Neck pain and shoulder tension: how Pilates can help

Stiff neck and tense shoulders after hours at a screen? What Pilates can work on, what to watch for during class and when neck pain needs an assessment.

Technical reviewAna Carina Silvaphysiotherapist and Clinical Pilates instructor

The neck and shoulder region is involved in many daily activities: working at a computer, driving, using your phone, carrying things or exercising.

When we spend long periods in the same position or using screens, we may start to feel tiredness, stiffness or discomfort in the neck and shoulders.1 However, neck pain can be influenced by different factors and should not automatically be blamed on a single position or on so-called “bad posture”.2

How can Pilates help?

Depending on the exercises chosen, Pilates can help work on:

  • Mobility of the thoracic spine;
  • Movement and control of the shoulder complex;
  • Strength and endurance of the shoulder and trunk muscles;
  • Awareness of head position and how the neck moves;
  • Coordination between breathing and movement;
  • Performing movements without creating excessive tension in the shoulders.

In some people with chronic neck pain, Pilates can help reduce pain and improve the ability to carry out daily activities.3

During class

Avoid holding your breath or creating excessive tension in your shoulders. When an exercise requires lifting your head, choose an adaptation or rest it back down if you feel discomfort. Stop the exercise if the discomfort persists or increases.

A general online class cannot assess the source of your symptoms or replace an individual assessment. Seek advice from a health professional when the pain:

  • Is intense, persistent or getting worse;
  • Started after a fall or other significant injury;
  • Spreads into the arm and comes with tingling, numbness or loss of strength;
  • Significantly interferes with daily activities.4

At DUO

Explore classes that work on spinal mobility, shoulder control, strength and coordination between breathing and movement. Use a comfortable range and stop the exercise if your symptoms increase.

View plans

Content written by DUO Clinical Pilates

References

  1. Meng Y, Xue Y, Yang S, Wu F, Dong Y. The associations between sedentary behavior and neck pain: a systematic review and meta-analysis. BMC Public Health. 2025;25:453. doi:10.1186/s12889-025-21685-9.
  2. Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG. The relationship between forward head posture and neck pain: a systematic review and meta-analysis. Current Reviews in Musculoskeletal Medicine. 2019;12(4):562–577. doi:10.1007/s12178-019-09594-y.
  3. Lazoura E, Savva C, Ploutarchou G, et al. Effectiveness of the Pilates method in patients with chronic neck pain: a systematic review with meta-analysis. BMC Musculoskeletal Disorders. 2025;26:629. doi:10.1186/s12891-025-08888-2.
  4. East Kent Hospitals University NHS Foundation Trust. Neck pain/injury: aftercare advice. Reviewed July 2026.
Reference 1

Meng Y, Xue Y, Yang S, Wu F, Dong Y. The associations between sedentary behavior and neck pain: a systematic review and meta-analysis. BMC Public Health. 2025;25:453. doi:10.1186/s12889-025-21685-9.

Reference 2

Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG. The relationship between forward head posture and neck pain: a systematic review and meta-analysis. Current Reviews in Musculoskeletal Medicine. 2019;12(4):562–577. doi:10.1007/s12178-019-09594-y.

Reference 3

Lazoura E, Savva C, Ploutarchou G, et al. Effectiveness of the Pilates method in patients with chronic neck pain: a systematic review with meta-analysis. BMC Musculoskeletal Disorders. 2025;26:629. doi:10.1186/s12891-025-08888-2.

Reference 4

East Kent Hospitals University NHS Foundation Trust. Neck pain/injury: aftercare advice. Reviewed July 2026.