For many people living with chronic neck pain, common treatments such as medications, ice, or heating pads do not always provide enough relief. Finding the best combination of treatments for your neck pain may take some trial and error. Here are some lesser-known tips for managing neck pain that you might want to consider.

1. Choose a neck-supporting chair

When you hunch forward with forward head posture, extra stress is placed on your spine.1Kapandji IA. The Physiology of the Joints, Volume III. 6th ed. London: Churchill Livingstone; 2007. Maintaining good posture throughout the day keeps the head naturally balanced on the cervical spine and may reduce pain. A headrest can help to keep your cervical spine in a neutral position, so consider getting an office chair with one—and using it. Keep the back of your head comfortably against the headrest with your ears above your shoulders. Also make it a point to use the headrest on your recliner and in your car when you can. If you're working at a computer screen be sure that the level of your eyes are even with the top third of the computer monitor. Also, consider a standing desk as a standing leads to a more natural position and dissuades us from hunching forward.

See Choosing the Right Ergonomic Office Chair

2. Try a water pillow

A major complaint of chronic neck pain is that it can interfere with a good night’s sleep and/or worsen when you wake up in the morning. While no one pillow type is the best for everyone who has neck pain, some people have found water pillows to be particularly helpful. With a water pillow, you can adjust the firmness by increasing or reducing the amount of water inside. Specifically, more water equals a firmer pillow; less water provides a softer pillow.

See Pillows for Neck Pain

Various water pillow products are available and may be worth considering if you’ve tried more traditional neck pillows and braces to no avail.

See Different Types of Pillows

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3. See a physical therapist

It’s common to think of physical therapy as a treatment aimed at rehabilitation from a given injury, such as from a sports injury or a collision. While this is correct, physical therapy for the neck can also have other benefits, such as:

  • Identifying poor posture or habits that may be contributing to pain and stiffness.
  • Teaching you how to reduce the risk of reinjury.
  • Strengthening the weak areas of the neck through targeted exercises.

Check with your doctor to see if your chronic neck pain might be better managed with physical therapy. Improving the neck’s strength and flexibility may help better support the cervical spine and reduce pain. Some evidence suggests physical therapy may have even more benefits when combined with other treatments, such as aerobic activity.2O'Riordan C, Clifford A, VanDeVen P, Nelson J. Chronic neck pain and exercise interventions: frequency, intensity, time, and type principle. Arch Phys Med Rehabil. 2014; 95(4):770-83.

See Physical Therapy for Neck Pain Relief

4. Give gua sha a chance

Gua sha typically involves having a trained practitioner use a spoon to apply short strokes down the skin of the painful area. Gua sha is from Chinese Traditional Medicine, and it’s applied to areas of the body where blood circulation is believed to be stagnant and blocking energy (called “qi”). While there is no scientific evidence for qi, some people have reported neck pain relief from gua sha. One small study found gua sha to relieve neck pain more than heat therapy,3Braun M, Schwickert M, Nielsen A, et al. Effectiveness of traditional Chinese "gua sha" therapy in patients with chronic neck pain: a randomized controlled trial. Pain Med. 2011; 12(3):362-9. but not all studies agree and more research is needed.4Lee MS, Choi T-Y, Kim J-I, Choi S-M. Using guasha to treat musculoskeletal pain: a systematic review of controlled clinical trials. Chin Med. 2010; 5: 5.

See Gua Sha for Chronic Neck Pain

When performed by a trained professional who uses sterile equipment, gua sha is generally considered safe. This treatment should not be applied to damaged or thinning skin. Also, as part of normal gua sha strokes across the skin, tiny capillaries break and cause petechiae (red spots) to form, which might be misinterpreted by others as a rash or bruising from abuse. The petechiae typically clear up within a few days.

See Efficacy and Risks of Gua Sha for Neck Pain

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5. Get in the pool

Swimming is a great low-impact exercise for many people who have neck or back pain. Being in the water adds buoyancy, which means less stress on the spine. Depending on the cause of your neck pain, consult with your doctor or physical therapist regarding which swim strokes may need to be avoided or modified.

For some, swimming is too strenuous on the neck. In that case, water therapy, which is gentle exercise done in a warm swimming pool, is often a great alternative to land-based exercises.

See Water Therapy Exercises

6. Make time for mindful meditation

Finding a quiet place to relax and focus the mind may help ease stress and bring new perspective. Some examples of mindful meditation include controlled breathing exercises or guided imagery, such as envisioning the pain moving from your neck to your arm and then eventually floating off your fingers.

See Mindful Meditation vs. Chronic Pain

There are free videos and apps online to help you get started with mindful meditation. While mindful meditation doesn’t work for everyone, some people have reported benefits.5Effects of mindfulness-based stress reduction vs. cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: a randomized clinical trial. JAMA. 2016; 315(12):1240-9

7. Keep a journal

Some evidence suggests that regularly expressing emotions, such as in a private journal, may help reduce stress and improve thinking.6Klein K, Boals A Expressive writing can increase working memory capacity. J Exp Psychol Gen. 2001; 130(2): 520-33.,7Langens TA, Schuler J. Effects of written emotional expression: the role of positive expectancies. Health Psychol. 2007; 26(2): 174-82. For people who prefer not to write, making audio recordings may also be beneficial.

Over time, keeping a journal of your thoughts and daily happenings may also help you to identify possible triggers that make your pain worse, such as certain foods or activities.

See How to Relieve Neck Pain Caused by Stress

8. Consider cognitive behavioral therapy

Chronic neck pain can be extremely frustrating, and treatment plans may be complicated and seemingly provide little or no results. A cognitive behavioral therapist may be able to help you by teaching new ways to think about challenges. With new strategies to focus more on the positives, you might be better able to follow the treatment plan for your neck pain.

Studies have been mixed on cognitive behavioral therapy’s efficacy on treating neck pain, but some people have reported benefits.8Monticone M, Cedraschi C, Ambrosini E, et al. Cognitive-behavioral treatment for subacute and chronic neck pain. Cochrane Database Syst Rev. 2015 May 26;(5):CD010664. doi: 10.1002/14651858.CD010664.pub2. A cognitive behavioral therapist may also offer guidance on mindful meditation and journaling.

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9. Be careful how you use your phone or tablet device

One way you may not even realize that you’re aggravating your neck is by cradling your phone while talking, which puts extra stress on your cervical spine. It is also common for people to bend the head forward while looking down to read a phone or tablet for hours a day, which can contribute to painful neck strains or text neck.

See How Does Text Neck Cause Pain?

Avoid neck pain from phone use with these tips:

  • Use a hands-free headset to make calls.
  • When you're browsing or texting, hold the phone up higher to decrease the angle at which you're holding your neck.
  • Take frequent breaks to stretch your neck.

Watch Text Neck Treatment Video

Hopefully at least a few of these 9 tips give you some new ideas to try for neck pain relief.

Learn more:

Treatment for Neck Pain

Neck Strain: Causes and Remedies

Video: The 3 Worst Things You Can Do To Your Neck

  • 1 Kapandji IA. The Physiology of the Joints, Volume III. 6th ed. London: Churchill Livingstone; 2007.
  • 2 O'Riordan C, Clifford A, VanDeVen P, Nelson J. Chronic neck pain and exercise interventions: frequency, intensity, time, and type principle. Arch Phys Med Rehabil. 2014; 95(4):770-83.
  • 3 Braun M, Schwickert M, Nielsen A, et al. Effectiveness of traditional Chinese "gua sha" therapy in patients with chronic neck pain: a randomized controlled trial. Pain Med. 2011; 12(3):362-9.
  • 4 Lee MS, Choi T-Y, Kim J-I, Choi S-M. Using guasha to treat musculoskeletal pain: a systematic review of controlled clinical trials. Chin Med. 2010; 5: 5.
  • 5 Effects of mindfulness-based stress reduction vs. cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: a randomized clinical trial. JAMA. 2016; 315(12):1240-9
  • 6 Klein K, Boals A Expressive writing can increase working memory capacity. J Exp Psychol Gen. 2001; 130(2): 520-33.
  • 7 Langens TA, Schuler J. Effects of written emotional expression: the role of positive expectancies. Health Psychol. 2007; 26(2): 174-82.
  • 8 Monticone M, Cedraschi C, Ambrosini E, et al. Cognitive-behavioral treatment for subacute and chronic neck pain. Cochrane Database Syst Rev. 2015 May 26;(5):CD010664. doi: 10.1002/14651858.CD010664.pub2.

Dr. Marco Funiciello is a physiatrist with Princeton Spine and Joint Center. He has a decade of clinical experience caring for spine and muscle conditions with non-surgical treatments.

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