Neck Pain: Causes and Solutions

July 1, 2026

IM  -  

Invariably, most instruments place some sort of strain on the body, especially the neck. Pianists and cellists spend long periods slightly hunched forward, leaning into their instruments. Violinists and guitarists tilt their heads for extended periods. Such demanding physicality places undue stress on the upper spine and shoulder muscles. Over time, these positions can result in spinal stress, leading to neck pain, or cervicalgia. Applying proper body mechanics and noninvasive techniques to resolving pain can help sustain a musician’s career and overall health for the long term.

The Design of the Cervical Spine

Your cervical spine consists of the first seven vertebrae in your spine. It provides support for the weight of your head, protects your spinal cord, and allows for a range of motion. Knots in your neck or upper back, sometimes called trigger points, are painful to the touch.

In the age of “text neck,” posture-related conditions are a common problem. In addition to performing, the daily tasks of musicians include working in front of computer screens, posting to social media, and texting. Neck pain affects 10-20% of adults, but is more common in women. Pain can be acute, lasting a few days to six weeks. If it lasts longer than three months, without intervention, it can become chronic.

Cervical myofascial pain syndrome is a condition in which the layer of connective tissue that surrounds your neck muscles becomes tight or damaged, potentially limiting your range of motion. The pain can extend to your shoulders and arms, and may radiate to your fingers.

Physical therapy and medical treatment include a plethora of corrective remedies. Myofascial release therapy, heat/ice application, ergonomic adjustments, and trigger point injections. Proper posture, taking regular breaks, and neck and upper back strengthening exercises—along with instrument support aids are all highly effective approaches to joint health.

An Integrative Medical Approach

If you are experiencing severe neck and shoulder back pain, a physical exam will reveal pressure points in your upper back, normally in two muscles: the trapezius and splenius capitis.

A healthcare provider will start with an anti-inflammatory medication regimen and a referral to a physical therapist. At some point, treatment might include myofascial release therapy. The simple technique involves applying gentle but direct pressure in long strokes on trigger points. Progress is measured by decreased pain and an increased range of motion and functionality.

Trigger Point Injections—This outpatient procedure takes only a few minutes. The physician inserts a needle through the skin and into the trigger point, injecting an anesthetic mixture. The goal is for the trigger point to relax enough so you can exercise and stretch. A brief course of this treatment often results in sustained relief. Acupuncture and massage by licensed professionals may relieve muscle knot pain as well.

Gentle Exercise—Perform exercises that stretch and strengthen neck and upper back muscles to help ease tightness, improve posture, and reduce myofascial pain. Aerobic activity, such as biking, swimming, and walking, is also recommended. You can find temporary relief by using trigger point massage yourself. Lie on your back and gently smooth out the tight knots with a roller or tennis ball under your neck and/or upper back.

Heat/Ice Therapy—Heat eases muscle tension by increasing local blood flow, while ice reduces inflammation and numbs acute pain. For both treatments, limit sessions to 15-20 minutes and always use a protective skin barrier. When alternating, start with ice for recent swelling, switch to heat for stiffness, and allow your skin to return to normal temperature between swaps.

Nsaids (Nonsteroidal Anti-Inflammatory Drugs)—Taking over-the-counter medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve) may help reduce inflammation and offer enough relief for you to stretch and exercise. Follow the label’s directions carefully.

Alexander Technique—Developed in the 1890s, the Alexander Technique has a long history of helping instrumentalists and singers perform with less stress. The technique emphasizes the natural alignment of the body, which promotes a balanced and upright posture. Through gentle guidance and hands-on instruction from a qualified Alexander Technique teacher, individuals can rediscover the optimal alignment of their spine, head, and neck. This improved posture not only reduces the strain on the neck muscles but also enhances overall body coordination and balance.

Self-care should be practiced under the guidance of a healthcare provider. If any of these exercises increase your pain, stop immediately.

Note: These resources are for educational use only and do not imply AFM endorsement. They are not a substitute for professional medical advice. Always consult with a licensed physician or practitioner regarding medical treatments and research.

---