Part 3 of 6 in the stiff and aching neck and shoulder series. Part 1 is "blocked means pain" and the four words; part 2 is sinew, bone and cold; part 4 is a table of five situations; part 5 is what a consultation does first; part 6 is when to see a doctor.
The first two parts were the TCM side. This part sets the NHS account beside it: four common causes, three directions, and its reason for "why keep moving".
The two languages are not translations of each other — section III says why.
The short version
- The NHS neck-pain page's four common causes: the neck locked in an awkward position while sleeping; bad posture such as sitting at a desk; a pinched nerve; an injury such as whiplash.
- The same page's three directions: keep the neck moving unless a doctor tells you not to; do not hold one position for a long time; heat or cold packs.
- Why move: the NHS shoulder-pain page says to use pain relief so that you can keep moving, and not to completely stop using your shoulder — this can stop it getting better.
- Why heat: the neck page lists the method only. The same organisation's back-pain page assigns an ice pack to pain and swelling, and a heat pack to joint stiffness or muscle spasms.
First, the things that cannot wait
Chest pain that feels tight or squeezing, or chest pain spreading to your arms, neck or jaw — call 999 now, or go to the nearest hospital emergency department. The NHS heart attack page lists both chest pains among its reasons to call 999, and states that a heart attack happens when blood flow to the heart is blocked. This is an emergency, not a consultation booking.
Persistent numbness or weakness in the arm or fingers — get urgent help. The NHS lists "pins and needles that do not go away" and "no feeling in your arm or shoulder" among the reasons to get urgent help.
The full list is in part 6.
A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.
I. The NHS's four common causes, and three directions
The NHS neck-pain page lists four common causes of neck pain: the neck becoming locked in an awkward position while sleeping; bad posture, for example when sitting at a desk for a long time; a pinched nerve (神经受压); and an injury, for example whiplash (挥鞭伤) from a traffic accident or fall.
Its directions are three: it is better to keep your neck moving, unless a doctor tells you not to; do not keep your neck in the same position for a long time; heat or cold packs.
Why move. Of the three, this is the one the NHS gives a reason for, on the shoulder-pain page: use pain relief so you can keep moving — and do not completely stop using your shoulder, this can stop it getting better.
II. Why heat: that reason is not on the neck-pain page
The neck-pain page lists the method and gives no reason.
The same organisation's back-pain page gives the two packs different jobs: an ice pack to reduce pain and swelling, a heat pack to relieve joint stiffness or muscle spasms (肌肉痉挛).
That page is about back pain. This article borrows only its division of labour between the two packs and does not move it to the neck. The NHS pages stop here: they do not say why a muscle tightens or why heat loosens it, and this article does not fill that in for them.
Do not apply heat first in any part 6 situation — the first step there is a doctor, not a pack.
III. Both put "movement" and "warmth" on the same side, but the two languages are not translations
Side by side: the NHS speaks of posture, joint stiffness and muscle spasm; TCM theory speaks of qi and blood flowing through the meridians, and of cold's congealing and contraction (part 2).
What matches is the direction: move, and keep warm. What differs is the language for "why".
"Blocked" is not the Chinese for "muscle spasm", and 温经散寒 is not another name for a hot water bottle. "Blocked" is the HKU column's summary — qi and blood not moving through that spot; 温经散寒 is a treatment method in the WHO's TCM terminology standard — warming yang, dissipating cold and unblocking the meridians, for conditions due to cold retention in the meridians. Neither translates a word on an NHS page.
The two accounts can be read side by side; this article does not merge them.
💡 Remember: both point to movement and warmth, but for different reasons. Read them side by side; do not translate one into the other.
IV. The pharmacy counter, and the videos online
- Pharmacy counters (Guardian, Watsons): the NHS neck-pain page lists heat and cold packs among the things to buy from a pharmacy; the pharmacist is someone to ask about choosing a painkiller — the NHS shoulder-pain page lists that among what a pharmacist helps with.
- Don't follow videos for neck movements: routines online may not suit your situation. Any movement aimed at the neck should be guided by a doctor, physiotherapist or TCM practitioner who has examined you. The NHS shoulder-pain page says it plainly: do not make up your own strenuous exercises.
⚠️ A safety note: TCM and Western medicine complement each other; it is not a choice between them. A great deal sits close together in the neck, so when there is numbness, weakness or anything nerve-related, medical assessment first is the sounder order — see part 6.
Frequently asked
What do I do about a "stiff neck" from sleeping (落枕)? 落枕 is the everyday name; the NHS's matching cause is "the neck becoming locked in an awkward position while sleeping". TCM theory looks at the "blocked means pain" line — local blockage of qi and blood (part 1), with wind-cold as the CUHK column's external cause for 漏肩风 (part 2).
The NHS's practice: do not wear a neck collar — it is better to keep your neck moving, unless a doctor tells you not to; a hot water bottle wrapped in a tea towel for 20 minutes, 2 to 3 times a day; and nothing dangerous while you cannot move your neck, such as driving or cycling.
Not gone after a few weeks, or with pins and needles: the NHS neck-pain page's threshold is to see a doctor; with high fever, severe headache or light sensitivity, it is part 6's 999.
How high should my pillow be? The NHS neck-pain page gives no number of centimetres, only a direction: a low, firm pillow; when sleeping, head the same height as the rest of the body; not on your front, and no twisting the neck in bed. So the answer to "how high" goes only as far as the guideline does: low and firm, head level with the body.
If the ache is still there a few weeks after changing the pillow, bring that — and which side you favour — to the consultation.
How many hours of phone a day is too many? There is no public "hours per day" limit to cite. What there is are two directions: the NHS says not to keep your neck in the same position for a long time; Malaysia's DOSH Display Screen Equipment guidelines list "continuously holding a phone or tablet" as an example of static posture.
So the consultation's question is not how many hours, but how long since you changed position and whether you got up in between. The public numbers for how often to get up are in screen height and how often to stand up.
The words in this part
- Whiplash (挥鞭伤) — the NHS neck-pain page's example of an injury: a neck injury from a traffic accident or fall.
- Pinched nerve (神经受压) — one of the four common causes on the same page; part 6 covers numbness.
- Muscle spasm (肌肉痉挛) — the NHS back-pain page's word: a heat pack relieves joint stiffness or muscle spasms.
- 落枕 — the everyday name; the NHS's matching description is "the neck becoming locked in an awkward position while sleeping".
- Blocked (不通) — the TCM term, in the HKU column's words: qi and blood not moving through that spot. Not the Chinese for "muscle spasm".
The other five parts
- Part 1: "Blocked means pain", and the four words
- Part 2: Sinew or bone, and why cold makes it worse
- Part 4: Five common neck-and-shoulder situations
- Part 5: A massage shop, or a consultation
- Part 6: When to see a doctor first
👉 If you are not sure where a neck and shoulder ache should go when it comes back the next day even after the packs and a new pillow, you are welcome to bring it to an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it; if anything in the section above or in part 6 applies, see a doctor first. In-person consultations are coming soon.
Sit with a licensed TCM practitioner from wherever you are.
HansMed Modern TCM
For general wellness education only — not medical advice. Consult a registered TCM practitioner for personal guidance.
Sources
- NHS, Neck pain, page last reviewed 27 April 2023 — https://www.nhs.uk/symptoms/neck-pain-and-stiff-neck/
- NHS, Shoulder pain, page last reviewed 22 May 2023 — https://www.nhs.uk/symptoms/shoulder-pain/
- NHS, Back pain, page last reviewed 05 March 2026 — https://www.nhs.uk/conditions/back-pain/
- NHS, Heart attack, page last reviewed 31 March 2026 — https://www.nhs.uk/conditions/heart-attack/
- University of Hong Kong, LKS Faculty of Medicine, School of Chinese Medicine, "TCM tuina technique and the treatment of pain", Chan Ka-wing, am730 column, 14 July 2025 — https://www.med.hku.hk/zh-hk/media/knowledge-exchange/newspaper-columns/2025/jul/am730_20250714
- Chinese University of Hong Kong, School of Chinese Medicine, "A brief talk on 漏肩风", Ngan Kit (registered TCM practitioner), Sky Post column, 16 November 2017 — https://www.scm.cuhk.edu.hk/zh-tw/news-and-literature/articles/articles-skypost-list/295-2017-11-16/
- Department of Occupational Safety and Health Malaysia, Guidelines on Occupational Safety and Health for Working with Display Screen Equipment 2024 — https://dosh.gov.my/wp-content/uploads/2025/01/GUIDELINES-ON-OSH-FOR-DSE_Full_21Nov.pdf
- World Health Organization, WHO international standard terminologies on traditional Chinese medicine, Geneva 2022 — https://www.who.int/publications/i/item/9789240042322
