it needs (remember, your head is heavy!)

Your cervical spine and spinal cord are not aligned throughout your sleep, and you feel the effects the next morning.

A very effective solution is to invest in a cervical pillow.

With the right pillow, you can effectively stop the pain cold!  (I should know – I use it all the time, and I have been pain-free for over a year now!)

Cervical pillows gently cradle your head and support your cervical spine’s natural curve and neutral position. 

Here is the one I use. It uses memory foam (Click on the image to buy):

Elviros Memory Foam Cervical Pillow

 

 

Another excellent choice is this one (Click image to buy):

Core Products Tri-Core Cervical Support Pillow

 

Allison Freer shared in her article in the New York Magazine about the success she had in completely eradicating her neck and shoulder pain when she started using this cervical pillow.

 

Medication management of neck pain

You can use over-the-counter painkillers to help ease the pain. 

Acetaminophen (Tylenol) is a good option.

Remember to stay within the recommended dosing, especially if you take other drugs containing acetaminophen and antihistamines (Tylenol PM, Advil PM, etc). 

Read all about the differences and risks of these agents in my articles Can I take NyQuil with Advil and NyQuil vs. ZzzQuil.

NSAIDs are also a good option.

However, use these carefully, and always consult your doctor before taking these agents.

While they may seem benign and readily available over the counter, they come with many potential problems. 

I highly recommend reading my article on NSAIDs to understand these issues better, especially if you are an older adult.

Tylenol and ibuprofen can be taken together safely, but you must be aware of certain warnings. Read my article about them here.

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When should I see a doctor about neck pain?

If your sore neck does not resolve within a few weeks, it may be time to schedule an appointment with your doctor. 

You should seek immediate medical attention if you experience a loss of strength in your arms or hands, feel a bolt of pain starting at your shoulder and traveling down your arm (radiating pain), or experience numbness. 

These are not signs of a normal strained neck and may suggest something much more serious that a qualified health care provider must immediately evaluate. 

Summary:

• Neck pain is caused by strain on the neck muscles.
• Causes of neck pain are improper posture and injury to the neck muscles.
• Neck pain can be managed with non-pharmacological methods such as cold and hot compresses, stretching, exercise, and sleeping with cervical pillows that provide neck support.
• Neck pain can be managed with common over-the-counter pain relievers such as acetaminophen and NSAIDs, but these come with risks too.