TL;DR - Quick Summary
If your neck feels stiff and painful after work, you probably have neck tension or a cervical muscle contracture. In this article you will find:
- What it is exactly and why it happens
- How to tell mild symptoms from serious ones
- Safe self-massage techniques you can do at home
- Step-by-step neck mobility exercises
- When you should see a professional
Reading time: 12 minutes
What is Neck Tension (Cervical Contracture)
A cervical contracture is an involuntary and sustained contraction of one or more neck muscles. Unlike a simple muscle strain, the contracture does not relax on its own and can persist for days or weeks.
Most Commonly Affected Muscles
The muscles usually involved are:
- Upper trapezius: The most frequent. It runs from the base of the skull to the shoulders
- Levator scapulae: Connects the neck to the shoulder blade
- Sternocleidomastoid: The lateral neck muscle
- Splenius cervicis: Deep muscles of the nape
When these muscles contract, they form what we commonly call "knots" or tension points that you can feel as hard, painful areas.
Difference from Other Conditions
It is important to differentiate neck tension from:
- Cervical disc herniation: Causes tingling or weakness in the arms
- Cervical osteoarthritis: Joint degeneration, more common in those over 50
- Torticollis: Acute blockage that prevents head turning
- Mechanical neck pain: A more general term covering various causes
Symptoms of Neck Tension
Main Symptoms
- Localized pain in the neck, nape, or upper shoulders
- Stiffness when turning or tilting the head
- Sensation of a "knot" or hard area when touched
- Pain that worsens at the end of the day
- Tension that extends to the shoulders
Associated Symptoms
- Tension headache: Head pain starting from the nape
- Referred pain: To shoulders, between shoulder blades, or back of the arm
- Mild dizziness: In more intense cases (not to be confused with true vertigo)
- Difficulty concentrating: Due to constant discomfort
Classification by Severity
| Level | Symptoms | Typical Duration |
|---|---|---|
| Mild | Discomfort with movement, no functional limitation | 2-5 days |
| Moderate | Constant pain, limited mobility | 1-2 weeks |
| Severe | Intense pain, inability to turn head, headache | 2-4 weeks |
Causes of Neck Tension
Poor Posture
The most frequent cause today. This includes:
"Text neck" Looking at your phone with your head tilted forward multiplies by 5 the weight your neck muscles must support. If you spend several hours a day in this position, the overload is enormous.
Office work Screen too low, chair without support, shoulders forward... Maintaining posture for 8 hours daily is one of the main causes of chronic tension.
Poor sleeping position A pillow that is too high, too low, or sleeping face down keeps the neck under tension throughout the night.
Stress and Anxiety
When we are stressed, we tend to raise our shoulders and tense the cervical muscles unconsciously. This pattern repeated day after day ends up generating chronic contractures.
If you notice that your shoulders are "glued to your ears" when you work, stress is probably contributing to your neck pain.
Other Causes
- Muscle overload: Intense exercise without proper warm-up
- Direct air conditioning: Cold on the cervical area promotes contractures
- Sudden movements: Quick head turns, traffic accidents
- Bruxism: Clenching teeth tenses all cervico-facial musculature
Professional Physiotherapy Treatment
When the contracture does not improve with home measures or symptoms are intense, physiotherapy treatment offers effective solutions.
Most Used Techniques
Manual therapy and therapeutic massage
Therapeutic massage is one of the most effective techniques for treating cervical contractures. Through specific maneuvers, the physiotherapist can:
- Release muscle tension points
- Improve circulation in the affected area
- Restore tissue elasticity
- Significantly reduce pain
Dry needling
A technique that uses fine needles to deactivate trigger points (muscle knots). It is very effective for chronic contractures that do not respond to other therapies.
Electrotherapy (TENS)
Low-intensity electrical currents that help:
- Reduce pain
- Relax musculature
- Improve local circulation
Thermotherapy
Heat applied in a controlled manner increases blood flow and promotes muscle relaxation. It can be combined with other techniques.
Sessions Needed
In general, a cervical contracture responds well to treatment in 3-6 sessions. Chronic or recurrent cases may require more sessions and a personalized exercise program.
Self-Massage Techniques for Neck Tension
These techniques are safe to perform at home and can provide significant relief. However, they do not replace professional assessment if symptoms persist.
Upper Trapezius Self-Massage
- Locate the painful area between the neck and shoulder
- With the opposite hand, press with your fingers on the tension point
- Maintain moderate pressure for 30-60 seconds
- Without releasing, perform small circular movements
- Repeat 3-4 times, resting between each application
Nape Self-Massage
- Place both hands on the back of the neck
- With your fingertips, gently press the muscles on both sides of the spine
- Perform kneading movements from the base of the skull towards the shoulders
- Spend 2-3 minutes on each side
Massage Ball Technique
- Place a tennis ball between your back and the wall
- Position the ball on the trapezius, at shoulder height
- Press your body against the wall
- Move slowly so the ball rolls over tension points
- When you find a painful point, maintain pressure for 30-60 seconds
Important Precautions
- Never press directly on the spine
- Avoid the side of the neck where important blood vessels pass
- Do not make sudden movements or forced turns
- Stop if pain increases significantly
- Self-massage pain should be "tolerable": discomfort that relieves, not acute pain
Neck Mobility Exercises
These exercises help maintain flexibility and prevent new contractures. Perform them with smooth, controlled movements.
1. Neck Rotations
- Starting position: Seated with straight back, looking forward
- Execution: Slowly turn your head to the right as far as you can without pain. Hold for 5 seconds. Return to center and repeat to the left
- Repetitions: 10 on each side
- Frequency: 3 times a day
2. Lateral Tilts
- Starting position: Seated with relaxed shoulders
- Execution: Tilt your right ear toward your right shoulder, without raising the shoulder. Hold 15-20 seconds. Repeat on the other side
- Repetitions: 3-5 on each side
- Note: You can gently assist with your hand, without forcing
3. Flexion and Extension
- Starting position: Seated upright
- Execution: Gently bring your chin to your chest. Hold 10 seconds. Then look up at the ceiling (without forcing). Hold 10 seconds
- Repetitions: 5-8 times
- Precaution: Do not force backward extension if you have pain
4. Cervical Retraction ("Chin Tuck")
- Starting position: Seated or standing with straight back
- Execution: Pull your chin back as if making a "double chin". Hold 5 seconds
- Repetitions: 10-15 times
- Benefit: Corrects forward head posture
5. Trapezius Stretch
- Starting position: Seated, hold the chair seat with your right hand
- Execution: Tilt your head to the left and slightly forward. Assist with your left hand. Hold 20-30 seconds
- Repetitions: 2-3 on each side
- Expected sensation: Stretch in the trapezius area on the opposite side
6. Shoulder Circles
- Starting position: Standing or seated with relaxed arms
- Execution: Raise your shoulders, bring them back, lower and repeat in circles
- Repetitions: 10 circles backward, 10 forward
- Benefit: Releases accumulated tension in the area
Prevention: Avoid Recurrence
Workplace Ergonomics
Computer screen
- The top edge should be at eye level
- Distance: an extended arm (50-70 cm)
- No reflections or glare that force you to tilt your head
Chair
- With lumbar support
- Feet flat on the floor or footrest
- Elbows at 90-degree angle
Phone
- Use headphones for long calls
- Never hold the phone between shoulder and ear
Posture Hygiene with Mobile Devices
- Raise your phone to eye level
- Rest your elbows to reduce load
- Limit continuous use time
- Take breaks every 20-30 minutes
Pillow Selection
- Side sleepers: Pillow that keeps the neck aligned with the spine
- Back sleepers: Low or medium pillow that does not project the head forward
- Avoid sleeping face down: Forces you to turn your head and tense the neck
Active Breaks
Every 45-60 minutes of sedentary work:
- Stand up and walk a few steps
- Perform the mobility exercises (2 minutes)
- Consciously relax your shoulders
Stress Management
- Identify when you tense your shoulders and consciously relax them
- Practice diaphragmatic breathing
- Consider activities such as yoga, pilates, or meditation
Red Flags: When to See a Doctor
Most cervical contractures are benign and improve with conservative treatment. However, you should seek urgent consultation if you experience:
- Neck pain after trauma (fall, traffic accident)
- Loss of strength in one or both arms
- Persistent tingling or numbness in hands or arms
- Pain that does not improve in 2-3 weeks despite treatment
- Fever associated with neck pain
- Unexplained weight loss
- Night pain that wakes you up
- Difficulty controlling sphincters (medical emergency)
- Severe headache of sudden onset
These symptoms may indicate conditions requiring immediate medical attention.
Frequently Asked Questions
How long does it take for neck tension to heal?
A mild contracture can resolve in 3-7 days with relative rest and basic care. Moderate contractures usually need 1-2 weeks. Chronic or recurrent cases may require several weeks of treatment and changes in postural habits.
Is cold or heat better for neck tension?
In general, heat is more effective for contractures because it relaxes the musculature and improves circulation. Apply dry heat (heating pad, seed bag) for 15-20 minutes. Cold is only indicated in the first 24-48 hours if there is acute inflammation or trauma.
Can I work with neck tension?
It will depend on the intensity of the pain and your type of work. If you have an office job, you can continue while taking frequent breaks and improving your ergonomics. Avoid carrying weight or performing repetitive neck movements until it improves.
Can I exercise with neck tension?
Avoid impact exercises and those involving load on the neck (such as barbell squats). You can do gentle cardiovascular exercise (walking, stationary bike) and the neck mobility exercises described. Listen to your body: if pain increases, stop.
Can neck tension cause dizziness?
Yes, in some cases. The cervical muscles are related to the vestibular and proprioceptive system. Intense tension can cause a feeling of instability or mild dizziness. However, if dizziness is intense or accompanied by other symptoms (double vision, difficulty speaking), consult urgently.
How should I sleep with neck tension?
The best position is on your side with a pillow that keeps your head aligned with your spine. You can also sleep on your back with a low pillow. Avoid sleeping face down because it forces you to turn your head. During acute episodes, you can place a rolled towel under your neck for extra support.
When to Seek Professional Help
If your neck tension:
- Does not improve in 1-2 weeks with home care
- Significantly interferes with your work or rest
- Recurs frequently (more than 3-4 times a year)
- Is accompanied by referred pain to the arm
It is time to consult a physiotherapist. At FisioBaix, Gemma Pastor Vila offers specialized treatment for neck tension at home in Sant Boi de Llobregat and surrounding areas.
Advantages of home treatment:
- No travel when pain is intense
- Assessment of your actual work environment
- Flexible hours adapted to you
Legal disclaimer: This article is for informational and educational purposes. It does not replace assessment, diagnosis, or treatment by a healthcare professional. If you have any doubts about your particular situation, consult your doctor or physiotherapist.