Neck Pain: exercise plan
Your neck isn’t fragile, it’s just underworked and over-screened. A little regular strength work does more than another heat pack ever will.
- Pain rules: muscle effort and mild discomfort are fine, as long as they settle within a day. Sharp pain, or pain or tingling spreading down your arm, means stop and get it checked.
- How often: one 20-minute strength session, 3 times a week, plus gentle neck movement through your workday.
- How long: in the study this plan is based on, office workers with neck and shoulder muscle pain had big drops in pain after 10 weeks. Keep going after that to keep the gains.
- Progress when: you can finish every set with good form. Add weight in small steps (0.5–1 kg).
- Based on: the US physiotherapy neck pain guideline (JOSPT 2017) and a 10-week neck and shoulder strength program tested in office workers (Andersen 2008).
Your exercises
- Neck movementSitting tall, slowly turn to look over each shoulder, tilt each ear towards your shoulder, then nod your chin down and up. Move as far as is comfortable; the range usually improves week by week.5 each way, a few times through the workday
- Shoulder shrugsStand tall holding a dumbbell or full water bottle in each hand. Lift your shoulders towards your ears, pause, then lower slowly. Pick a weight that feels hard by the end of each set; increase it as it gets easy.3 sets, 3 times a week
- One-arm rowOne hand and knee on a bench or chair, back flat. Pull the weight up towards your lower ribs, squeezing your shoulder blade back, then lower slowly. Progress by adding weight.3 sets each arm, 3 times a week
- Side raiseStand with weights by your sides. Raise your arms out to the side to shoulder height (no higher), then lower slowly. Start light; this one is harder than it looks.3 sets, 3 times a week
- Reverse flyLean forward from the hips with a flat back, arms hanging down. Raise your arms out to the sides, squeezing your shoulder blades together, then lower slowly. Progress by adding weight.3 sets, 3 times a week
- Upright rowHold the weights in front of your thighs. Pull them up close to your body to chest height, leading with your elbows, then lower slowly. Skip this one if it pinches the front of your shoulder.3 sets, 3 times a week
Desk tips: there’s no single perfect posture, so change position often and get up for a short walk regularly. Set your screen at eye height and keep your keyboard and mouse close. Do the strength exercises in one block (they take about 20 minutes), not scattered through the day.
Stop and see your GP or physio if
- Numbness, tingling or weakness in your arm or hand
- Clumsy hands, or new problems with balance or walking
- Neck pain after a fall, car accident or other injury (same day)
- Severe headache, dizziness, double vision, or trouble speaking or swallowing (call 000)
- Fever, feeling unwell, unexplained weight loss, or a past history of cancer
- Pain that’s constant, worse at night, or not improving after 10 weeks of regular exercise
Want a supervised program?
A physio can check your neck, add hands-on treatment where it helps, and adjust your program. An exercise physiologist can help with the strength work and your workstation. If you have a chronic condition, ask your GP about a GP Chronic Condition Management Plan (GPCCMP): it gives a Medicare rebate for up to 5 allied health visits a year (physio, exercise physiologist or podiatrist).
Evidence and more information
- JOSPT 2017: Neck pain clinical practice guideline (revision 2017)
- Andersen et al, Arthritis Care & Research 2008: specific strength training for neck and shoulder muscle pain (summary)
maladywise.com/exercises/neck-pain/