Chapter 15 · Head & Neck
Neck Pain protocol
Indexed — full page in progressSource: Rehab Science · Ch 15 · PDF pp. 266–297📖 Rehab ScienceBuild my programme →
AMBER — get assessed before starting rehab
Screen for red flags before starting any protocol (safety check). Progress by symptoms and function, not by the calendar: > 3/10 pain → start phase 1; < 3/10 → phase 2 (PDF p. 205).Follow this programme to treat
- General neck pain and stiffness (back and side)
- Neck strains and sprains (whiplash)
- Cervical spondylosis (arthritis)
Conditions in this protocol
- General (non-specific) neck pain PDF p. 266
- Neck strain and sprain (whiplash) PDF p. 269
- Cervical spondylosis (neck arthritis) PDF p. 273
Good for
- Alleviating neck pain
- Relieving muscle tension
- Warm-up for phase 2 and 3 exercises
Guidelines
- Perform every day
- Tools: small massage ball, peanut tool, yoga block, foam roller
- Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises
Soft Tissue Mobilizations
▶ Spend 1−2 minutes on each area · Perform in any order on both sides · Stop on tender points for 10−20 seconds
side view · red = working arm
Levator scapulae mobilisation
Ease tension at the top inner corner of the shoulder blade.
PDF p. 276
front view · red = working arm
Upper trapezius mobilisation
Reduce tension across the top of the shoulder.
PDF p. 277
diagram pending
Cervical extensor mobilization
PDF p. 278 · instructions pending
diagram pending
With peanut tool
PDF p. 278 · instructions pending
diagram pending
Manual variation
PDF p. 279 · instructions pending
side view · red = working arm
Rhomboid mobilisation
Relieve tension between the shoulder blade and spine.
PDF p. 279
side view · red = working arm
Thoracic mobilisation (foam roller)
Loosen the mid-back so the shoulder can move more freely.
PDF p. 280
diagram pending
Roll up and down the spine
PDF p. 280 · instructions pending
diagram pending
Flex and extend
PDF p. 281 · instructions pending
diagram pending
Rotate and roll side-to-side
PDF p. 282 · instructions pending
Good for
- Improving neck range of motion
- Strengthening the neck
- Warm-up for phase 3 exercises
Guidelines
- Perform every day
- Add phase 3 when you can do the exercises with no more than mild pain (3/10)
Stretching Exercises
▶ Do 3 reps with 30- to 60-second holds · Perform in any order on both sides · Don’t stretch into pain
Mobility Exercises
▶ Do 3 sets of 10–15 reps · Perform seated or standing · Active range of motion (AROM)—move as far as you can without pain · Pause at end range for 2–3 seconds
Isometric Exercises
▶ Do 4 or 5 reps with 30- to 45-second resisted holds · Apply as much force as your neck can tolerate without pain · Perform seated or standing
diagram pending
Cervical manual isometrics (four directions)
PDF p. 288 · instructions pending
diagram pending
Flexion
PDF p. 288 · instructions pending
diagram pending
Lateral flexion (side-bend)
PDF p. 288 · instructions pending
diagram pending
Extension
PDF p. 289 · instructions pending
diagram pending
Rotation
PDF p. 286 · instructions pending
Good for
- Strengthening the neck and surrounding muscles
- Preventing neck pain and injury
Guidelines
- Perform 3 or 4 days a week
- Do 3 sets of 10–15 reps
- Push sets to fatigue
- Add load or reps to increase difficulty
- Tools: resistance band, dumbbells, bench
Exercises
diagram pending
Cervical flexor curl
PDF p. 291 · instructions pending
diagram pending
Cervical lateral flexor curl
PDF p. 292 · instructions pending
diagram pending
Cervical rotator curl
PDF p. 292 · instructions pending
diagram pending
Banded cervical retraction
PDF p. 292 · instructions pending
side view · red = working arm
Dumbbell row
Strengthen the muscles that pull the shoulder blades back.
PDF p. 293
side view · red = working arm
Banded row (kneeling)
Strengthen the scapular retractors with a band.
PDF p. 294
diagram pending
Dumbbell shrug
PDF p. 295 · instructions pending
front view · red = working arm
Lateral raise
Strengthen lifting the arm out to the side.
PDF p. 296
diagram pending
Bent-over lateral raise
PDF p. 297 · instructions pending
Source: Rehab Science · Ch 15 · PDF pp. 266–277· 9 original research citationsshow sources ▾
Also cited by the book on these pages:
- [Ch 15·1] Childs JD, Cleland JA, Elliott JM, et al. Neck pain: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopedic section of the American Physical Therapy Association [published correction appears in J Orthop Sports Phys Ther. 2009 Apr;39(4):297]. J Orthop Sports Phys Ther. 2008;38(9):A1-A34. find original ↗
- [Ch 15·2] Côté P, Cassidy DJ, Carroll LJ, Kristman V. The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain. 2004;112(3):267-273. find original ↗
- [Ch 15·3] Borghouts JAJ, Koes BW, Bouter LM. The clinical course and prognostic factors of non-specific neck pain: a systematic review. Pain. 1998;77(1):1-13. find original ↗
- [Ch 15·4] Kazeminasab S, Nejadghaderi SA, Amiri P, et al. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2022;23(1):26. find original ↗
- [Ch 15·5] Andersen LL, Saervoll CA, Mortensen OS, Poulsen OM, Hannerz H, Zebis MK. Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial. Pain. 2011;152(2):440-446. find original ↗
- [Ch 15·6] Andersen LL, Kjaer M, Søgaard K, Hansen L, Kryger AI, Sjøgaard G. Effect of two contrasting types of physical exercise on chronic neck muscle pain. Arthritis Rheum. 2008;59(1):84-91. find original ↗
- [Ch 15·7] Hidalgo B, Hall T, Bossert J, Dugeny A, Cagnie B, Pitance L. The efficacy of manual therapy and exercise for treating non-specific neck pain: a systematic review. J Back Musculoskelet Rehabil. 2017;30(6):1149-1169. find original ↗
- [Ch 15·8] Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. find original ↗
- [Ch 15·9] Gore DR. Roentgenographic findings in the cervical spine in asymptomatic persons: a ten-year follow-up. Spine (Phila Pa 1976). 2001;26(22):2463-2466. find original ↗
Page numbers are those of the uploaded PDF edition. "Find original" opens a PubMed search for the cited study.