Strengthening Not Stretching Effective For Neck Pain

Neck pain is the sensation of discomfort in the neck, back of the skull and shoulders, which can result from disorders of any of the structures in the neck, including the cervical vertebrae and intervertebral discs, nerves, muscles and ligaments.


In 2015 a Cochrane review was completed that included active exercises (including specific neck and shoulder exercises, stretching, strengthening, postural, breathing, cognitive, functional, eye-fixation and proprioception exercises) prescribed or performed in the treatment of neck pain.


Results of the review concluded that exercise is safe, with some types of exercise showing an advantage over the others. There appears to be a role for strengthening exercises in the treatment of chronic neck pain, cervicogenic headache and cervical radiculopathy if these exercises are focused on the neck, shoulder and shoulder blade region.


Furthermore, the use of strengthening exercises, combined with endurance or stretching exercises has also been shown to be beneficial. There is some evidence to suggest the beneficial effects of specific exercises (e.g. sustained natural apophyseal glides) with cervicogenic headaches and mindfulness exercises (e.g. Qigong) for chronic mechanical neck pain.


There appears to be minimal effect on neck pain and function when only stretching or endurance type exercises are used for the neck, shoulder and shoulder blade region.


A great review that shows us that using specific strengthening exercises as a part of routine practice for chronic neck pain, cervicogenic headache and radiculopathy may be beneficial. Research showed the use of strengthening and endurance exercises for the cervico-scapulothoracic and shoulder may be beneficial in reducing pain and improving function. However, when only stretching exercises were used no beneficial effects may be expected.


At Sydney Muscle & Joint Clinic Penrith our physiotherapists and exercise physiologists utilise combined multi-modal techniques in the treatment of neck pain, neck pain with headaches and cervical radiculopathy. This review supports the use of strength exercise in the management of neck pain. Our physios and exercise physiologists use passive joint and muscle techniques together with strengthening exercises directed at the neck, shoulder and shoulder blade.