Neck Pain Causes, Diagnosis and Treatment

What is neck pain?

Neck pain is defined as pain in the neck with or without pain referred into one or both upper limbs that lasts for at least 1 day. People with neck pain may also have accompanying headache or shoulder pain, but neck pain is the primary complaint.

Neck pain is a serious public health problem in the general population. Among all musculoskeletal disorders, low back pain (ranked first) and neck pain (ranked fourth) are the most common worldwide.

Causes of neck pain?

There are several factors that indicate an increased risk of developing neck pain. The most important of these prognostic factors are:

  • Trauma (whiplash from traffic accident or fall).

  • Bad posture (sleeping in awkward position and the neck becoming locked, sitting at a desk for a long time).

  • Work-related factors (low job satisfaction, poor perceived work support, high work stress levels).

  • Psychological factors (self-perceived depression, poor psychological health).

  • Spine related conditions (Muscular, ligament or joint strain, irritation of the disc, Arthritis of the spine, facet joint dysfunction, disc prolapse or protrusion, nerve root compression).

How is neck pain diagnosed?

The diagnostic process within physiotherapy practice consists of history taking, physical examination and, if deemed necessary, referral for diagnostic imaging. History taking leads to an initial hypothesis, which can be confirmed or excluded via physical examination (or diagnostic imaging).

Signs and symptoms include:

  • Pain that's often worsened by holding your head in one place for long periods, such as when driving or working at a computer.

  • Muscle tightness and spasms.

  • Decreased ability to move your head, neck stiffness.

  • Headache

Physical examination may consist of inspection of the posture, palpation, measuring the range of motion, measuring muscle strength, testing reflexes, testing sensation and specific tests. The choice of which of these physical examination procedures will be performed depends on the findings from the history taking and whatever diagnosis or diagnoses those findings suggest.

Various guidelines recommend not to refer people with neck pain to diagnostic imaging. Despite this, diagnostic imaging is sometimes used to confirm or rule out a specific pathology – most often a cervical radiculopathy (cervical disc herniation). Imaging is usually discouraged unless there is severe trauma, mainly because diagnostic imaging also produces a high number of false positives. In a study with 1,211 relatively healthy and asymptomatic participants who received diagnostic imaging using MRI, over 87% of the participants presented with a ‘bulging disc’ and 5.3% with a spinal cord compression. Nakashima H et al, 2016.

Best Physiotherapy treatment for neck pain?

The majority of neck pain guidelines on diagnosis and treatment of patients with neck pain recommend a combination of manual therapy, exercise and education as the preferred evidence-based physiotherapy treatments. Parikh P et al, 2019.


Education is defined as a process of enabling individuals to make informed decisions about their personal health-related behaviour. The patient educational interventions that are evaluated and recommended by the guidelines are: reassuring patients about the neck pain; providing information on pain and prognosis, including information that imaging is not recommended; advising to stay active; and educating about self-care, exercises and (stress) coping skills.


Physical exercises vary widely from general land-based or aquatic exercise to neck-specific Physiotherapy endurance, strength, stretching or McKenzie exercises. Several researchers have assumed that changes in motor control in the deep cervical muscles contribute to the origin or persistence of neck pain Martin-Gomez C et al, 2019.

Manual Therapy

Massage therapy is one of the oldest treatment strategies for musculoskeletal pain. It involves mobilisation and manipulation of the soft tissues of the body through touch. There is a wide spectrum of techniques that fall under the umbrella term of massage therapy. The different techniques vary in the manner in which touch is applied, as well as the amount of pressure that is applied.

Other Proven Physiotherapy Therapies

Laser Therapy

Low-level laser therapy appears to ease a common form of neck pain, a review of studies finds. "It is effective against non-specific pain arising from the muscles and the joints, where there is not a clear cause.

Dry Needling

Trigger points can be a source of pain and limitation for neck movements. Dry needling is a specialized treatment for trigger points that some Physiotherapists provide. In the short term, the findings of this study suggest that a single treatment of dry needling can decrease pain and improve motion.


Mulligan a mobilization techniques have distinguished as a functional approach producing an immediate pain alleviation and range of rotion improvements in chronic musculoskeletal conditions mainly in peripheral joints via mobilizations with movement.

GB Sports Physiotherapist employs the most advanced evidence based techniques and their results are instantaneous. Apart from providing rapid pain relief, there are a number of other important ways that our Physiotherapist can help with neck pain.

If you are experiencing undiagnosed neck pain use our website to book an appointment now.


1. Nakashima H, Yukawa Y, Suda K, Yamagata M, Ueta T, Kato F. Narrow cervical canal in 1211 asymptomatic healthy subjects: the relationship with spinal cord compression on MRI. Eur Spine J. 2016;25:2149–2154.

2. Parikh P, Santaguida P, Macdermid J, Gross A, Eshtiaghi A. Comparison of CPG’s for the diagnosis, prognosis and management of non-specific neck pain: a systematic review. BMC Musculoskelet Disord. 2019;20:81.

3. Martin-Gomez C, Sestelo-Diaz R, Carrillo-Sanjuan V, Navarro-Santana MJ, Bardon- Romero J, Plaza-Manzano G. Motor control using cranio-cervical flexion exercises versus other treatments for non-specific chronic neck pain: a systematic review and meta-analysis. Musculoskelet Sci Pract. 2019;42:52–59.

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