Neck Pain, Anatomy, and Treatment

Neck pain is a common cause of discomfort in everyone, from athletes to elderly individuals to desk workers. Neck pain can be very debilitating to our everyday lives and result in limited ability to drive, sleep, use our arms, lift objects, and many other daily tasks. Neck pain can also prompt headaches and jaw pain. By understanding the structure and intricacies of our necks, you can develop a better understanding of how to minimize and treat neck pain.

Causes: Neck pain has a wide range of causes including whiplash, concussions, car accidents, stress/clenching, poor posture, sleeping habits, heavy lifting, overhead tasks, and repetitive movements. Neck pain can come on suddenly from the result of a trauma, or it can come on gradually from continual irritation. Once you have experienced neck pain from a trauma or chronically poor posture, it is easy to get reoccurring pain.

Anatomy: The back of the neck has three layers of muscles covering up the spine and nerves.

  • Outer layer (shown above on the left side)

    • Trapezius muscle: helps up move the neck and shoulder blade

    • Sternocleidomastoid muscle: helps us rotate our head, bring our ear towards our shoulder, and look down

  • Middle layer (shown above on the right side)

    • Semispinalis capitis: helps us look up

    • Splenius muscles: help us move the head and neck in many directions

    • Levator scapulae: helps us move the neck primarily to rotate and bring our ear towards our shoulder

    • Rhomboids: help us move the shoulder blade

  • Inner layer (shown below)

    • Subocciptal muscles: at the base of the skull, help us with small movements of our head including rotating and looking up

    • Interspinalis, Rotators, and Multifidus muscles: deep in the spine attached to our vertebrae, help stabilize and move the spine


Treatments: Treatment is different for everyone and depends on the cause of the pain as well as personal preferences.

  • Posture: Number one is to fix any problems with your posture. Are you sitting with your head forward at your desk? Are you constantly looking down at your phone? Are you straining to see your computer screen? Are you slouching on the couch when you watch TV? Are you looking up all day painting ceilings? All of these will result in the strain of at least one of the muscles mentioned above and can irritate our nerves. If you have trouble determining what your posture looks like, ask someone else look for you. Make sure your ears are in line with your shoulders to assure proper positioning. Here is some more information on posture.

  • Range of motion: Gentle movement of the neck and shoulders that is pain free will help bring new blood into the area. Try not to move in ways that hurt you as this is similar to picking at a scab and the pain will continue. The neck moves in many ways, so often times we can move a little in one direction but have to avoid other directions. For example, it may hurt to look down, but you can still rotate your head a little bit side to side. It is very unlikely that you will have damaged all the muscles in your neck.

  • Massage: Gentle massage will also help increase blood flow to the area. When you get a massage, the outer and middle layer are the primary muscles being worked on. It is difficult to get to the deeper muscles, and they can be more sensitive. Too much massage or poking/prodding in the neck can make the pain worse and may even cause headaches or migraines. You can also get nerve pain radiating down your spine or into your arms with too much pressure on the neck as the nerves will get irritated.

  • Aerobic exercise: Gentle exercise such as walking is another way to increase blood flow indirectly if the neck is too sensitive to touch or move. This will help warm the whole body and heal the neck as long as it does not cause too much pain.

  • Sleeping: Make sure you have a good pillow and mattress that are appropriate for your body size and type. A pillow or mattress that is too small/large or firm/soft can make you more susceptible to neck and back pain. Also, try not to sleep on your stomach as that puts your spine into a compromised position and can exacerbate neck and back problems.

  • Ice and Heat: Either will work, although make sure you limit the time to 10-15 minutes as the neck has many nerves and arteries running through it and prolonged heat or ice can cause damage.

  • Physical therapy: If you continue to experience pain or it becomes a chronic reoccurring problem, try having a specialist evaluate your neck alignment. They can provide alternative solutions and give you personalized exercises to help strength your neck and surrounding areas. Here are a few to get you started. People with poor posture often have weak upper backs, tight chests, rounded forward shoulders, and weak core/abdominals. Strengthening the back/core and stretching the chest can make a big difference for your neck.

  • Immobilization: Rarely do people with neck pain need to be immobilized, but it is important for people with fractures in their neck or life threatening conditions such as damage to certain arteries or nerves.

Hopefully this provides a good insight and/or reference to come back to if you experience neck pain. Don’t let neck pain sideline you from living your life!