How to Relieve Neck Spasms: Causes, Treatments, and Exercises

Ever had a tight, painful neck? Couldn’t move your head as much as usual? You may have had a muscle spasm in your neck. This is a tightening of your neck muscles, which may also involve connecting muscles in the shoulder and upper back. A classic spasm feels like a cramp, contracting and releasing. The muscle also may clamp down and stay tight. The pain may range from a slight twitch to pure agony. 

“A neck spasm usually occurs because you did something your body didn’t like, like overworking the muscles or holding a certain position for too long,” says Cody Anderson, PT, DPT, a physical therapist at Hinge Health. A spasm is your body’s natural defense mechanism to protect against injury by limiting your movement. 

Muscle spasms are a bit more aggressive than typical muscle tightness. Neck spasms typically aren’t serious but occasionally can signal some joint irritation. 

Here, learn what causes neck spasms, when to seek professional care, and how to prevent and treat them, including how to relieve muscle spasms in the neck and shoulder from our team of physical therapists.

Neck Pain: A Hinge Health Perspective

If there’s one thing we want you to know about your neck spasms, it’s this: There are always things you can do to get back to doing what you love and get pain relief. You may have tight neck muscles. You may have a diagnosis of disc degeneration, spinal stenosis, or arthritis. 

You’ll read about these possible causes below but remember: No matter what’s involved in your neck pain, you’re not stuck and your condition is not impossible to change. How do we know this? As one example, in a study of 1,000 people without any neck pain, 88% had disc bulges present on an MRI.

This means your imaging doesn’t dictate your symptoms. And while you may not be able to control every factor that’s involved in your neck pain, you do have the power to change some important things. You can always take action to improve your situation — and that often starts with moving more. As our Hinge Health care team says, movement is medicine.

What Causes Neck Spasms?

Neck muscle spasms most often signal that you’ve overworked the muscles of the neck, upper shoulder, or back. Any issues that contribute to muscle tightness make this more likely. However, neck spasms can also indicate an issue with the joints of the spine or even a nutrition imbalance. Here are some of the most common reasons you may experience muscle spasms in the neck and shoulders.

• Neck sprain. The soft tissues that support the neck can be stretched or torn — say, because of an accident or collision. This can cause pain, stiffness, limited mobility, and muscle spasms. Neck sprains heal gradually over four to six weeks.

• Overworked neck muscles. Neck, shoulder, and back spasms and persistent tightness often indicate that the muscles have been overworked, leading to tension and inflammation that may lead to spasm. This may happen from being in an awkward position (typing at a desk, painting a ceiling, or sleeping uncomfortably) for a long time. 

• Stress. Stress releases the hormone cortisol and puts your body in a state of being hyperalert, ready to fight or flee. Over time, that may create chronic tension of the muscles, making them more prone to overuse injuries and spasm. 

• Posture issues. If you tend to sit for hours a day, your posture-related muscles can get grumpy. This can cause you to hold unnatural positions, leading to tension and raising the risk of neck spasms. You want to have options for sitting (and standing), which gives different back muscles a break. Shift around from sitting very relaxed to sitting upright. And, of course, take breaks to stretch, stand, and walk. 

These causes may involve metabolic issues like mineral imbalances.

• Dehydration. If you sweat a lot and don’t replenish your body’s fluids, you’ll lose minerals such as sodium, potassium, and calcium, which can trigger muscle cramps. 

• Hot days. Exercising in hot weather increases your risk for dehydration and nutrient depletion. Also, with age, you have a harder time sensing and responding to temperature changes. This raises your risk for heat-related events like muscle cramps. 

These causes involve joint issues, which often respond to home remedies and physical therapy. Remember: Just because you have an official “diagnosis” doesn’t mean you can’t do anything about it. There’s a lot you can do to feel better and reduce your pain.

• Changes in the spine. The facet joints line the vertebrae of the spine and help it move, bend, and twist. These joints are normally covered with cushioning cartilage. These spinal structures naturally wear with age. We call these changes arthritis, even though it’s not always accompanied by neck spasms or pain. Sometimes, the facet joints may rub together as they lose cartilage. This can lead to tight muscles and inflammation, increasing the chance of muscle spasms.

• Spinal stenosis. As facet joints wear, they may grow extra bone as part of the aging process. These bony overgrowths (osteophytes) can narrow the spinal canal where the nerves pass through. This can compress nerves, which may lead to pain and muscle spasms. 

• Herniated disc. The bones of the spine are cushioned by strong fibrous discs. If the discs in the neck area are injured or wear with age, a disc can bulge and push against nerves. This can lead to pain, inflammation, and spasm. However, many people have “bulging discs” on imaging of their spine without any painful symptoms. 

When to See a Doctor

Neck spasms can be painful, but they usually heal on their own with home remedies, stretches, and physical therapy. Occasionally, though, neck spasms may be affected by a condition that requires a doctor’s care. Here are signs you should see your healthcare provider:

• You have high levels of pain that are unrelenting 

• You can’t function, or do normal daily tasks

• The spasms happen frequently and do not respond to home remedies 

• Your pain also radiates down your arms or legs 

• You also have a headache and weakness in your arms or legs 

• You experience dizziness, sudden falls, or loss of balance 

• You have difficulty speaking or swallowing 

• Symptoms occur after a trauma or impact

• You have unexplained weight loss, fever, or chills

Your doctor will likely ask when the neck spasm first occurred, what the pain feels like, whether there are visible palpitations, and whether certain movements or positions make it better or worse. They may order imaging (X-rays, MRI) to further evaluate the issue, but these aren’t usually needed for neck spasms. 

How to Prevent Neck Spasms

A tense muscle is more likely to get overworked, which leads to spasms. Daily stress and posture issues can contribute to everyday muscle tension, says Dr. Anderson. “We tend to carry our stress in our shoulders, or the upper trapezius muscles, and raise them a little as a protective posture.” 

Another issue: As you sit and face forward (at a desk or watching TV) your neck naturally tilts to try to raise your eyes to the horizon, which means your neck is in a constant state of tension. Healthy lifestyle choices and stress reduction techniques can help you relax your muscles and prevent and relieve neck pain. 

• Increase your daily steps. Office workers who increased the amount of daily steps they walked for six months were significantly more likely to prevent neck pain than those who did not change their routine. (Both groups were considered at high risk for neck pain.) A good general goal to strive for is 10,000 steps per day, but you can slowly work up from your current baseline. 

• Practice meditation. German researchers found that people who had chronic neck pain who practiced an eight-week meditation routine experienced significant relief and were less bothered by their pain. Researchers theorized that meditation improved neck pain by relieving stress. Try a meditation app like Calm or Headspace, or look for videos you find soothing and helpful on YouTube.

• Do deep breathing throughout the day. Stress elevates cortisol levels and activates the “fight-or-flight” mode of your sympathetic nervous system. Deep breathing counteracts this. It lowers stress hormone levels and induces relaxation and calm, according to the Cleveland Clinic. One common technique from the world of yoga is “box breathing,” also called 4-4-4-4 breathing:

  • Inhale as you silently count to four.

  • Hold your breath as you count to four.

  • Exhale as you count to four.

  • Hold your breath again as you count to four.

  • Repeat for four cycles. Do this one to two times a day. 

• Get enough sleep. A number of studies have linked poor sleep quality to chronic neck pain in both adults and adolescents. Adults generally need seven or more hours of sleep per night to maintain good health. If pain is preventing you from getting a healthy dose of slumber, talk to your doctor. 

• Make room for mindfulness. Mindfulness refers to being present in the moment without judging it as good or bad. A small study found that volunteers who practiced an eight-week mindfulness-based stress reduction program (consisting of meditation, yoga, and body scanning exercises) reduced stress, depression, and pain while increasing energy. Try these tips from a Hinge Health coach to bake moments of mindfulness into your daily routine. 

• Take regular posture breaks. There is no one “bad position” for your body, says Dr. Anderson. Rather, try to avoid holding any one position for too long. “Our bodies are resilient and can tolerate an awkward position for a certain amount of time,” he says. However, your body wasn’t built to do the same repetitive activity for hours at a time, whether sitting at a desk or on the couch or even sleeping awkwardly. Every half hour to an hour, take a break from whatever it is you’re doing. Stand up and stretch, take a brief stroll, or even just shift your position and stretch while seated. This gives you a chance to tune in to how you’re holding your body, and reset it in a more relaxed position.

How to Relieve Neck Pain: At-Home Remedies

Most of these home remedies temporarily break the pain cycle, which is important both physically and psychologically. “When you’re stuck in pain for a long time, your tolerance decreases even if the pain itself stays the same,” says Dr. Anderson. In other words, a pain you rate as a four (on a one to 10 scale) may eventually start to feel like a seven simply because you’ve been feeling that way for hours. Giving your brain a break from the pain allows you to reset. “When you apply ice and rest, or go for a walk, you are telling the brain, ‘Okay, we’re going to get out of this mode,’” says Dr. Anderson. 

For long-term relief, “you still have to address the core issues causing your pain or it will return,” says Dr. Anderson. Long-term solutions include physical therapy to help musculoskeletal issues, lifestyle solutions to reduce stress (see above), or, in some rare cases, surgery. 

Cold/Heat Therapy

Heat (like a heating pad) temporarily relieves pain by relaxing tight muscles. Ice or cold packs, meanwhile, bring short-term relief by preventing the nerves from transmitting pain signals. Whichever one you prefer is the best one to use. If heat or cold alone don’t work, try contrast therapy, or alternating heat and cold. Here are some suggested regimens, which you can do multiple times throughout the day.

• Heat therapy: 20 minutes on, 30 minutes off 

• Cold therapy: 10 minutes on, 15 to 30 minutes off

• Contrast therapy: Apply heat for five minutes, ice for five minutes, heat for five minutes; repeat for a second cycle if needed

For all these regimens: Check your skin after the first couple of minutes and between applications to make sure you are not giving yourself an “ice burn,” heat rash, or other irritation. 

Over-the-counter medications 

Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for neck pain. It’s important to make sure that you are safely able to take these medications, based on your medical history. They can help relieve pain in the short term as you explore longer-term remedies like exercise, physical therapy, and stress-reduction strategies. 

Massage, including self-massage

“Pressing on the muscle is like giving it a little stretch, helping it relax,” says Dr. Anderson. “It also signals to the brain that you want the muscle to be relaxed.” Some people get weeks of relief after, say, a monthly massage appointment. Others may get only a few hours. You can also use mechanical self-massagers (such as massage guns) gently around the neck area. Try the upper trapezius muscles and avoid the sensitive muscles on the side of the neck, recommends Dr. Anderson.

Physical therapy

This is a first-line treatment for neck pain, according to the American Academy of Orthopaedic Surgeons. Physical therapists can design a customized routine to stretch tight areas and strengthen weak ones, restoring mobility and reducing and preventing pain. (See recommended moves below.) You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

Surgery

If you have an underlying issue like spinal stenosis, and conservative remedies are not working, you could consider surgery. Talk to your doctor about whether you’re a good candidate for surgery. 

Here are a few gentle exercises from Hinge Health that are commonly used to prevent and treat neck pain. You can do these moves daily, and you’ll benefit if you work them into your routine at least once or twice a week. Try them as a way to take regular posture breaks throughout the day. If you are currently in pain, move just up to the point where pain begins and return to your starting position. 

If you have any concerns or questions about whether this routine is right for you, check with your healthcare provider first. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Do a 5-Second Shrug

You often don’t realize how you’re holding your shoulders during the day. When you’re sitting and typing or using a mouse, your shoulders tend to creep up, and that causes the upper trapezius muscle to work more. To change this, shrug your shoulders all the way up, and then relax them all the way down, says Dr. Anderson. “Now, notice how far down your shoulders can come when they’re in a relaxed posture. Every half hour or hour, do a nice, big shrug and then a nice, big, relaxed lowering to reset your posture while you work.”

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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