Chronic Neck Pain Treatments: Latest Research & Expert Advice

Find the exact care you need, from exactly the right doctors.

Find My Doctor
neck massage for chronic neck pain

Do you ever take pain-free movement in your neck for granted? For those with chronic neck pain, tasks like looking over the shoulder or driving become major ordeals requiring planning and recovery time. The good news is there are many effective treatment options nowadays that can successfully reduce chronic neck pain and improve function.

We’ve drawn from the latest medical research as well as real-world expertise from our chronic pain specialists to lay out the most effective treatments for getting chronic neck pain under control.

Why Isn’t My Neck Pain Going Away Despite Taking Medication?

a woman suffering from chronic neck pain

For neck pain that persists beyond a few weeks despite taking over-the-counter medications, the cause likely stems from an underlying mechanical issue with the cervical spine structure, rather than a simple muscle strain.

Neck pain can stem from many complex factors and underlying health conditions. According to research, it’s not simply caused by strained muscles or poor posture – sometimes neuromuscular disorders or autoimmune diseases are the culprit. This complex nature is why there’s no single “fix” that works for everyone. 

According to our experience, some common reasons why medication alone fails to resolve chronic neck pain include:

  • The pain is stemming from an injury, condition, or degenerative changes affecting discs, vertebrae, facet joints, or connective tissues in the neck – problems that cannot be fixed with medication alone.
  • The patient requires prescription-strength pain relievers, muscle relaxers, or anti-inflammatories, rather than OTC doses.
  • Structural problems in the cervical spine need to be addressed through physical therapy, massage, or chiropractic methods focused on alignment.
  • The patient may require injections, surgery, or other interventional procedures to correct the underlying cause of their stubborn neck pain.

A study on prescription medication use among U.S. adults with neck pain found that the use of acetaminophen, NSAIDs, muscle relaxants, and gabapentin was much more common in the chronic neck pain group than in the no-neck pain group. This suggests that stronger, prescription-strength medications might be necessary for chronic neck pain.

What Type of Doctor Should I See for Chronic Neck Pain?

For chronic neck pain, common specialists who can diagnose and develop a treatment plan include primary care physicians, physiatrists, orthopedists, neurosurgeons, neurologists, physical therapists, chiropractors, and massage therapists.

SpecialistRole in Treating Chronic Neck Pain
Primary care physicianInitial evaluation and referrals
PhysiatristNonsurgical treatments
Orthopedist or neurosurgeonSurgery for spinal/nerve issues
NeurologistDiagnose neurological causes
Physical therapistRehab exercises and techniques
ChiropractorSpinal manipulation and alignment
Massage therapistRelax muscles and increase mobility

A study published in the American Family Physician Journal emphasizes the role of primary care physicians in the initial evaluation of neck pain. The study suggests that primary care physicians should be able to recognize when neck pain signals a potentially serious condition.

Another study conducted by researchers at the Michigan State University College of Osteopathic Medicine found that osteopathic manipulative treatment (OMT), a type of treatment often performed by physiatrists, was effective in reducing pain and disability in patients with chronic neck pain.

What Are the Most Effective Treatments Specifically for Chronic Neck Muscle Pain?

oral medications for chronic neck pain

Some of the most effective treatments for chronic neck muscle pain involve targeted massage, gentle stretching, low-impact exercises, posture training, topical analgesics, muscle relaxants, physical therapy modalities, and ergonomic corrections according to Kaly specialists.

  1. Targeted deep tissue massage to release myofascial trigger points.
  2. Gentle stretching focused on the neck to improve mobility and flexibility.
  3. Low-impact exercises like yoga or pilates designed to strengthen the neck musculature.
  4. Posture training exercises to correct any imbalances.
  5. Topical pain relieving creams containing menthol, capsaicin, CBD, or other analgesics.
  6. Oral muscle relaxants and NSAID medications to relieve muscle spasms and inflammation.
  7. Physical therapy using modalities like heat/ice therapy, electrical stimulation, and foam rolling.
  8. Ergonomic corrections to eliminate daily habits that strain the neck.

A systematic review of randomized controlled trials of a single session of manual therapy for chronic mechanical neck pain in adults found that there is moderate-to-high quality evidence that immediate clinically important improvements are obtained from a single session of spinal manipulation. The evidence for mobilization is less substantial, with fewer studies reporting smaller immediate changes.

According to our experience, a combination of hands-on therapies, at-home exercises, medication, and lifestyle changes often works best for stubborn chronic neck muscle pain.

What Is the Best Medication for Chronic Neck Pain?

Kaly specialists recommend NSAIDs like ibuprofen or naproxen, muscle relaxants like cyclobenzaprine, and topical creams containing menthol or CBD based on their effectiveness and safety.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or aspirin provide anti-inflammatory and analgesic effects. They are available over-the-counter or in stronger prescription doses. NSAIDs carry side effects like stomach ulcers or kidney problems with long-term use.

    A study titled “Real-World Evidence in Prescription Medication Use Among U.S. Adults with Neck Pain” found that NSAIDs were among the most common analgesics used for neck pain, along with opioids and acetaminophen. This study was conducted using data from the National Health and Nutrition Examination Survey (NHANES).
  • Muscle relaxants such as cyclobenzaprine or tizanidine can relieve painful muscle spasms associated with chronic neck pain. Some may cause drowsiness.

    The study “Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis” found that non-benzodiazepine antispasmodics, a type of muscle relaxant, might provide small reductions in pain intensity for acute low back pain.
  • Topical creams containing menthol or CBD applied locally help temporarily numb and relieve neck pain. They come with minimal side effects compared to oral medication.

    The Cochrane Review “Topical analgesics for acute and chronic pain in adults” found that certain topical NSAIDs were effective for strains, sprains, and osteoarthritis of the hand and knee.
  • Narcotics like opioids are not recommended as a first-line or long-term medication choice due to their habit-forming properties and side effects.

    The study “Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis” found that the clinical benefit of opioid treatment does not outweigh the harm it might cause in patients with osteoarthritis.

What Should I Do If I Have Persistent Neck Pain That Doesn’t Improve with Rest?

If you have persistent neck pain lasting over 2-4 weeks that fails to improve with rest and over-the-counter medication, Kaly specialists advise seeing your doctor for evaluation and possible imaging, trying prescription medication, getting spinal mobilization therapy, and exploring steroid injections for temporary relief. 

  • Consult your primary care physician for an evaluation, possible imaging, and specialist referrals.
  • Ask your doctor about trying prescription-strength anti-inflammatory medication or muscle relaxants.
  • Get a referral to a physical therapist or chiropractor for spinal mobilization techniques.
  • Explore steroid injections like epidurals to temporarily relieve pain and inflammation.

The Cleveland Clinic states that healthcare providers use cervical epidural steroid injections (ESIs) as a temporary pain relief option for certain causes of chronic neck pain. They inject an anti-inflammatory medication into the epidural space around your spinal nerves. About 40% to 84% of people who receive cervical ESIs experience temporary pain relief.

Can Chronic Neck Pain Be Fully Cured?

There is no definitive cure for most chronic neck pain cases; the prognosis depends on the cause. Muscular neck pain has a better outlook with treatment, while degenerative changes cannot be reversed. Severe structural problems may require surgery for lasting relief according to studies on prognostic factors. Younger age predicts better outcomes.

  • Muscular neck pain from repetitive strain has a better prognosis and can be healed over time with stretching, exercise, massage, and posture corrections.
  • Degenerative changes like arthritis, spondylosis, or disc disease cannot be reversed, but symptoms can be managed with treatment.
  • Severe structural problems like spinal stenosis or disc herniation may require surgery for lasting pain relief.

A study on prognostic factors for neck pain in general practice found that older age and concomitant low back pain were the most consistent indicators of a less favorable prognosis for neck pain.

Research on the course and prognostic factors for neck pain in the general population discovered that younger age predicted better outcomes, and psychosocial factors, including psychological health, coping patterns, and need to socialize, were the strongest prognostic factors.

Tired of Constant Neck Pain? We Can Help Connect You to Better Expert Care

doctor and patient consult on chronic neck pain

Kaly can match you with top local specialists based on your specific symptoms and needs. Our experienced chronic pain specialists create customized treatment plans designed to maximize comfort and function so you can get back to living your life. 

Contact Kaly today to take control of your chronic neck pain!