Neck and Back Pain From Cycling

Cycling is low-impact and easy on the joints, which is why people take it up when running or the gym starts to hurt.

It’s also the position that most reliably produces a stiff neck and an aching lower back, because you hold one posture for hours without a break.

Why the neck goes first

On a road or hybrid bike, your trunk leans forward and your head has to tilt back to look ahead. That extends the neck and holds the muscles at the base of the skull contracted for the whole ride. It’s the mirror image of tech neck, and it loads the same muscles.

The lower back is the same story in reverse: held in a sustained forward bend, with the hip flexors shortened and the glutes doing less than they should.

Neither is an injury. It’s fatigue from a position held too long, which is why the ache builds through the ride and peaks afterwards. Tender spots between the shoulder blades are common with it: muscle knots, heat and a massage ball.

After a ride

1. Walk for a few minutes before you sit down. Getting off the bike and straight onto a chair prolongs the same position.
2. Heat, 15–20 minutes on the neck and shoulders, or the lower back, whichever is worse. Sitting upright and supported, cover on, lowest setting.
3. Then move: chin tucks, a gentle backward arch, shoulder blade squeezes, a doorway chest stretch. Ten of each. See why the movement has to follow the heat.

If you’re getting off a long ride in the heat, cool down and rehydrate first. A heat pad on top of an already overheated body isn’t what you want. Legs that cramp overnight after a big ride: calf cramps at night.

On the bike

• Change hand position regularly. Tops, hoods, drops. Each one alters your neck and back angle slightly, and that variation is the point.
• Shrug and roll your shoulders every few kilometres. Most people ride with their shoulders locked up.
• Bend your elbows. Locked arms transmit every bump straight into your neck.
• Get out of the saddle for short stretches on climbs.
• Build distance gradually. Jumping from 20 km to 80 km is the usual cause of a bad week afterwards, and the usual cause of outer knee pain and Achilles stiffness too.

The fit is usually the answer

Persistent neck or back pain on the bike is most often a fit problem, and a bike fit is worth more than any amount of stretching afterwards.

The usual culprits are a saddle set too high or too far back, a stem too long or too low, and handlebars set for a rider more flexible than you are. Raising the bars is the single most common fix for neck pain, and it costs very little.

Off the bike, hip flexor and chest stretches plus glute and upper back strengthening address the positions cycling reinforces. See upper back pain from desk work, because a desk job plus cycling loads the same tissues twice.

See a doctor or physio if…

• Numbness or tingling in your hands, particularly in the little and ring fingers, which can come from pressure on a nerve at the handlebar. Don’t ignore it; padded gloves and a fit change usually sort it.
• Numbness or pain in the groin or saddle area, which needs a saddle change and possibly medical advice. Pain right at the tailbone: coccyx pain.
• Pain, numbness or weakness down a leg. See sciatica and heat.
• Neck pain with headache, dizziness or visual changes
• Anything following a crash, especially a head or neck impact. Bruising and swelling mean cold first: the 48–72 hour rule.
• It isn’t settling between rides, or you’re cutting rides short because of it

Clinically reviewed by: Nigel Chua (Hand Occupational Therapist) & Louise Yow (Physiotherapist). This article is general information, not a diagnosis. electricheatpad.com sells electric heat pads.