Neck pain common ailment

Q: While not debilitating, the pain in my neck is becoming, well, a real pain in the neck. I don't know what I did to bring it on, but is there anything I can do to make it go away?

A: Doctors estimate that 70 percent of us will be troubled by neck pain at some point in our lives. One in 10 adults hurts right now, and in some cases, the pain is bad enough to limit work and play.

Sometimes a single event such as getting rear-ended in a car crash is to blame, but usually the neck begins to ache after years of overuse or even a brief misuse of muscles and ligaments.

Today's computer-dominated workplace can be especially tough on necks because so many of us sit with shoulders slumped and heads extended toward monitors.

Why is neck pain, which often spreads to the shoulders, so common? Your neck not only supports a heavy weight, your head, but it also allows you to tilt, turn and nod. This feat requires a combination of strength and flexibility, which is provided by a complex network of muscles, bones, tendons and nerves. All of those moving parts are vulnerable to strain and injury.

There is no magic bullet for neck pain. But take heart. Neck pain is rarely a serious medical problem, and in most cases, you can manage it yourself with a combination of patience, exercises and mild pain relievers. But if you have warning signs such as arm weakness or numbness, fever, weight loss or difficulty swallowing, get medical help.

When your neck hurts, even simple movements can be painful. Although you may feel like keeping your head and neck as still as possible, start gentle neck exercises. At first, you may find it best to move your neck gently while standing under a warm shower. When that's comfortable, you can move on to specific exercises that help people break free from neck pain.

Studies suggest that exercises to strengthen neck muscles may be more effective at reducing pain than other types of activity.

A 2003 study published in the Journal of the American Medical Association looked at female office workers with chronic neck pain who followed different exercise programs.

Those who did neck strengthening exercises reported less pain than the women who stretched and did aerobics. Those who took part in even more intensive strength training, using elastic bands to provide resistance during exercises, reported the least pain and disability. They also improved their strength and range of motion.

In January 2008, Danish researchers reported similar results: A randomized trial of 48 women concluded that work-related neck pain can be relieved by regularly performing exercises that strengthen neck muscles. General workouts, by contrast, reduced the pain only slightly.

The scientists recruited women who had chronic neck pain and tightness in the muscles that run down the back of the neck and fan out toward the shoulders for more than a month during the previous year. They worked mainly on computers at banks, post offices, administrative offices and an industrial facility.

Researchers randomly assigned participants to one of three groups. One group received strength training focused on neck and shoulder muscles. The second group worked on their overall fitness by riding an exercise bike without holding on to the handlebars. The third group was counseled on workplace ergonomics, diet, health, relaxation, and stress management. The two exercise groups worked out for 20 minutes three times a week for 10 weeks.

On average, the women in the strength-training group experienced a 75 percent decrease in pain. General fitness training resulted in only a short-term decrease in pain that was too small to be considered clinically important, although the researchers did suggest that even a little reduction in pain severity could encourage people to give exercise a try. Women assigned to health counseling experienced no reduction in pain.

Your best bet is to talk with a physical therapist, physician or trainer who can tailor an exercise program to meet your needs. He might recommend some simple stretching and strengthening exercises or suggest working out with hand weights. A therapist also can motivate you to work hard enough to see results without causing further injury.

If you exercise on your own, start with a gentle aerobic activity, such as walking, before targeting your neck muscles. Perform the exercises slowly and carefully.

Never exercise to a point that causes pain. And if you use weights, avoid doing too much too soon. Start with a few pounds and build up gradually.

With a little bit of effort, your neck pain no longer will be, as you put it, a pain in the neck.

The Harvard Medical School Adviser is researched and written by the faculty and staff of Harvard Medical School. Visit www.health.harvard.edu/adviser.