Living With Chronic Pain

Preventing Neck Pain

The human neck is flexible and strong; consider the incredible mechanics of a stick supporting a bowling ball. As a result, the neck is often vulnerable to injuries and conditions that cause pain and restrict motion. Most of us have experienced neck stiffness or pain at some time in our lives. The key is understanding when to seek medical help and learning how to prevent it. Here are some tips.

According to the Mayo Clinic, causes of neck pain include:

• Muscle strains- Overuse, such as too many hours hunched over your computer or smartphone, often triggers muscle strains. Even minor things, such as reading in bed or grinding your teeth, can strain neck muscles.

• Worn joints- Just like the other joints in your body, your neck joints tend to wear down with age. Osteoarthritis causes the cushions (cartilage) between your bones (vertebrae) to deteriorate. Your body then forms bone spurs that affect joint motion and cause pain. Long term impact from sports such as gymnastics, jogging, or horse back riding can also take their toll.

• Nerve compression- Herniated disks or bone spurs in the vertebrae of your neck can press on the nerves as they exit from the spinal cord.

• Injuries- Rear-end auto collisions often result in whiplash injury, which occurs when the head is jerked backward and then forward, straining the soft tissues of the neck. Mine started when I was thrown off my horse after the saddle broke.

• Diseases- Certain diseases, such as rheumatoid arthritis, meningitis, and cancer can cause neck pain.


Most neck pain is associated with poor posture, combined with age-related wear and tear. To help prevent neck pain, keep your head centered over your spine. Some simple changes in your daily routine may help. Consider trying to:

• Use good posture- When standing and sitting, be sure your shoulders are in a straight line over your hips and your ears are directly over your shoulders.

• Take frequent breaks- If you travel long distances or work long hours at your computer, get up, move around and stretch your neck and shoulders.

• Adjust your desk, chair and computer- The monitor should be at eye level. Knees should be slightly lower than hips. Use your chair’s armrests.

• Use a headset or speakerphone– Avoid tucking the phone between your ear and shoulder when you talk.

• Quit smoking- Smoking can put you at higher risk of developing neck pain.

• Keep the loads light- Avoid carrying heavy bags with straps over your shoulder. The weight can strain your neck.

• Be careful- Be mindful of activities that stress the neck while exercising. This can put pressure on it in ways that contribute to early wear and tear. Pilates for example, encourages flexing the neck and putting chin to chest in order to better engage core muscles. This can be problematic for those of us with underlying neck issues.

• Sleep in a good position- Your head and neck should be aligned with your body. Use a small pillow under your neck. Try sleeping on your back with your thighs elevated on pillows, which will flatten your spinal muscles.

What is the best sleeping position for neck pain?

According to Harvard University, the best positions for preventing neck pain are on your side or back. If you sleep on your back, choose a rounded pillow to support the natural curve of your neck, with a flatter pillow cushioning your head. This can be achieved by tucking a small neck roll into the pillowcase of a flatter, softer pillow, or by using a special pillow that has a built-in neck support with an indentation for the head to rest in.

back sleeping

But use caution, because these pillows are generically sized, they may not fit everyone’s body and can end up increasing the very pain they were meant to diminish. Here are some additional tips for side and back sleepers:

1. Try using a feather pillow, which easily conforms to the shape of the neck. Feather pillows will collapse over time, however, and should be replaced every year or so.

2. Another option is a traditionally shaped pillow with “memory foam” that conforms to the contour of your head and neck. Manufacturers of memory-foam pillows claim they help foster proper spinal alignment.

3. Avoid using too high or stiff a pillow, which keeps the neck flexed overnight and can result in morning pain and stiffness.

4. If you sleep on your side, keep your spine straight by using a pillow that is higher under your neck than your head.

neck position side
Image courtesy of:

5. When traveling by plane, train, or car, or even just reclining to watch TV, a horseshoe-shaped pillow can support your neck and prevent your head from dropping to one side if you doze. If the pillow is too large behind the neck, however, it will force your head forward.

6. Stomach sleepers are tough on the spine because the back is arched and the neck is turned to the side. Try sleeping on your back or side.

Most of us have established preferred sleeping positions early in life which can be tough to change. We often fall asleep in one position but rarely find ourselves there in the morning. Still, it’s worth trying to start the night sleeping on your back or side in a well-supported, healthy position and hope you’re there the next day.

The key is to find ways that work for you. Even small changes can help maintain a healthy, pain free neck.

dsc_0323-1    Dr. Courtney

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