Neck Pain
I see neck pain often in my clinics and it is something I have lived with myself, so I am very aware of how wearing it can be. If your neck is feeling stiff, restricting your movements and getting in the way of everyday tasks, I can help.
What neck pain can feel like
Patients experience neck pain in a lot of different ways. You may recognise some of these descriptions yourself:
- Stiffness and difficulty in turning your head, often requiring you to turn your whole body to look around
- Difficulty with tasks such as driving because your neck feels restricted
- Waking up with a “cricked” neck for no reason
- A deep ache at the base of the skull, or across the tops of the shoulders
- Pain or discomfort that often builds up and is worse towards the end of the day
- Pain spreading out from the base of the neck into the shoulders, the shoulder blade or the upper back
- Headaches that seem to start in the neck or base of the skull
- Pain, aching, burning, pins and needles or numbness that travels into the arm and/or hand
- A tense and vulnerable feeling neck that makes you avoid certain movements
You won’t have all of these, and neck pain looks different from person to person. My job is to work out what’s going on in your particular case.
Why it happens
Most neck pain has a mechanical cause, which means it’s coming from structures in your neck such as the joints, muscles, ligaments and discs. These structures can become sensitive to load, sustained positions, strain through activity, or even being held too still (as counterintuitive as that might sound). For example, if we use our neck a lot and subject it to high load, our muscles might go into spasm as a protection mechanism. Another example: the little joints on the side of our neck, called the facet joints, can become irritated, inflamed, locked up, or suffer wear and tear. The result of this is restriction of our movements, and muscular spasms often accompany this too.
The neck has to be both mobile and stable, balancing the weight of the head all day and giving us the range of motion we need for daily activities. It can become prone to aches and discomfort as a result. The reassuring thing is that these mechanical causes can be treated and managed with a well-structured treatment plan.
How I assess and treat neck pain
I start with a comprehensive assessment to work out what’s causing your neck pain. I’ll ask about your symptoms, what brought the pain on and how it’s affecting your day-to-day life. I’ll also perform a physical examination to see how your neck moves and which movements bring on pain. If you’re experiencing symptoms travelling into your arm, I’ll do some specific tests to see if there is any nerve irritation. Part of this is checking for anything that would need further investigation or onward referral. This is rare and not required most of the time, but if I think you need it, I’ll tell you and point you in the right direction.
Once we know what’s going on, I can develop a clear plan of how we’ll look to tackle it. Treatment will usually involve a mixture of hands-on work to reduce pain and improve range of movement, alongside advice and exercises for you to do at home to continue improving the work we’ve done in session.
If this all sounds familiar and it’s holding you back, let’s take a proper look and get a plan together.
What to expect
A lot of neck pain improves over time and a recent onset can often settle within a few days or a few weeks, providing there is nothing more complex going on underneath. The longer you have had it, the longer it might take to resolve. While many patients respond very well to treatment, progress isn’t always in a straight line and you might have small setbacks along the way. This is entirely normal when working through a treatment plan alongside everyday life.
Neck pain can be worrying, so a big part of my treatment is listening to you, addressing your concerns, and then giving you a clear picture of what is going on, why it’s happening, and what we’ll do about it.
It’s important to say that I cannot promise you specific outcomes and it would be quite unethical to do so. What I will promise you is honesty and a plan that aims to get you back to doing the things that matter to you.
While most neck pain is not serious, there are a few symptoms to be aware of that would require further action. If you have any of the following, you should seek urgent care either at A&E or calling 999:
- Rapid onset of loss of balance, or unsteadiness when walking or difficulty climbing stairs
- Severe shooting pains down both arms and legs
- Sudden loss of control of your urination or bowel movements
- Sudden pain after a major fall, especially from height, or a direct blow to the head or neck
- Recent unexplained difficulty swallowing or slurring speech
It is also worth booking an urgent GP appointment (ideally the same day), or calling NHS 111, instead of booking with me, if you experience any of the following:
- Worsening weakness or a loss of grip in one or both hands (frequently dropping objects or difficulty writing or doing up buttons)
- A new severe headache with neck stiffness, fever or sensitivity to light
- Neck pain along with chills, unexplained weight loss, night sweats or high temperature
It’s important to stress that the above are rare and the vast majority of people with neck pain will not experience them. However, it’s important to highlight them so you are aware of when to seek more urgent care. If you’re ever in doubt, contact your GP and get it looked at.
Sources: Newcastle Hospitals NHS — Neck pain · Patient.info — When to worry about neck pain · NICE CKS — Neck pain (cervical radiculopathy)
Written by David Graham, GOsC Registered Osteopath (reg. no. 10852)
Common questions about neck pain
Most of the time a scan is not required or recommended. A full clinical assessment can identify what is going on and screen for anything that would require one. A lot of findings shown on a scan are common in people without neck pain and often cause more worry. If I genuinely think you need one, I’ll tell you and help you get one.
You may have seen the ‘neck cracks’ that are often associated with chiropractors and osteopaths. While I do use these techniques in my treatments, I only ever do them if I think it is genuinely appropriate for you and only ever with your full consent. It is never compulsory and there are always alternative things we can do should you not want this done. I will always explain this before I do anything.
Symptoms travelling into the arm can mean that a nerve in the neck is being irritated. These usually settle down over time. If you have any of these symptoms, I’ll conduct some specific tests to find out exactly what is happening, whether it is something I can help with, or requires a referral. These symptoms can be concerning for patients, so I’ll always make sure to explain what is going on and give you advice to manage it. If you’re experiencing it in both arms or legs and/or have problems with balance, then I recommend booking an urgent appointment with your GP rather than seeing me.
Patients often think that bad posture is to blame for their neck pain, and while it can contribute, it’s rarely the sole cause. The way we sit, stand or carry out activities can add strain to the neck and exacerbate issues. The biggest issue is spending too long in one position without variation. I’ll suggest some small changes to your posture and work habits that can help ease symptoms as part of a treatment plan.
Sleep position may play a role, but is rarely the sole cause. Many patients do find making small changes to sleeping positions beneficial for managing symptoms, especially if it feels worse in the morning. This doesn’t have to mean expensive orthopaedic pillows or other solutions and I’ve had patients find benefit from simple changes with a regular pillow, for example. If sleep might be affecting your neck, I’ll discuss this with you, and suggest some easy changes to try.
Yes, I can often help regardless of the amount of time you’ve been suffering. Typically, the longer you’ve had it, the longer it may take to get better. Over time, symptoms do usually start to resolve and the aim is the same whether you’ve had it a short while or much longer. I’ll give you an honest opinion of how long I think it may take after I’ve assessed you.
Generally speaking, most people benefit from staying active and keeping the neck moving. It’s rare that complete rest is the answer, even though that might feel counterintuitive when you’re in pain. The amount of movement will depend on your symptoms and stage of recovery. I’ll help you find the amount of movement and exercise that is right for you and help progress this so we’ve got a clear plan going forward.
This is always the hardest question to answer and it really depends on a combination of factors, including how long you’ve had it, the underlying cause, and what your day-to-day life demands look like. It’s variable for everyone so I cannot give an exact number. What I do make sure though is that we review regularly, and if we’re not making headway in three to six treatments, we’ll either change our plan or consider if a referral to someone else might be more appropriate for you.
Recognise this, and is neck pain
holding you back?
Let’s go through a full assessment and work together to put a plan in place to do something about it.