Exercises for a Pinched Nerve in the Neck

Do you have neck pain? This blog post will cover all of the best exercises for a pinched nerve in the neck.

What is a pinched nerve?

A pinched nerve in the neck is the compression of a nerve (usually by the disc and/or joint) in the cervical spine.

This can lead to pain on the side of neck that can refer neurological symptoms (see below) down the arm.

(It is also referred to as a Cervical Radiculopathy.)

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How do you tell if you have a pinched nerve in your neck?

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a) Scans (MRI, CT)

A scan to the Cervical spine (neck) can be used to determine if there are structural abnormalities pressing onto a nerve.

Key words to look for in your scan report:

(Note: Since these scans are usually performed in the lying down position, the results may not necessarily reflect what is happening to the nerve when you are in the up right position.)

b) Symptoms of a pinched nerve in the neck

What does a pinched nerve in the neck feel like?

There will be neurological symptoms in the arm such as:

(Note: These symptoms are shared with other potential issues such as Thoracic Outlet Syndrome.)

c) Pain pattern

Impingement of certain nerves in the neck (C5-T1) can refer symptoms in specific patterns. (see above)

(Note: There is a degree of variability in the location of the referral patterns from person to person. Use it as a rough guide line!)

d) Spurling’s test

Instructions:

• Look upwards.
• Tilt your head TOWARDS the side of pain.
• Apply a downward pressure on the side of your head with your hand.
• (Note: Be gentle when performing this test. You do not want to further irritate your nerve.)

e) Upper limb tension test

For best results – I would recommend a healthcare professional to perform this test on you.

Instructions:

• Have your arm straight by your side with the palms facing forwards.
• Depress your shoulder downwards.
• Lift your arm up to shoulder height.
• Bend your wrist backwards.
• Twist your forearm backwards so that your fingers are facing towards the floor.
• Take note of any stretch sensation experienced in the arm.
• Slightly bend your elbow until the sensation in the arm starts to reduce.
• Tilt your head to the opposite side to see if this movement brings back the same sensation in the arm.
• Compare with the unaffected side.
  • Be careful when tilting your head towards the side of pain!

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The best Exercises for a pinched nerve in the neck

Note: These exercises can be performed at home and are designed to be completely pain-free.

Stop the exercise immediately if the pain worsens or spreads down the arm (Peripheralization).

If there are any doubts, please consult a healthcare professional before commencing the exercises.

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1. Address inflammation

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a) Anti-inflammatory gel

Apply an anti-inflammatory gel to the site of the nerve impingement to help manage excessive inflammation.

Recommendation: 2-3/day

c) Heat or Ice?

If the goal is to purely address the inflammation, I would personally suggest ice.

(However – if you feel more relief from applying heat, go with that!)

c) Non-steroidal Anti-Inflammatory Drugs (NSAIDs)

This oral medication reduces inflammation in the whole body.

Keep in mind – there are different strengths of NSAIDs and is best used if the prescribed medication is appropriate to the severity.

d) Cortisone injection

This injection consists of a steroid (cortisone) and an analgesic substance.

The aim of the injection is to:

• reduce the inflammation
• reduce the pain by numbing the area

e) Other

There are also pain killers and nerve medication that can help reduce symptoms.

2. Repeated Gentle Neck movements

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a) McKenzie chin retraction

Instructions:

• Look slightly downwards.
  • This is to reduce the likelihood of pinching the nerve as you perform this movement.
• Gently tuck your chin in.
  • Also known as “making a double chin”.
  • Think of this movement like a book sliding back into the shelf.
• Make sure to keep your jaw and neck muscles relaxed.
• Repeat 20 times.
• Note: You can also perform this lying down on your back.

b) Flexion/Extension

Instructions:

• Slowly (and carefully) alternate between looking up and down.
  • Make sure that your chin does not poke forwards throughout the exercise.
• Repeat 20 times.

c) Rotation

Instructions:

• Slowly (and carefully) alternate between looking towards your left and right.
  • Make sure that you do not allow your chin to poke forwards at the end of the movement.
• Repeat 20 times.

d) Lateral flexion

Instructions:

• Look slightly downwards.
• Slowly (and carefully) tilt your neck from side-to-side.
• You might notice moving your head towards the affected side is more painful.
  • Do not push into pain.
• Repeat 20 times.

3. Releases

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a) Back of neck

Instructions:

• Lie down on the floor.
• Place a massage ball at the back of your neck.
• Aim to cover the muscles from the base of the skull to the base of the neck.
• Continue for 1-2 minutes on each side.

b) Front of the neck

Instructions:

• Locate the Sternocleidomastoid muscle.
  • (Use Google if you are not sure where this muscle is.)
• You should be able to feel a prominent band of muscle on the side of the neck.
• Do not to press in too deep as you may hit other sensitive structures of the neck.
• Gently massage up and down these muscles using a pinch grip. (see above)
• Continue for 1-2 minutes.

c) Side of the neck

Instructions:

• Place the flat part of your fist at the bottom of the side of your neck.
• Make sure that you are not pressing onto the structures at the front of the neck.
• Apply a gentle sliding pressure up towards behind the ear region.
• Repeat 5 upwards strokes on either side of the neck.

4. Stretches for a Pinched Nerve

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a) Lateral flexion stretch

Instructions:

• Tilt your head AWAY from the side of the nerve impingement.
  • (“Bring your ear to the shoulder”)
• Place your hand on the side of your head and apply a downwards pressure.
• Whilst holding this position, slightly rotate your head towards the side of pain.
• Aim to feel a prominent stretch on the side of your neck.
• Avoid any pinching sensation on the side that you are pulling your head towards.
• Hold for 30 seconds.
• Repeat 3 times.
• Note: Do NOT perform this stretch towards the other side as you may potentially compress the nerve.

b) Back of neck (Lower)

Instructions:

• Look down.
• With your hands at the back of your head, pull your head in a downwards direction.
• Aim to feel the stretch at the back of your neck.
• Hold for 30 seconds.
• Repeat 3 times.

c) Back of neck (Upper)

Instructions:

• Place one hand at the front of your chin and the other at the back of your head.
• Apply a force to the front of your chin as to gently glide the chin backwards.
• Whilst maintaining this pressure, proceed to pull your head forward/down.
• Aim to feel a stretch at the back of your upper neck.
• Hold for 30 seconds.
• Repeat 3 times.

c) Levator Scapulae Stretches

Instructions:

• Place the arm (on the same side that you would like stretch) behind your back.
• Pull your shoulder blade downwards.
• Look towards the arm pit on the opposite side.
• Place your hand on the top of your head and pull your head towards the arm pit.
• Aim to feel a stretch on the side of the neck.
• Hold for 30 seconds.
• For more stretches like this, check out this post: Levator Scapulae Stretches.

5. Traction

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a) Manual self-traction

Instructions:

• Loop and hook a strap under the base of the skull.
• Hold onto both ends of the strap with your hands.
• Gently pull the band in an upwards direction.
• Allow for the chin to nod downwards.
• Aim to feel a stretch at the back of your neck.
• Hold for 3-5 seconds
• Repeat 10 times.

b) Resistance band

(This exercise is more advanced than the previous. Only progress to this stretch if your neck can tolerate it!)

Instructions:

• Tie a resistance band to a stationary object. (Height: ~3-4 feet)
• Lie on the floor with your knees bent.
• Wrap the band under the base of the skull.
• Whilst still holding the band with your hands, slowly shuffle your body away from the anchor point.
• Slowly let go and let the band pull on your head.
• Move as far away until you can feel a stretch at the back of your neck.
• Completely relax.
• Hold for 30-60 seconds.
• Note: Place a small towel between the head and the band to prevent your hair from being pulled.

c) Devices

There are many mechanical traction devices available on the market that you can use to help decompress the joints in the neck.

(NOTE: If you would like to see a list of exercises that will decompress your neck, check out this post: How to Decompress Your Neck.)

6. Nerve glides/stretches

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Gentle

These exercises will glide the nerve.

There should be a minimal amount of sensation in the arm as you perform these exercises.

a) Median nerve (C5-T1)

Instructions:

Starting position:

• Keep your head centered.
• Pull your shoulder downwards.
• Keep your arms straight by the side of your body.
• Twist your arm so that your palms are facing outwards.
• Bend your wrist backwards towards the side of your body.
• Start to slowly raise your arm to the side and stop when you first start to feel a prominent stretch in the arm.

End position:

• Moving at the same time: Bend the wrist up towards the sky whilst you tilt your head towards the opposite side.
• Repeat 20 times.

b) Radial nerve (C5-T1)

Instructions:

Starting position

• Keep your head centered.
• Pull your shoulder downwards.
• Straighten your arm by your side.
• Twist your arm inwards so that your elbow and palm is facing outwards.
• Make a fist with your hand.
• Bend your fist towards the side.
• Slowly raise your arm out to the side and stop when you feel a stretch sensation at the top of your forearm.

End position

• Moving at the same time: Straighten the wrist whilst you tilt your head towards the opposite side.
• Repeat 20 times.

c) Ulnar nerve (C8-T1)

Instructions:

Starting position

• Keep your head centered.
• Pull your shoulder downwards.
• With your arm by your side, completely bend your elbow with the palm facing forwards.
• Bend your wrist backwards so that your fingers are pointing upwards/behind you.
• Slowly lift your elbow to the side and stop when you feel a gentle stretch in the pinky/ring finger and/or inside of the elbow/arm.

End position

• Moving at the same time: Bend the wrist forwards whilst you tilt your head towards the opposite side.
• Repeat 20 times.

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Firm

The following exercises will stretch the nerve.

It is important that you do NOT over stretch the nerve.

The goal is to feel a gentle pulling sensation.

a) Median nerve

Instructions:

• Keep your head centered.
• Pull your shoulder downwards.
• Keep your arms straight by the side of your body.
• Twist your arm so that your palms are facing outwards.
• Bend your wrist backwards towards the side of your body.
• Start to slowly raise your arm to the side and stop when you first start to feel a gentle stretch in the arm.
• Tilt your head to the opposite side.
• Aim to feel a gentle stretch in the thumb/pointer/index finger, front of arm and/or side of neck.
  • Do not over stretch!
• Hold for 5 seconds.
• Repeat 5 times.

b) Radial nerve

Instructions:

• Pull your shoulder downwards.
• Straighten your arm by your side.
• Twist your arm so that your elbow and palm is facing outwards.
• Make a fist with your hand.
• Bend your wrist towards the side.
• Raise your arm out to the side.
• Tilt your head to the opposite side.
• Aim to feel a gentle stretch in the top of your forearm and side of neck.
  • Do not over stretch!
• Hold for 5 seconds.
• Repeat 5 times.

c) Ulnar nerve

Instructions:

• Pull your shoulder downwards.
• Completely bend your elbow.
• Bend your wrist backwards.
• Lift your elbow up towards the side.
• Tilt your head to the opposite side.
• Aim to feel a gentle stretch in the pinky/ring finger, inside of the elbow/arm and/or side of neck.
  • Do not over stretch!
• Hold for 5 seconds.
• Repeat 5 times.

7. Address your Posture

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a) Forward Head Posture

The Forward Head Posture is where the head pokes forward from the neutral position.

In this position, part of the neck is actually kinked backwards (extension).

This can lead to narrowing of the holes (foramina) in which the nerve passes through.

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b) Dowager’s Hump

The Dowager’s hump is an enlarged prominence that is formed at the lower region of the neck.

It can increase the chance of pinching nerve for the same reason as stated above.

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c) Hunchback Posture

If the thoracic spine (upper back) is hunched forwards, it can force the head to poke forwards.

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d) Rounded Shoulders

Having Rounded Shoulders is when the resting shoulder position is in front of the mid line of the torso.

The forward position of the shoulders can pull your head forwards along with it.

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8. Daily tips

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a) Cues

Here is a cue to help you hold your head in a better position:

• “Imagine your head as a balloon that is floating away from your body.”
• Think of having a “Long and tall” neck.

b) Head position

If you have a Forward Head Posture, maintain your gaze in a slight downwards angle. (in the short term)

This is to prevent the neck from kinking backwards and squashing the joint/nerves.

c) How should I sleep with a pinched nerve in my neck?

I recommend sleeping on the back or the side.

• When you are lying down, it is important to keep your neck in a position that minimizes the chance of the nerve from being pinched.
• Make sure that your pillow provides an adequate amount of support. The goal is to keep the neck in a neutral position.

Do not sleep on your stomach.

• This position forces your head to rotate towards one side.

Avoid poking your chin forwards:

• The chin should be in a slightly nodded position.
• Think about the bottom of the chin moving towards the upper chest region.

d) Exercises to avoid

High impact exercises that involve movements such as jumping, running and quick changes in direction can potentially cause further compression of the nerve.

Generally speaking – you should be fine with any exercise where you can maintain your head in a fairly neutral position and your symptoms are not aggravated.

8. How long does it take to get over a pinched nerve in your neck?

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Surgery for a pinched nerve in the neck:

• Foraminotomy
• Laminectomy
• Microdiscectomy
• Disc replacement
• Fusion

These surgical interventions are aimed at increasing the size of the hole (foramina) to which the nerves passes through to reduce impingement.

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