Treating neck pain with a dose of exercise

Kay Cahill Allison

Former Editor, Harvard Health

Do your neck and shoulders ache? Not long ago, you would have been told to rest, maybe use a neck brace, and wait until the pain had ebbed away. Doctors have changed their song about the best treatment for neck and shoulder pain. They now recommend movement instead of rest.

As described in Neck and Shoulder Pain, a newly updated Special Health Report from Harvard Health Publishing, there is mounting scientific evidence for the role of stretching and muscle strengthening in treating people with neck and shoulder pain. After a whiplash injury, for example, people heal sooner and are less likely to develop chronic pain if they start gentle exercise as soon as possible. For those with long-term pain (called chronic pain), results from controlled studies show that exercise provides some relief.

One review of the research found that exercise programs to stretch and strengthen either the neck alone or the neck plus the shoulders and the trunk improve pain in the short and long term compared with standard treatment with pain relief medication. Other studies support strengthening, stretching, and general physical activity. But exactly how much exercise to do, what types are best, and how often it should be done have yet to be determined. That uncertainty might explain why, despite the evidence favoring the role of exercise in relieving neck and shoulder pain, fewer than half of people who see a health professional for these problems are prescribed exercise as part of their treatment plan.

Taking steps

If you’re interested in using exercise to help relieve neck or shoulder pain, make sure to see your doctor for evaluation. Ask if you can get help from a physical therapist or other professional who can create an individualized exercise program based on your pain severity, limitation of movement, and current strength. The program should have clearly stated goals and include stretching and strengthening exercises, as well as exercises to improve how you use your neck muscles.

Ideally, if you are working with a therapist, he or she will guide you through appropriate exercises, motivating you to work hard enough to see results but not so hard as to cause further injury. At some point, you will be given exercises to do at home. Before you exercise independently, make sure you understand which exercises to do and how to do them safely. Ask for written instructions and illustrations if you are still unsure.

For more information, take a look at Neck and Shoulder Pain, which is available at There you can see a description of the report, its table of contents, and a free excerpt that covers causes of neck pain and common types of it.


  1. Danilo Teodoro

    I always discuss about the condition of muscles and chronic pain, because the different conditions of muscles are the caused of chronic pain. These are those knots, lumlpy and tight muscles, those adherent tissues, muscle adhesion, muscle got mated to each other because of injury according to Manual of Surgery. Following the advised from that book have good results to all my clients. The only thing I don’t like is the always forget me, but remember also when pain come back. There is no total cure for chronic pain because of stress and wear & tear of everyday life, but you get relief if you find the right therapist.

  2. rosei

    hi,i was not in an accident but six weeks ago after a facial and massage my neck started hurting so bad esp during my sleep. It hurts to lift it to move in bed. the lumps at the base of my hed hurt.My hands are also very sore and achy . I have R/A and fibromyalga and MRI and ERK showed nerve damage at C5 =c6..Ido not want to have surgery yet.ant help

  3. paula

    A useful article, but we know that the shoulder pain stems from various causes and we need to clarify the cause of our problem, I agree with his view that the exercise and movement is better than relaxation to overcome our shoulder pain.

    • Danilo Teodoro

      Hi rosei, chances are your nerve is trap by the tight muscles, it might be a knot or lumpy muscles, so that when you move and those knots & lumps move it put pressure on the trap nerves resulting in pain. The best massage is the Controlled sliding deep tissue massage to slowly loosen it.You will feel the pain slowly subsides and go away as my clients always say. Try it, it may help

    • Danilo Teodoro

      I have works with clients who have shoulder pain & others have frozen shoulder Here the muscle are very tight or solid.These tightness affect also the pectoral muscles and the teres muscles. So a sliding deep tissue massage on said muscles loosen it and gradually you will feel the pain subsides and go away.You know these are the usuall problem I have work with for 20 yrs now.I know it sounds too good to be true that’s why I usually ask them to go to my websites ask my clients. Name & number of some are there as my proof of what I say.

  4. Anonymous

    Yoga is the best way to overcome neck pains.

  5. Peter Bloch

    Possibly the best way to deal with chronic neck pain that is not caused by serious medical conditions will prove to be the Alexander Technique. A major study published in the British Medical Journal in 2008 found that 24 lessons in the technique reduced chronic low back pain by an average of 86% even a year after the lessons were completed. A similar large Randomised Controlled Trial (RCT)is just starting in England to determine the effectiveness of the technique for neck pain. Results are expected to be similar to the back pain study.

  6. Windsor Yoga

    A Gently Yoga class with a experienced teacher an have a great effect on neck pain, or any muscle pain for that matter. My only caveat is to make sure the teacher is qualified, experienced and knowledgeable.

  7. sean

    I have had a bad neck and right shoulder for 5 years and I do rotator cuff exercises to get the blood flow going because the shoulders have very restricted blood flow which in turn takes longer to heal and easier to injure.

  8. Paula

    according to his article gentle exercises help shoulder pain, I tried with the help of my doctor I’m improving a lot, thanks for your article is very helpful.

  9. Heather Smith

    I agree with your post, one way to treat neck and back pain is exercise, in order to loosen the muscles and not irritate the nerves.Thanks for tips, keep on blogging!

    • Danilo Teodoro

      For me the best approached to loosen the tight muscles is the sliding deep tissue massage and circle movement wherever the knot due to whiplash. Well it works to all my clients I’ve work. Exercise don’t loosen muscles it help the muscle to stretch. When you sleep at night and don’t move for six hours it tightens up again as you can feel when you try to stretch it when you woke up in the morning. At least that’s my observation

  10. Danilo Teodoro

    I have been doing Chronic pain management for more that two decages. What ever pain problem it maybe like migraine, neck pain, shoulder and frozen shoulder, back & low back pain, sciatica, hip and knee pain or even pain due to injury cause by accident and even sprain, Muscles are tight to the point of muscle adhesion, which trapped and irritate the nerve and every move caused tension on the nerve resulting in pain. It means it is clogged and no circulation of blood or fluid to tissues. The type of massage that really help is the HSDTM- Hilot/Sliding deep Tissus Massage, which can break the tight muscles and muscles adhesion so that fresh supply of blood to injured part will start repair and pain subsides and eventually go away. At least that’s what happen to my clients. So chronic pain problem is due to muscle tightness and adherent tissues and muscles adhesion.So whenever I always look for the conditions of muscles.

  11. Rockin Body Workout

    Awesome post, I also bookmarked this page, will be back later to read more because this was a great post, keep up the good work!!! 😉

    Shaun T.

  12. Arthur Veilleux, PT

    Dry Needling, a treatment to release trigger points using small gauge disposable sterile needles, is now being researched and used by physical therapists in some areas of the country. This intervention holds promise in relieving a persistent cause of pain in the neck and shoulder as well as elsewhere in the body.

  13. Danilo Teodoro

    One thing you will notice for those with neck pain is that that neck muscles are very tight and those who had whiplash has knot at the back of neck near the the base of the skull. Hilot or Sliding or Controlled sliding deep tissue massage help loosen it to free the trap nerve that is being irritated by the tight muscle. Loosen it and pain gradually subsides and go away because the nerve are free’d

  14. Abhishek

    Nice nack pain resolve my discuss because i have discuss many doctor but not relaxe but your blog read totally relaxed thanks

  15. Gretchen N Smith

    This needs to be passed along with a grain of salt. I was in two serious car accidents and the repetitive motion from neck exercises led me to have severe spinal stenous. Sometimes, exercise is not the best solution.

    After having a three level ACDF surgery to prevent paralysis, I am left with chronic pain and new pains from the surgery. Had I not had so much repetative motions in my neck, the stenous would not have progressed so rapidly (per my nuerologist).

    If you suffer from neck and back pain and do PT, make sure to have x-rays every few months.

    • Danilo Teodoro

      Sorry about what happen to you. I have work with clients with neck pain and whiplash. Most of the time their neck muscles are tight and just 30 minutes ago I work with a client with neck pain. You know her neck muscles are very tight and it’s painfull when she move. It took me a while to loosen it, but after the session she can move it without pain. As I always said, tight muscles are the reason why we have pain and I think nobody is really taking an interest to see about it. That’s too bad, because working on muscles help a lot to my clients as I said no drugs, no steroids and others.

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