What to Do for Mild Neck (or Back) Pain

Stop Irritating the Thing That Causes Your Neck Pain

When you have mild neck or back pain on a busy or demanding day, it's easy to forget the obvious - stop doing what makes it worse.

But Dr. Santhosh Thomas, D.O., physical medicine specialist and director of the Westlake Spine Center at the Cleveland Clinic, says ​the first thing to do for a mild back or neck problem is figure out which activities led to the problem – and stop doing them.

Daniel L. Riddle, PT, Ph.D., and professor at Virginia Commonwealth University, says a "crick in the neck" can be due to mechanical factors such as sleeping positions that don't work for you.

So, if you like to pillow up, or if there is no give in your pillow, realize that you'll likely be setting yourself up for pain in the morning. To stop irritating your neck in this particular case, avoid having your neck and head propped forward.

Try Over-the-Counter Pain Medications

The medicine chest is their first stop for many of us who get mild neck or back pain. Most of the time, an over-the-counter pain medication will do the job. The dosage of an OTC drug is less than what you would get with a prescription drug, and healthcare providers generally suggest starting there.

OTC pain medications come in two main types – acetaminophen (such as Tylenol) and NSAIDs such as Motrin (ibuprofen) and Aleve (naproxen).

NSAIDs also help control the inflammatory process that is likely contributing to the pain. Both types of OTCs may have side effects, so read the label before taking any drug for your back or neck pain.

Apply Ice to Your Neck or Back

Applying ice to the affected area for up to 48 to 72 hours after pain or injury starts is another way to control inflammation. The inflammation causes pain and, left unchecked, can contribute to a chronic problem in your neck or shoulders.

There are a number of ways to give yourself ice, as suggested by healthcare providers and physical therapists.

For example, consider this method from the American Physical Therapy Association:

1. Fill a plastic bag with crushed ice.
2. Place a towel around the area of your neck that has the pain.
3. Put the homemade ice bag on the towel. Ice for 15 to 20 minutes.
4. Take a 40-minute break.
5. Repeat.

Never apply ice directly to your skin.

Apply Heat

Applying heat to an acute injury is usually not the way to go, and most healthcare providers will advise against it. This is because heat tends to increase inflammation. There are some disagreements among experts about this, but in general, this is the advice that is given.

After the first 2 or 3 days, applying heat is fair game, and it may help relax those stubborn muscle spasms.

Heat should be applied pretty much the same way ice is – for 15 to 20 minutes at a time, with a 40-minute break between treatments. Heat wraps that are on the market may provide relief for painfully tense muscles.

You can also alternate between heat and ice (after the initial 2 to 3 days) to get the benefits of each.

Get a Massage

Dr. Thomas also recommends massage for muscle spasms that are attributed to a "crick in the neck."

For neck and low back pain, the massage should be very gentle during the first few days to avoid making things worse. You may even choose to wait until the acute phase of the injury has completely past (at least 72 hours.)

Massage moves fluid around, which may help to prevent scar tissue. After the first few days, massage can help work out tension and knots in your muscles. If you can't afford a massage here are a few moves you can try on yourself like the tops of your own shoulders or the sore spot on the back of your shoulder blade.

Keep Active

Years ago, healthcare providers advised people with back pain or injury to respond with immobility (i.e., bed rest.)

More recently, medical research has shown that patients with acute low back pain who stop activity may actually have more pain than those who don't.

Many healthcare providers now recommend staying active within your pain limits as the most effective way to deal with acute low back pain and accompanying the loss of physical functioning. That said, a 2010 review done by the Cochrane Back Group found moderate evidence for this advice when given to people with acute low back pain (when compared to the bed rest advice.)

In the case of sciatica, the researchers found little to no difference between taking a bed rest approach and a staying active (within limits) approach.

If you're up for a bit of gentle movement/positioning, you might try lying on your back with your knees bent and legs resting on a chair or bed to temporarily relieve pain.

...But Take a Gentle Approach

Right after the pain starts, you'll probably feel like protecting the area for a while.

But depending on the severity of your pain, you may benefit from some very gentle movements. Like massage, gentle movement may help to prevent chronic scar tissue from taking hold.

At this stage, it's important to respect the limits of your pain; stop if notice new inflammation or more pain. (Ideally, you will work with a skilled therapist who can mobilize the injured area safely and appropriately.)

After the acute phase is over, you will likely feel better, but keeping the movement gentle is still very important. The new tissues laid down in the acute phase of injury healing are fragile, and they can be easily damaged by resuming activity at previous, more aggressive levels.

Know When It's Time to See a Healthcare Provider

Technically speaking, there are no established guidelines for when to see a healthcare provider about mild back or neck pain.

But according to Thomas (and as I mentioned in the beginning,) if the pain persists for a week or longer - and especially if it interrupts your daily functioning, it is time to get it checked.

Sometimes the pain you think may be due to a simple "crick in the neck" or to low back strain can actually be pointing to something more serious, such as an infection or tumor.

A medical doctor has the diagnostic skills to determine if your pain indicates a serious problem not directly related to the pain. Thomas also says that sometimes conditions such as disc herniation or spinal stenosis can mimic the symptoms of a "crick in the neck" – another reason to get it checked.