Why Do Women Suffer More Neck Pain Than Men?

Neck pain is increasingly getting noticed in today’s society and women are at the forefront of this annoyance. We do not know exactly why women suffer neck pain more than men, however, there are some theories. The tendency for women to experience neck pain in significantly higher numbers than men indicate the importance of proper knowledge in attempts at relief and prevention.

• A 2004 study in the Journal of Occupational and Environmental Medicine indicates that the incidence of women seeking health care for neck and shoulder pain is 29% compared to 18% for men. That is a significance gender difference.

Genetic factors have an important influence on neck pain reporting in women. These factors include the genetic determinants of structural degeneration commonly known as neck arthritis and an individuals inherited tendency toward psychological distress which necessitates further methods of coping with neck pain.

Women tend to report more tension neck syndrome, cervicogenic – neck related headaches and tension headaches. Interestingly, women also report more dizziness, vertigo and motion sickness, which may also be related to the neck. In the case of tension sensitive women, mental stress decreases blood circulation around the neck and shoulder muscles like the trapezius, which may result in stiffness.

Studies have shown that women developing trapezius muscle pain problems had higher muscle activity during breaks at work but not during actual work. There is a sustained low-level muscle activity which seems to be a risk factor for muscular pain. Similar findings have found that women cashiers suffering from trapezius myalgia had much less muscle rest during work, compared to cashiers without neck and shoulder pain. Furthermore, cashiers reporting distress at work had elevated electrical muscle activity compared to cashiers reporting more positive reactions at work.

• It has also been noted that stress tests induced a significant increase, not only in perceived stress and blood pressure, but also in the muscular tension (trapezius activity) of women. Interestingly, a 2008 study in Physical Therapy showed that women with trapezius myalgia, which causes chronic pain and stiffness in the neck and shoulders, can be helped with a specific strengthening exercise program.

• A 2008 study in the Journal of Applied Physiology concluded that specific strengthening training can relieve pain and increases maximum activity of the painful trapezius muscle in women with trapezius myalgia. The also indicated, “”Furthermore, decreased relative workload may indirectly augment pain reduction.”

• An interesting 2006 study of Japanese women published in the Hiroshima Journal of Medical Science noted in women that sloping shoulders and low muscle strength caused the weight of the arms and chest to become a burden on neck and shoulder pain. They further indicated women may be more sensitive to pain in the neck and shoulders than men and women had a tendency to feel more stiffness.

Oddly enough, this study indicated that men are more susceptible to neck stiffness from stress related conditions and that women had more of a physical related condition. Nonetheless, it is established that psychological stress including depression, anxiety and factors related to working conditions can have a significant impact on musculoskeletal pain.

Another proposed explanation of the higher incidence of neck pain found among women could be that women more often have jobs characterized by static load as in computer operators and monotonous and repetitive tasks, and are more often exposed to additional stress from unpaid work (such as, housekeeping and child care).

Additionally, one cannot ignore how hormones such as estrogen and testosterone affect the central nervous system, which is responsible for perceiving and transmitting the sensation of pain. This is one reason why conditions such as neck pain and headaches strike women at higher rates than men.

Our physical differences also matter. We’ve begun to grasp that women have a different neck architecture than men. This can pressure joints, muscles, and bones in very different ways than in men. Women are more likely to sustain a whiplash neck injury than men and are also less likely to recover. Studies have shown that the spinal canal in women are significantly narrower that in men which allows for less room for error during injuries.

There is a greater instance of neck instability in women who have sustained neck injuries, especially in the middle of the neck which can refer pain to the shoulders. Women also have less cartilage in the back portions of the neck joints providing less cushioning which may lead to increased injury damage causing a neck facet syndrome.

There is a general tendency of higher prevalence of musculoskeletal complaints among women, and more specifically, biological factors such as lower strength of shoulder girdle muscle among women. Higher prevalence of musculoskeletal pain among women is explained by 3 factors: 1) women are more willing to report musculoskeletal pain; 2) women are more exposed to risk factors for musculoskeletal pain; and 3) women are more vulnerable to develop musculoskeletal pain meaning that women react in different way to risk factors for musculoskeletal pain. The gender difference in vulnerability may be due to biologic factors (hormones or physiology), difference in pain sensitivity, or difference in social or psychological factors.

Whatever the reason(s) for a higher incidence of neck pain in women, it is important for women to use proper posture modification during work, leisure and rest. Current research indicates exercise is important not only in attempts at neck pain relief, but also to maintain the benefits. Stress reduction is very important both at work and home, so try to resolve issues and not let them linger.

Another important aspect for women is to prevent neck injury, especially in auto accidents causing whiplash. Because women are usually shorter than men, they may drive up closer to the steering wheel and have the back of the seat more upright, it is important that you adjust the seat and headrest properly in order to avoid excessive forces during a rear impact in a whiplash neck injury.

• A 2021 study in Military Medicine found that cervical shearing and loading forces under acceleration (the first phase in whiplash) reached their peaks earlier in female than male spines. The authors concluded, “Because female spines have a lower biomechanical tolerance to injury, female spines may be more vulnerable to injury under this load vector.”

• A 2021 study in the Journal of Anatomy indicates chronic or persistent neck pain after whiplash is twice as common in females. Female athletes sustain a higher percentage of concussions compared to male athletes. The male subjects in this study exhibited a greater muscle coverage of the posterior neck both. The findings highlight a distinct difference in attachment points of posterior cervical musculature, reinforcing that the female neck is not a scaled version of the male neck and may explain differences in muscle torque, range of motion and cervical spine stabilization. The study helps highlight the reason for higher whiplash rates, concussion, and chronic cervical pain among women.

• A 2022 study in Musculoskeletal Science and Practice found females had significantly lower normalized overall average sternocleidomastoid (SCM) muscle cross-sectional area and volume.