Which exercises for neck pain?
For common neck pain with no red flags, the Assurance Maladie recommends continuing activities while adapting them and maintaining physical activity, even minimal: resuming adapted physical activity is, in its view, the best guarantee of a quick recovery. When pain lasts, the reference Cochrane review (2015) indicates that strengthening and endurance exercises for the neck, shoulder, and scapulothoracic muscles may reduce pain and improve function, with evidence of moderate quality at best. Stretching alone shows no benefit.
What we know about common neck pain
Prolonged postures play a role. The INRS, the French occupational safety institute, describes neck and shoulder muscle pain during tasks such as screen work, and the Assurance Maladie advises looking for a poor position held for a long time, at work or during leisure, when pain recurs. Images do not tell the whole story: more than half of people with cervical osteoarthritis on X-rays have no neck pain. Some psychological and social factors, such as tension at work or at home, can slow recovery. When pain has lasted at least six months, it is called chronic neck pain.
Structuring the program
- Assess: rule out red flags, measure mobility and limitation, identify the positions that trigger pain;
- Start low: keep up activities while adapting them, with gentle movements within the tolerated range;
- Progress: introduce and then gradually increase strengthening of the neck, shoulders, and scapulothoracic region;
- Build it into daily life: avoid holding fixed postures for too long and plan active breaks at the workstation.
The method (assess, dose, progress, maintain) is that of any functional rehabilitation, as in common low back pain. If shoulder pain is also present, see our article on rotator cuff tendinopathy.
Frequently asked questions
Is a cervical collar recommended for neck pain?
Not for long. According to the Assurance Maladie, immobilizing the neck with a collar increases stiffness. For very intense pain, a foam collar may help, but for no more than 2 to 3 days, because of the risk of dependence and weakening of the neck muscles.
Which daily exercises help with neck pain?
First, keep up activities while adapting them, with gentle movements within the pain-free range. If pain persists, strengthening the neck and shoulder muscles is the approach best supported by the 2015 Cochrane review, whereas stretching alone shows no benefit. A physical therapist can help set the program's starting dose.
Can neck pain come from screen work?
Prolonged postures contribute: the INRS lists screen work among the tasks associated with neck and shoulder muscle pain. The Assurance Maladie recommends avoiding fixed postures for too long and setting up the workstation properly.
When should you see a doctor for neck pain?
Call emergency services (15 or 112 in France) after major trauma, for fever with headache, or for speech, vision, or walking problems. See a doctor the same day for tingling, heaviness, or weakness in an arm, or for pain that wakes you at night. See a doctor within a few days if pain does not ease after a few days of analgesics, if a stiff neck lasts more than 8 days, or if pain radiates into the arm.
Is an X-ray needed for neck pain?
Not for common neck pain lasting less than 4 to 6 weeks: the doctor's examination is enough, according to the Assurance Maladie. Immediate imaging is only indicated for signs of severity (intense pain and stiffness from the outset, fever, arm weakness, dizziness, etc.) or after certain injuries. More than half of people with cervical osteoarthritis on X-rays have no neck pain.
Does stress play a role in neck pain?
It can. The Assurance Maladie suggests relaxation when stress worsens the pain, and lists tension at work or at home among the psychological and social factors that can slow recovery.
Editorial review in progress by MYA's editorial committee.
Editorial content intended to inform health professionals. It does not constitute individual medical advice and does not replace assessment by a professional.