The short version
- Muscle strain and posture habits are the most common causes of neck pain.
- Manipulation and mobilization show similar results in research, and exercise adds to both.
- Numbness or weakness in the arm or hand suggests a pinched nerve and needs a careful exam.
- A stiff neck with fever and headache, or neck pain with chest symptoms, is an emergency.
What is neck pain?
Neck pain is discomfort anywhere in the structures of the neck: the muscles, ligaments, small spinal joints, discs and nerves. It often comes with stiffness that makes it hard to turn your head. Some people also feel pain spread into the shoulders, upper back or head.
Most neck pain is mechanical. That means it comes from how the neck moves and how much load it carries, not from disease. It can be acute, after a single strain, or chronic, lasting three months or longer.
What causes neck pain?
Everyday habits cause most neck pain. Long hours bent over a laptop in a Deep Ellum coworking space, a monitor set too low, or sleeping in an awkward position can all strain the neck. Common causes include:
- Muscle strain and tension from posture and repetitive work
- Stiff or irritated facet joints, the small joints at the back of the spine
- Age-related disc and joint changes, called cervical spondylosis
- A disc that bulges and presses on a nerve root
- Injuries such as whiplash from a car accident
Forward head posture is linked to neck pain in adults. A 2019 meta-analysis found adults with neck pain held their heads further forward than adults without pain. Our page on posture and tech neck covers this in more detail.
What symptoms come with neck pain?
Neck pain can feel like a dull ache, a sharp catch when you turn, or tight muscles across the top of the shoulders. Many people also get headaches that start at the base of the skull.
Pain, numbness, tingling or weakness that travels into the arm or hand suggests an irritated nerve. That pattern needs a careful neurological exam.
How do we evaluate neck pain at our clinic?
We start with a detailed history: when the pain began, what makes it better or worse, and what your work and sleep look like. Then a physical exam checks your range of motion, posture, muscle tenderness, strength, reflexes and sensation.
X-rays are taken if they are needed, such as after an injury or when we are assessing the curve of your neck for corrective care. Dr. Currington uses X-ray and postural analysis to see how your neck is aligned. We review the findings and a personalized plan with you before starting.
Which treatments can help neck pain?
Most people do best with a mix of hands-on care and exercise. Results vary, and we adjust care to how you respond.
| Treatment | Why we use it |
|---|---|
| Chiropractic adjustments | Restore motion in stiff joints of the neck and upper back |
| Chiropractic BioPhysics | Address posture and the curve of the neck |
| Physical rehab | Strengthen deep neck and upper back muscles |
| Medical massage | Ease muscle tension and trigger points |
| Dry needling | Target tight, tender bands of muscle |
What does the research show?
A 2015 Cochrane review found that neck manipulation and mobilization, a gentler movement technique, produced similar results for pain and function. It also found that several sessions of manipulation may relieve pain better than some medicines. The authors called for more high-quality research.
The National Center for Complementary and Integrative Health summarizes that manipulation can help acute neck pain, and manipulation or mobilization can help chronic neck pain. Evidence quality is low to moderate because many studies are small. Adding exercise tends to improve results, which is why rehab is part of most of our plans.
What can I do at home for neck pain?
You can do a lot to calm neck pain and keep it from returning:
- Use ice for the first two to three days after a strain, then switch to heat.
- Do slow range of motion movements: up and down, side to side, ear toward shoulder.
- Raise your screen to eye level and bring your keyboard close.
- Take a short break every 30 to 45 minutes to stand and roll your shoulders.
- Sleep with a pillow that keeps your neck level with your spine.
Our desk posture and spine tips guide walks through a simple workstation setup.
When to see a doctor or go to the ER instead
- A stiff neck with fever and headache, especially if you cannot touch your chin to your chest, can signal meningitis and needs emergency care.
- Neck or arm pain with shortness of breath, sweating, nausea or jaw pain can be a heart attack; call 911.
- Neck pain after a fall, blow or car crash, especially with numbness or trouble moving an arm, needs emergency evaluation.
- Weakness in the arms or hands, trouble walking or balancing, or loss of bladder or bowel control needs urgent medical care.
- Neck pain with fever, a new lump, trouble swallowing, or weight loss you cannot explain should be checked by a physician.
If you think you are having a medical emergency, call 911.
How we treat it
Frequently asked questions
For most people, neck manipulation is considered low risk, and mild soreness for a day is the most common side effect. Very rarely, neck manipulation has been linked to a tear in an artery in the neck, although whether it causes these tears is debated. We screen for risk factors and can use gentler mobilization instead if you prefer.
Holding your head forward for long periods makes the muscles at the back of your neck and upper back work harder. Over hours, that can cause aching, stiffness and headaches. Raising your screen to eye level, taking breaks and strengthening the upper back often help. See our page on posture and tech neck for more.
Pain, numbness or tingling that travels into the arm or hand can mean a nerve root in the neck is irritated, often by a disc or bone spur. This is called cervical radiculopathy. It needs a careful exam of strength, reflexes and sensation. Worsening weakness needs prompt medical evaluation.
Many episodes of neck pain from strain improve within days to a few weeks. Pain that keeps coming back usually relates to posture, strength and work habits, and those take longer to change. Results vary, and we review progress with you regularly.
Sources
- MedlinePlus: Neck pain (opens in a new tab)
- Cochrane: Manipulation and mobilisation for neck pain (2015) (opens in a new tab)
- NCCIH: Spinal manipulation, what you need to know (opens in a new tab)
- Curr Rev Musculoskelet Med: Forward head posture and neck pain, meta-analysis (2019) (opens in a new tab)
- MedlinePlus: Guide to good posture (opens in a new tab)
This page is general education, not medical advice. It cannot replace an exam. Results from any treatment vary from person to person.
