Care of Neck, Head, and Upper Back

When you are having discomfort in the neck, upper back, head, and/or shoulders, ordinary activities which you have taken for granted become a source of irritation. Therefore, it is important for you to be aware of the basic principles of good care.

General Advice:

  1. Balance activities with rest. Change positions and take short rest periods often. Slowly increase activities over a period of time.
  2. Use ice or contrast treatments to help alleviate muscle tension and increase circulation. Moist heat applied to the muscle is the next best alternative for non-acute problems.


  1. Avoid sleeping on stomach
  2. When sleeping on back:
    1. Use a Therapeutic© pillow or towel roll under neck
    2. Elevate legs by placing one pillow under the knees.
  3. Try to quiet the mind; when our minds are active, so are our muscles. Focus on deep breathing.

When sleeping on side:

  1. Lay head on pillow large enough to fill from one ear to shoulder
  2. Place a pillow between the knees and ankle to support the hips

Standing or Sitting:

  1. Keep the chin tucked in, shoulders back and relaxed, abdomen tightened, maintain the hollow in the back, and knees slightly relaxed. REMEMBER: head over shoulders and chin level!
  2. Avoid bending head backwards into extreme positions.
  3. Avoid pushing the head forward (think of an apple between the chin and chest)
  4. Sit and stand, pretending a string is pulling up from the back of the head.
  5. When sitting, have support in the small of the back.


  1. Perform all work with hands as close to the body and elbows at your sides.
  2. Avoid holding arms overhead or at shoulder height
  3. Pull the seat forward and hold onto the bottom of the steering wheel when driving.
  4. Place your work surface high enough so that it is not necessary to bend over your work.
  5. Change your work position often to avoid stiffening.
  6. Avoid lifting. If you have to lift, keep your back straight, stoop with knees bent, keep the close to you, and then lift with your legs.
  7. Check your alignment several times throughout your work day. Keep your head over your shoulders. Remember the rule of 90°; ankles, knees, hips, elbows, shoulder and chin should all be 90° to the floor.

Should you wish to book an appointment with Dr. Serné, please call the office or email us at