Advice from an Expert: How to Fix Nagging Neck Pain and Chronic Headaches

Advice from an Expert: How to Fix Nagging Neck Pain and Chronic Headaches

‍Advice from an Expert

How to Fix Nagging Neck Pain and Chronic Headaches

By: Anna Staehli Wiser, DPT, FAAOMPT


‍The most common cause of chronic neck pain and headaches aside from trauma is poor posture1.  Slouching posture results from the effects of gravity pushing down on our bodies over time.  When the spine becomes rounded, the head migrates forward in relation to the shoulders and is no longer sitting in a balanced resting position.  This postural imbalance causes a disruption in the length-tension relationship between the muscles in the front and back of the spine.  Muscles in the posterior neck to become short and tight, and the muscles in the anterior neck to become elongated and insufficient.  


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Here are 5 exercises and pro-tips that you can start implementing right away to get your posture back in balance, which will have a significant impact on neck pain and headaches.  


  1. Attention to sitting posture:  Sitting causes added tension through the spine and makes it all too easy to slouch.  Start using a pillow in the small of your back to rotate your rib cage upward and shoulders backward.  This will create a stable foundation for your neck and head2,3.

  2. Deep neck flexor strengthening:  Research has shown a strong correlation between chronic neck pain and headaches, and weakness of the deep neck flexors4,5.  One simple way to test your neck strength is to lie on your back and tuck your chin toward your throat.  Try to lift your head 1 inch while maintaining your chin tucked.  If you are unable to maintain this position for 30 seconds, you may want to consider implementing neck strengthening into your exercise routine.  Start by performing the movement described above, holding for 10 seconds, and repeating 5 times, 2-3 sets, once per day6-8. 

  3. Foam rolling:  Constant slouching leads to joint stiffness through the upper back, at the apex of the kyphosis of your spine.  Work on streightening out this exaggerated curve by rolling back and forth on a 6” diameter foam roller for 30 seconds, 3 reps, once per day9. 

  4. Opening up the chest:  Slouching posture over time will cause the muscles of the anterior chest wall, the pectoralis, to become tight and shortened.  Work on stretching out the chest muscles in a doorway or with a sidelying thoracic rotation stretch, 30 second hold x 3 reps each day10. 

  5. Strengthening your back:  The paraspinals and mid to lower trapezius are your anti-gravity muscles that resist kyphosis.  Improving strength and endurance in these muscles will help you resist the forces of gravity pushing down on you throughout the day.  Try lying prone (on your stomach), and lifting your torso while raising your arms to the side and to the front (Is, Ts, and Ys) 3 sets of 10 reps, once per day10

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Following the tips mentioned above should significantly improve the way you feel very quickly within just a few weeks.  Of course, some people may still require hands-on treatment to clear up stubborn joint and muscle restrictions.  Once these restrictions are cleared through joint manipulations, myofascial release and dry needling, then the restorative exercise program listed above will be effective.  


R‍esources:

 

1. Overview: Neck Pain. Institute for Quality and Efficiency in Health Care (IQWiG); 2022.

 

2. Seung-Hyun K, Yu-Shin K. Influence of the lumbar spine adjustment using the lumbar roll support on head and neck posture in older adults. J Korea Contents Assoc

3. 2011;9:800-806.3. Horton SJ, Johnson GM, Skinner MA. Changes in head and neck posture using an office chair with and without lumbar roll support. Spine (Phila Pa 1976). 2010;35(12):E542-E548.

4. Jull GA, Falla D, Vicenzino B, Hodges PW. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther. 2009;14(6):696-701.

5. Falla D, Farina D. Neural and muscular factors associated with motor impairment in neck pain. Curr Rheumatol Rep. 2007;9(6):497-502.

6. Ylinen J, Takala EP, Nykänen M, et al. Active neck muscle training in the treatment of chronic neck pain in women. JAMA. 2003;289(19):2509.

7. Ylinen J, Häkkinen A, Nykänen M, Kautiainen H, Takala EP. Neck muscle training in the treatment of chronic neck pain: a three-year follow-up study. Eura Medicophys. 2007;43(2):161-169.

8. Bobos P, Billis E, Papanikolaou DT, Koutsojannis C, MacDermid JC. Does deep cervical flexor muscle training affect pain pressure thresholds of myofascial trigger points in patients with chronic neck pain? A prospective randomized controlled trial. Rehabil Res Pract. 2016;2016:6480826.

9. Fonta M, Tsepis E, Fousekis K, Mandalidis D. Acute effects of static self-stretching exercises and foam roller self-massaging on the trunk range of motions and strength of the trunk extensors. Sports. 2021;9(12):159.

10. Yoo WG. Comparison of the effects of pectoralis muscles stretching exercise and scapular retraction strengthening exercise on forward shoulder. J Phys Ther Sci. 2018;30(4):584-585.