A lot of information is available about low-back pain, a topic I've covered here. But less attention is paid to neck pain, despite the fact that as many of two-thirds of adults experience it.
Neck, or cervical, pain, can stem from a variety of causes, including serious concerns such as trauma to the vertebrae, ruptured discs, or infection. These are conditions that must be evaluated by a doctor, and I would recommend avoiding activities like yoga while in treatment.
But yoga can be incredibly helpful in addressing the less complicated causes of chronic or occasional neck pain, brought on by things like tension, poor posture, minor neck strain, occupational and sports injuries. The structural changes that lead to the pain are usually soft-tissue (muscle, ligament, tendon, disc, cartilage) abnormalities due to injury, or prolonged wear and tear on the vertebrae. And for many people, neck pain results from tightness in the upper back, shoulder, and arms. When the neck pain has been around long enough, it is reclassified as chronic, and the same underlying mechanisms of injury, with secondary scar tissue, and degenerative changes on soft-tissue structure, as well as the added changes to bones, contribute to the persistent nature of the pain.
The first line treatment for neck pain usually involves ice or heat, anti-inflammatory medications like ibuprofen, and rest. If the pain lingers, the non-surgical treatment (and don’t we all want to avoid surgery) can then include physical therapy. What are so interesting about this added treatment are the reported goals of physical therapy: strengthening and stretching weakened or strained muscles, postural therapy, and cervical traction—which also happen to be the benefits of a balanced, beginning-level yoga practice!
Time and time again, my students who complain of neck pain at the start of class report improvement in their symptoms by the end of class.
How Yoga Helps
Let’s start with postural alignment. When we do Mountain Pose, as we do in almost every class, we do it with great attention to detail regarding our posture. We use language like “place the shoulders over the hips and float the head evenly over the shoulders” to re-align the standing position if we tend to sag, list, or jut out of good alignment. For some of us, this will immediately require that we strengthen some muscle groups and stretch others to maintain this neutral, beneficial way of standing. And then we take this new awareness into poses like High Lunge, Plank, and Downward Dog by asking ourselves to find and keep the neutral position of the neck and head relative to the rest of the body.
Many poses will help to strengthen the muscles that flex and extend, sidebend, and rotate the neck. And while one side of the neck is experiencing strengthening of a muscle group, the opposite side is usually doing a bit of the opposite, which is to say, stretching. Examples of this include Cobra and Locust poses, which strengthen the back of the neck while stretching the front, Boat Pose for the front of the neck while extending the back, Triangle when performed looking forward, so that one side of the neck is strenthened while the other stretches, and Side Angle Pose done looking up, to strengthen and stretch the muscles that rotate the neck.
That leaves the idea of traction for last. One of the simplest and probably safest ways to create a gentle traction for the soft tissues of the neck is to hang the head and release into the pull of gravity. This is nicely accomplished via Standing Forward Bend and Downward-Facing Dog. In Uttanasana, I usually suggest that students with tight hamstrings bend the knees a bit to help release the head and neck more directly toward the floor. With Down Dog, it is wonderful to have a partner place a strap around the upper thighs standing behind you, lean back and take on some of the work of the legs and arms for you, so you can more fully release the neck, not push it, toward the floor.
And be cautious during active times of neck pain with poses that obviously put extra pressure on the neck, like Bridge, Shoulderstand, Headstand, and Fish. With the exception of the first one, the others are more advanced poses and are best left to times the neck is pain-free.
And don’t wait too long to have your family doc check you over thoroughly if your neck pain is not improving in a reasonable amount of time. In the meantime, a mindful yoga sequence could be a nice supplement to your healing regimen for neck pain.