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Causes of Neck Pain

How Common Is Neck Pain

There are many causes of neck pain – thankfully most are not harmful, but they can be very painful. Over the span of 3 months, roughly 15% of people will experience neck pain symptoms that lasts for a day or more. I have been one of those people. I’m guessing you or someone you know has been suffering as well. Neck aches and pains are one of the most common things I see in my Kensington and Ascot Osteopathy clinics.

What are the types of neck pain?


Acute Neck pain is discomfort that is less than about a month or so old. It’s often a result of a minor, transient issue with the neck itself that can be managed well using manual therapy or exercise rehabilitation.  This kind of pain is a bit like a ‘fire alarm’ alerting you to a fire.


Chronic neck pain is usually the result of longstanding underlying issue that needs ongoing management (such as arthrosis of the joints OR very commonly a more complex association between a previous injury and a person’s psychological makeup.  For example, someone can have a very bad disc prolapse and have no pain, and another person can have a minor injury and pain that goes on long after the physical tissues have healed. The factors at play in chronic pain are complex but are often related to activity avoidance and fear, which contribute to creating a ‘sensitive’ nervous system that turns on that fire alarm of pain signals when they aren’t needed.

What causes this kind of pain?

Neck Muscles spasms

Muscle spasms in the neck and the muscles that cross from the neck into the posterior (back) of the shoulder can spasm as a result of injury, cold (such as an air conditioning unit blowing on you), or awkward positioning (such as when you have neck pain and stiffness after waking up in the morning). These spasms are very common – and also very painful.  People describe this as ‘nerve’ pain, however, these spasms on their own are not neural in origin.

A jolt to the neck – whiplash

‘Whiplash’ pain in the neck doesn’t have to have been caused by a car accident. Any kind of impact to the body or the head can cause a jolt that creates a range of potential pain generators: muscle spasms, nerve root impingements, ligament injuries and even fractures (though rare). You should always get a jolting injury that hurts your neck checked out.

Wear and ‘repair’

They used to call this ‘wear and tear’ and ‘degeneration’ – however, the real physiological process is actually one of wear and repair. The joints in the spine, and particularly in our very mobile necks, go through a lot of change and adaptation as we use them.  Some amount of wear and repair processes are normal and are very common, particularly where the neck meets the upper back, with nearly everyone over age 30 showing some signs of change. These are not always problems, but if there is more ‘wear’ than ‘repair’ the changes can result in pain for some people (but not all). Some people will feel a dull aching and sometimes sharp pain, and can hear crunching or rubbing sounds. These are not dangerous but can be unnerving.

Cervical radiculopathy

Where many people point to muscle spasms when they think of ‘nerve pain’, radiating pain from the neck into the arm is more of a ‘true’ nerve pain. ‘Radiculopathy’ is the name for this nerve pain which is often caused by pressure placed on the root of the nerve as it exits the neck joints.  The reasons people can get this kind of pain vary. Some people will have prolapses of the discs in their neck, and some will have ‘wear’ spots rubbing on the nerve root. And, not uncommonly, an old injury to a nerve root can ‘flare up’ and cause pain in the arm later on – even without a new injury.   Symptoms can include pain shooting into the arm or hand, as well as ‘pins and needles’ feelings in the fingers that don’t go away with the movement of your hand. Always get these symptoms checked out.

Rarer and more serious causes

Much rarer causes of neck pain can include fractures, problems with the arteries in the neck, heart problems, and more.  These causes are not as common as the other kinds of neck pain.

How you can prevent neck pain

Avoiding prolonged positions at a desk or while sitting is one way of preventing neck pain. Necks like to move! You can also help avoid neck pain by making sure you sleep with the correct pillow for your sleeping style. Avoid sleeping on your front (which creates a lot of twisting in the neck). If you must sleep on your stomach, ask for advice on how to reduce the impact on your neck position.

When should you worry about neck pain?

You should get any neck pain that concerns you checked out by a qualified provider. Get seen by a professional if you experience severe pain, or pins and needles or cold feelings in your arms or legs. Also speak to someone if you have headaches with neck pain, neck pain after an accident, or if you have numbness, or weakness in your arms or legs.  If you first go to your GP or doctor, and they suggest physiotherapy, then osteopathic care with exercise rehabilitation would be helpful.

What is the outcome for people with neck pain

Most people with acute neck pain respond rapidly to manual therapy and other conservative treatment. Over 90% are free from pain or stiffness within two weeks. Early treatment is important, however, so that this acute neck pain doesn’t become longerstanding.  If your neck pain has been longerstanding (chronic neck pain – though I dislike that term!) treatment will still be helpful. Recovery may require slightly longer treatment and rehabilitation.  Treatment will emphasize ongoing exercise to help your neck stay in good shape. You should also get support in navigating the emotional side of your pain. If you want qualified professional care for your neck pain, visit my Kensington Osteopathy Clinic or my Ascot Osteopathy Clinic. I’ll be writing more about the treatments soon.

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