One-sided neck pain is one of the most annoying aches to deal with. Maybe you just woke up one morning and were unable to turn your head a certain way, or maybe you felt a little “tweak” in your neck during your workout which eventually caused it to “lock up.” Even better...maybe you didn’t do anything at all, and now you’re wondering “Why is my neck so painful?”
We want to help you. If you’ve tried all of the typical remedies such as heat, ice, e-stim, and rest, with little permanent success, this article is for you. Let’s talk about how to fix one-sided neck pain for good!
What Causes One-Sided Neck Pain?
There are a few different factors that can contribute to an acute episode of one-sided neck pain. But one thing is for sure...it’s a little more complicated than just having a tight muscle. Pain is a multifactorial experience influenced by variables such as sleep, stress, anxiety, depression, false beliefs, and lack of social support.
So, solely blaming one-sided neck pain on a “tight upper trap” can be quite a reductionist mindset. You need to zone out and look at the bigger picture.
Recent Life Stressors
There have been many times when I evaluated a patient with sudden onset of one-sided neck pain, where they, at first, had no clue what could have caused it. However, upon further investigation, some sort of increased stressor over the past month usually shines through:
“Now that you mention it...I’ve been pretty stressed lately”
“I’m going through a nasty divorce right now and haven’t been sleeping as well”
“We are closing on our first home and it’s a very stressful experience”
I’ve heard all three of these and many many more. And all of them could be a contributing factor as to why these folks suddenly experienced neck pain “out of nowhere.”
Increased stress often causes our muscles to reflexively tighten up. Your brain is essentially going into “protect mode” because it senses dangers. Many neck and back tweaks are influenced by an inability to cope with new life stressors such as these.
Now, before you go assuming that all pain is driven by psychological factors, let’s talk about some biomechanical variables that can contribute to that dreaded one-sided neck pain. These include posture and load management errors.
Posture and One-Sided Neck Pain
Posture during the day can certainly play a role in influencing neck pain. If you spend the entire day at a desk with your head turned one way, this could cause one side of your neck to reflexively tighten up.
While there is technically no such thing as "good posture" (no, you don’t need to sit at your desk upright stiff as a board all day) you should strive to maintain some form of postural variability. I recommend choosing 4-5 different sitting positions that feel comfortable for you and just rotating through them throughout the day.
No posture is off limits here! Scooting your butt forward in the chair and leaning back, or sitting with your butt back and leaning forward are both fair game. As long as it’s comfortable, and you’re not sitting in one position for too long, this can really help reduce the risk of back pain or one-sided neck tightness. Getting up and going for a quick walk around the office every 30-45 minutes can be beneficial too.
Load Management and Form Errors
Sometimes one-sided neck pain is a simple as this: you did too much too fast too soon during your workouts. If you recently added in some sort of overhead pressing variation at too high of an intensity, volume, and/or frequency, I’ve seen plenty of neck tweaks occur after this.
If this is the case, all you need to do is back things down a tad until your neck calms down, and then proceed forward with an optimized training program. I recommend reading our 4-Step Framework to Training with Pain E-book for more information about adjusting form and programming around pain.
One form error I commonly see that may contribute to one-sided neck pain is excessively shoving the head through during the overhead press. In the lockout position of the overhead press, the neck should just be in resting anatomical position. Watch the video below to see exactly what I mean.
This video is part of our CEU approved online course, The Barbell Rehab Workshop. If you’re a fitness or rehab professional who wants to learn more about coaching and modifying the barbell lifts for clients with pain or mobility limitations, check out the workshop right here.
Overcoming One-Sided Neck Pain
Now that we’ve gone through all of the different factors that can contribute to one-sided neck pain, let’s talk about how to remedy it. We are going to split the remainder of the article into two sections.
First, we will talk about some quick and effective self-management strategies to help you reduce the pain, and then, utilizing our 4-Step Framework for Training with Pain, we will go into some more detail for how to permanently overcome it and reduce the risk of it occurring again.
The First 24 Hours...Leave it Alone!
So let's revisit our initial scenario. You wake up with a stiff neck, and unable to turn to one side. What do you do? Rub it? Dig at it? Roll it? No! One of the best ways to rapidly overcome acute pain is....are you ready? To leave it alone!
I know. You want to intervene. You want to dig at it to make it feel better, but all this will do is provide input to your brain that "hey something is going on here." You want to do the exact opposite. By leaving it alone, you are showing your body and brain that your neck isn't something that it needs to provide a bunch of input to. So just try and go throughout your day as best as you can for the first 24 hours.
Rapidly overcoming a neck tweak is pretty similar to the approach we recommend for overcoming a low back tweak. You can read that right here. So, big picture? For the first day or two...just leave it alone!
Should You Stretch Your Tight Neck?
Many times stretching a tight or painful muscle can help give you some immediate relief. However, it is usually only temporary relief. I’ve done it countless times, and I’m sure you have too: You have a tight/painful muscle, you stretch it a little, and it immediately reduces the pain and tightness...only for it to come back again with a vengeance in a few hours.
Why does this happen? Most of the time in cases of one-sided neck pain, your neck muscles aren’t physiologically “tight” or “short.” In other words, the muscle tightness didn’t CAUSE the pain...it’s in RESPONSE to it. So when you try and stretch a tight neck, you’re not addressing the root cause, you’re trying to treat a symptom. What should you do instead...load it!
Load the Neck Instead!
After a day or two goes by, gradually reintroducing some load and getting the neck muscles to CONTRACT can help promote a more permanent reduction in tightness and pain. This may seem counterintuitive at first, but give it a try! Two of my favorite exercises to start with are slow tempo dumbbell shrugs and lateral neck flexion isometrics.
For the dumbbell shrugs, be sure to use a lighter weight and work on getting a good squeeze at the top for 2-3 seconds. 2-3 sets of 8-15 reps work well here. Try not to shove your head through on these. Just aim to raise your shoulders to your ears.
To perform lateral neck flexion isometrics, put a hand on the side of your head where your neck is hurting. Then, gently push your hand into your head, without letting your head or neck move. You should feel the tight side of your neck contract. I recommend holding these reps for 10-15 seconds and doing 3-4 of them a few times a day.
Once you’ve mastered the lateral neck flexion isometrics, you can perform them sidelying in an isotonic fashion, going through the full ROM. For these, you want to make sure the tight side of your neck is facing up. In other words, if the left side of you neck is tight, lie on your right side, and vice versa.
Perform these nice and slow, through a full ROM, and feel that tight side of your neck contracting. Perform for 2-3 sets of 8-15 reps.
A Note on Ice, Heat, Massage, and E-Stim
As you probably noticed, we didn’t recommend any kind of ice, heat, massage, or e-stim to help manage one-sided neck pain. Why? Although there’s nothing wrong with these (they won’t hurt you or anything), I’ve found them rather easy to overdo.
At first, 5-10 minutes of heat may feel good, but this can quickly lead to needing to use a hot pad all day long just to get temporary relief. If heat, ice, massage, or e-stim feels good temporarily, feel free to use it. Just be cognizant to not OVERUSE it.
Optimizing Form and Modifying Your Exercises
While the exercise and tactics above can help you overcome one-sided neck pain in the short term, permanently overcoming it and reducing chances of flare ups involves knowing how to adjust your exercises and programming.
We touched on this before, but the number one thing I’d look at form wise is making sure you’re not excessively shoving your head through on the overhead press, clean & jerk, or snatch. While you want to make sure you achieve a full lockout position, aggressively shoving the head through is a little overkill and may contribute to neck tweaks.
Second, you can also try different pressing variations. If you find yourself constantly tweaking your neck after standing barbell military presses, try doing them with dumbbells. Furthermore, with dumbbells, you can also adjust what I like to call your “arm slot” or amount of shoulder horizontal abduction to further experiment with what will feel best to you.
Some prefer to press in the plane of scaption. Others may prefer pressing with their arms more out to the side in the abduction plane.
This image is directly from our live Barbell Rehab Method Certification Course Manual. If you’re a fitness or rehab professional, check out our current live course schedule list here and earn some CEUs!
Adjusting Programming for Pain
You can optimize your form and work on stress reducing habits until the cows come home, but if you’re not optimizing your programming, you’re not going to get very far! Programming, or HOW we apply a dose of exercise is often an overlooked aspect of why someone could be experiencing pain.
While a complete overview of programming strategies to reduce pain is outside the scope of this article, I’d recommend the following:
- Program your compound lifts in the RPE 7-8.5 range. This means that you’re going to stop 2-3 reps short of failure on all of your sets.
- Consistently training to failure can contribute to a load management error and thus a pain experience. Read more about RPE here
- When returning to training after a layoff, or when reintegrating a once painful lift...start light! I recommend starting in the RPE 3-4 range and then building from there.
For a more in-depth analysis of programming variables, check out this article.
Final Thoughts on One-Sided Neck Pain
One-sided neck pain can be truly an annoying experience. Walking up in the morning and not being able to turn your head one way and wondering “what did I do” can lead to a cycle of panic and frustration. Fortunately, in the absence of red flag symptoms, these neck tweaks are rarely a serious issue.
Start by gradually loading your neck muscles to calm the pain down, and then make sure your exercise programming and stress coping abilities are optimized in order to reduce the risk of it happening again!