Stiff Neck and Shoulders After Radiation — Easing Them Loose, Slowly, Through Exercise

After receiving head and neck radiation therapy, quite a few people experience the neck and shoulders stiffening up. The muscles and connective tissue around the treated area gradually tighten over time, which is called fibrosis in medical terms. When you actually go through it, even turning your head to the side in the morning feels awkward, and you may feel as if one shoulder is raised higher than the other. Some people think "is it just like this?" and leave it alone, but in fact gently moving the body during this period is quite important for what comes later.

The places that stiffen most often are the side line of the neck, under the jaw, and the trapezius muscle on top of the shoulder. If lymph nodes were removed or that area received radiation, the nerve that lifts the shoulder can become sensitive, so the arm may not lift well. That is why, at first, rather than grand exercises, it is enough to slowly turn the neck left and right a few short times a day, and to tilt one ear toward the shoulder and then move it to the other side. The knack is to stop exactly at the point where pain begins. Pulling forcefully all the way to the end only makes it more stiff and sore the next day.

For the shoulders, it is good to move both sides together. Shrugging the shoulders up and dropping them down with a thud, slowly rolling them backward as if drawing circles, and walking the fingers up a wall one notch at a time to raise the arm are all low-burden movements. Doing them in front of a mirror lets you see which side lifts less, so you can pay a little more attention to the stiff side. Doing one movement about five to ten times, breathing out long without holding your breath, lets the muscles stretch much better.

Stretching after a shower, or after laying a warm towel on the neck for a moment, goes much more smoothly. When the body is warmed, the muscles soften. Conversely, during a period when the skin is still red and raw or oozing, do not irritate that area — keep to gentle, pain-free movements elsewhere only. Doing a little every day, fitting it into the gaps of daily life such as while brushing your teeth or watching TV, is better for keeping it up consistently than cramming it all in at once.

But if your arm suddenly will not lift at all, if one shoulder droops with a feeling of strength draining away, or if a sharp pain shoots all the way to your fingertips when you move your neck, do not judge it alone — it is best to be sure to tell your treatment team. It could be accessory nerve damage or another problem, and in some cases you need to learn tailored movements from a rehabilitation-medicine specialist or physical therapist. A stiffened body does not loosen in just a few days. With the mindset of taking it slowly over a month or two, start with simply turning your neck gently once today.

What is written here is general guidance, so please proceed while checking in from time to time with the medical team at the hospital where you are treated, to see whether it suits your own condition.

This article is intended to convey general medical information in an accessible way and does not replace individual diagnosis or treatment. Please be sure to consult your own physician for any specific decisions.