As physical therapists, we often hear complaints from patients who have a “tight” or painful neck that persists despite stretching. Many patients attribute their pain to stress and poor posture. However, blaming a lack of progress on stretching, posture, or the need for mobilizations is not the solution. To treat neck pain, it is important to identify the root cause.

One common misconception is that stretching is the only solution to tight muscles. Often, muscles feel tight because they are “turned on” to protect a joint, nerve, ligament, or other structure from injury. Your nervous system alerts your brain of any potential danger, and your brain tells your muscles how to react to avoid injury. The same process happens when your muscles are trying to protect other areas, resulting in a state of guarding where your muscles won’t relax. Therefore, identifying why your muscles are guarding is essential.

Poor posture is one possible cause of neck pain. However, it’s not necessary to maintain a perfectly upright position at all times. The best posture is one that’s constantly changing. Therefore, if your job requires you to sit at a computer for eight hours a day, we must find several different postures that work for you, along with frequency of breaks, stretching, and exercises to keep your muscles and joints healthy and moving.

Weakness in the muscles of the neck, shoulder blades, and upper back can also cause neck pain. Strengthening these muscles may help increase joint mobility, making stretching easier. Nerve irritation is another cause of neck pain, and the brain will respond by telling the joints to not move as much. Severe nerve injury can interrupt the lines of communication from the brain to the rest of the body.

If you have a tight neck and have been stretching for years without progress, it’s time to try a different approach. It’s time to find the root cause of your pain and move away from treating the symptoms.

To dive into some of the science behind tight neck treatment, check out this article published by the Journal of Orthopedic and Sports Physical Therapy- https://www.jospt.org/doi/full/10.2519/jospt.2020.8821.