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Neck Pain

Neck pain can be caused by a  variety of conditions that affect the spine, muscles, and ligaments around the base of the skull. Pain can be localized directly around the neck to or can spread down your arms and spine. Symptoms of neck pain are widespread, it’s the 3rd most reported medical condition with 15% of adults in the United States having a neck condition that causes them pain. At any one time, 10% of adults are suffering from a stiff neck. It’s one of the most common medical conditions that requires medical care, with 50% to 85% of people with neck pain experiencing symptoms of chronic pain. Beyond causing pain, neck pain also seriously affects an individual’s ability to work and participate in day-to-day activities. 1 in 2 Americans assume that pain is a part of the aging process. Neck pain isn’t an issue that should be expected with age; it’s key to take the necessary steps for treatment to find relief.

Symptoms & Causes of Neck Pain

Generally, neck pain is felt directly around the neck area but it could also be felt through the upper arm, shoulder blade, forearm, or hand. Therefore, neck pain can be felt in secondary areas beyond the neck as well. Neck conditions have the potential to become chronic if the source of the pain isn’t treated. Neck pain is the number 3 cause of chronic pain.

Localized Neck Pain

Neck problems can be more mechanical and related to pressure and strain to the muscles along the neck and shoulders. With more localized pain, you may see loss of range of motion around the neck. The tightness of the neck muscles could also cause pain to radiate up the base of the skull to the scalp. You might experience:

  • Neck stiffness, tightness, or tenderness
  • Headaches or a pressure-like sensation around the entire head

Forty-five percent of the working population will have one attack of a stiff neck. Maintaining correct everyday posture plays an important role with any general neck stiffness and pain. Any type of prolonged positions, such as sleeping or sitting, with incorrect posture can put strain on your neck. Slouching over while using your phone plays its part with neck pain, 53% to 83% of subjects reported some neck pain during texting and mobile phone use.

Nerve-Related Neck Pain

When symptoms are felt in the shoulder, arm or hand, the neck may be the source. This type of pain is called cervical radiculopathy and is related to nerve compression, or impingement, somewhere in the upper spine. Generally, a worsening of the neck injury is related to the progression of the symptoms down your arm. There are many causes of cervical radiculopathy including disc herniation and stenosis. Symptoms of cervical radiculopathy include:

  • Tingling or feeling “pins and needles” arm or hands
  • Pain that radiates from your neck, shoulders, arms, or hands
  • Weakness in the muscles of the arm, shoulder, or hand
  • Loss of sensation in your upper extremities

The earlier you get a diagnosis for nerve compression, the more quickly you’ll find relief.

Physical Therapy Evaluation

A comprehensive physical therapy evaluation for neck pain is used to help determine the source of your pain and the treatment plan to help you feel better. An evaluation includes analysis of your alignment or posture, a neurological screen to see if any nerves are involved, mobility testing to see how your neck moves, and strength testing in your neck and arms. Education regarding postural alignment during daily activities is key for successful treatment.

Comprehensive Physical Therapy Treatment

Physical therapists have many tools in their “toolbox” to help you feel better. Treatment may include manual, hands on techniques, mechanical treatment, strengthening exercises, and posture training. There is significant improvement with neck pain when having comprehensive treatment alongside manual therapy. In a study, when patients received both manual therapy and mobility exercises for the neck, 75% pain reduction and 70% improvement in ability to do daily tasks. Patients see more improvement in range of motion when complementing manual therapy with a different mode of treatment.

Manual Therapy

The goal of manual therapy or hands on techniques, is to restore motion. Sometimes neck pain is related to loss of motion in the joints.  Specific mobilization to the joints in the spine can help restore normal motion. Manual techniques also are used to treat the soft tissues, which are all the structures in the neck other than the joints.  Tight and restricted soft tissues can cause pain, limit motion, and make it difficult for you to hold your neck in proper posture.  Just as there are many ways to mobilize the joints, there are several ways to treat the soft tissues.

Mechanical Treatment

A mechanical assessment and treatment of your neck uses repetitive movements which include  patient generated mobilization and combinations of manual treatments to produce a symptomatic response that will lead to centralization and abolishment of pain

Strengthening Exercises and Posture Training

The key to success in relieving your neck pain is addressing your posture.  When working to restore proper posture, strengthening and stretching exercises are used to compliment manual techniques and to address the muscle imbalance that develops from prolonged poor posture.  There are many ways to stretch and strengthen including yoga, TRX training, and weight training.


Many times, neck pain is related to the position of your neck while you are working. Whether you sit at a desk or perform more manual labor, a physical therapist can analyze your working environment to promote healthy alignment. The main goal of an ergonomic analysis is to determine if the prolonged postures or movements you use at work are contributing to your symptoms and to make appropriate changes to those postures and movements.  These changes could include adjusting the position of your computer, adjusting your chair, or changing the faulty movement patterns.

When To Seek Help

You should seek help if you have any stiffness or pain in your neck or experience radiating symptoms in your arms.  A thorough physical therapy evaluation can help determine the source of the pain and if you need to see a medical doctor for further testing. Once you have a better understanding of your pain, you can begin to make the necessary changes to feel better.