Neck Pain: 5 Causes, Symptoms and Treatment

Neck pain is something that can happen to anyone, and chances are, you’ve felt it before. Approximately one third of adults experience neck pain annually, with a lifetime prevalence of around 50%¹. Whether it’s from sitting too long at your desk or waking up with a stiff neck, it can really make daily life uncomfortable.

Your neck pain might be caused by poor posture, stress, or even a simple muscle strain. Sometimes, it’s because of an injury or just sleeping in a strange position. Whatever the cause, neck pain can make even simple things, like turning your head, feel difficult.

As a physiotherapist, I’m here to help you understand why your neck hurts and show you how to manage it. With the right approach and treatments, you can feel better and get back to your normal routine.

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What is Neck Pain?

Neck pain is basically any discomfort you feel in your neck’s muscles, joints, or nerves. It can be a dull ache or sharp pain, and it can make moving your head or shoulders really tough. For some people, it comes and goes, but for others, it sticks around and affects their daily life.

Neck pain is really common. Around 30-50% of adults deal with neck pain each year¹, and about 15% of them have neck pain that lasts for more than three months².

If you spend a lot of time sitting, especially at a desk, you’re more likely to experience neck pain. Middle-aged adults, especially women, seem to be affected more often than men³. Jobs that involve repetitive movements or heavy lifting also put people at higher risk.

Why Does Neck Pain Happen?

One of the biggest causes of neck pain is poor posture. Whether you’re slouching at your desk or constantly looking down at your phone, this puts a lot of strain on your neck muscles and joints. Injuries, like whiplash from a car accident, can also cause long-lasting neck pain⁴.

Muscle Strain and Tension

One of the most common reasons for neck pain is muscle strain. This happens when your muscles get overworked, often because of poor posture—like slouching at a desk. Over time, this strain can lead to tightness and discomfort in your neck. Stress can also make things worse by tightening your muscles even more³.

Joint and Disc Problems

As we get older, the joints and discs in our neck naturally start to wear down. The discs between your vertebrae can lose flexibility, and sometimes, they bulge or herniate, pressing on nearby nerves. This can cause pain that shoots down your arms. The joints in your neck might also develop arthritis, causing stiffness and pain when you move.²

Nerve Compression

If something, like a bulging disc or bone spur, presses on a nerve in your neck, you’ll feel more than just pain in your neck. You might notice numbness or tingling in your arms and hands. This happens because the nerves that run through your neck get pinched.²

Poor Posture and Daily Habits

Bad posture, like slouching or looking down at your phone for too long, is a major cause of neck pain. This forward head posture puts extra stress on your neck muscles and spine. Over time, this can lead to serious discomfort and even long-term damage if not corrected.⁴

Inflammation

When your muscles or joints become irritated from overuse or injury, they can swell, leading to pain and reduced movement. If inflammation doesn’t settle down, it can lead to ongoing pain and stiffness.^.6

What are Common Symptoms of Neck Pain?

• Stiffness or Difficulty Moving Your Neck – You may find it hard or painful to turn your head.
• Aching or Dull Pain – A constant ache that can stretch from your neck down to your shoulders.
• Sharp Pain – Sudden pain in one spot, especially when you move your neck in certain ways.
• Muscle Tightness or Spasms – You might feel tightness or even spasms in your neck muscles.
• Pain that Radiates to Your Shoulders or Arms – Sometimes, the pain moves down to your upper back, shoulders, or arms.
• Headaches – Neck pain can cause headaches, especially at the base of your skull.
• Tingling or Numbness in Arms or Hands – If your neck pain is pinching a nerve, you might feel tingling or numbness in your arms or hands.
• Pain During Certain Activities – Looking down at your phone or sitting for too long might make the pain worse.
• Trouble Sleeping – Neck pain can make it hard to find a comfortable sleeping position, leading to restless nights.

Common Conditions That Cause Neck Pain

1. Cervical Spondylosis (Arthritis) – Age-related wear and tear on your neck joints and discs.
2. Cervical Disc Herniation – A bulging disc that presses on nerves, causing pain that radiates to your arms.
3. Whiplash – Sudden neck movement, like in a car accident, causing injury to muscles and ligaments.
4. Cervical Radiculopathy – Nerve compression in your neck that causes pain, numbness, or weakness in your arms.
5. Tension Headaches – Tight neck muscles can trigger headaches.
6. Muscle Strain – Usually from poor posture or repetitive movements, leading to stiffness and pain.
7. Cervical Stenosis – Narrowing of the spine that puts pressure on your nerves.
8. Fibromyalgia – A condition that causes widespread pain, including neck pain.

What Are Common Mistakes People Make When They have Neck Pain?

Ignoring the Pain

A lot of people hope neck pain will just go away on its own. While some mild pain might get better with time, ongoing pain usually means something is wrong. If you ignore it, the pain could turn into a long-term issue that’s much harder to fix. In some cases, it can even lead to nerve damage.

Sticking with Bad Posture

If you keep slouching or staring down at your phone for long periods, you’re putting extra stress on your neck. Over time, this can lead to bigger problems, like disc degeneration. Fixing your posture early can prevent this.

Relying on Painkillers Too Much

Painkillers might take the edge off your neck pain, but they don’t fix the problem. If you keep using them to mask the pain without addressing the cause, the condition could get worse. In some cases, this could lead to the need for more serious treatments, like injections or surgery.

Long-term Effects of Ignoring Neck Pain

If left untreated, neck pain can lead to chronic problems, like muscle weakness, reduced flexibility, and bad posture. This can make everyday tasks harder and might even cause permanent nerve damage, leading to numbness or weakness in your arms.

Types of Scans for Neck Pain

X-Rays

An X-ray is usually the first scan we’ll use. It helps us see the bones in your neck, so we can check for things like fractures or problems with the alignment of your spine.

We also use it to look for signs of arthritis, which can cause neck pain when the joints wear down. However, an X-ray won’t show muscles, discs, or nerves, so if we suspect an issue with those, we may need other scans.

MRI (Magnetic Resonance Imaging)

An MRI gives us a detailed look at both the bones and soft tissues, like muscles, discs, and nerves. We often use an MRI to check for things like a herniated disc or inflammation that might be pressing on a nerve.

It’s also helpful if we think there might be spinal cord compression, which can cause more serious symptoms like numbness or weakness in your arms.

CT Scans (Computed Tomography)

A CT scan is like a more detailed X-ray. It gives us a 3D image of your neck, which can help us spot fractures, bone spurs, or other structural issues that might not show up clearly on a regular X-ray. We usually use a CT scan when we need a closer look at the bones or if we suspect something more complex is going on.

When Is Surgery Needed?

Surgery is usually a last resort for neck pain. We typically only recommend surgery if non-surgical treatments haven’t worked or if you’re dealing with a more serious issue like nerve compression or spinal cord damage.

If you’re having severe pain, numbness, weakness in your arms, or trouble walking, surgery might be the next step.

The most common surgeries for neck pain are discectomy (removing part of a herniated disc) and spinal fusion (fusing two vertebrae together to stabilize the spine). In some cases, artificial disc replacement may be an option, which helps maintain movement in your neck instead of limiting it through fusion⁴.

Surgery is typically recommended when:

• Non-surgical treatments like physical therapy, medication, or injections haven’t helped.
• There’s significant nerve compression causing severe arm pain, numbness, or weakness.
• Spinal cord compression is present, which can lead to loss of coordination or trouble walking.
• Structural issues like a herniated disc or bone spurs are causing pain and aren’t improving with other treatments⁶.

If you need surgery, physiotherapy will be an important part of your recovery. Once you’ve healed from the surgery, we’ll start working on rebuilding your strength and mobility. Physiotherapy helps restore normal movement in your neck, prevents stiffness, and strengthens the muscles around the area to support your spine.

Treatment Options for Neck Pain

As your physiotherapist, I can offer a variety of effective non-surgical treatments to help manage and reduce your neck pain. These treatments are tailored to your specific needs to help ease discomfort, improve movement, and prevent future problems. Below are some of the treatment options we might use:

Myofascial Release

Myofascial release is a hands-on technique where I apply gentle pressure to the tight areas in your muscles and fascia (the connective tissue around muscles). This helps relieve tension, increase blood flow, and improve mobility. It’s especially helpful for neck pain caused by muscle stiffness.⁷

Orthopedic manual therapy

Orthopedic manual therapy involves using hands-on techniques like joint mobilizations and manipulations to improve movement and reduce pain. This can help loosen up stiff joints in your neck and spine. We often combine this therapy with specific exercises to strengthen the muscles that support your neck.⁶

Laser Therapy

Laser therapy is a non-invasive treatment that uses light energy to reduce inflammation and promote healing. It’s a good option for both acute and chronic neck pain. Laser therapy speeds up tissue healing, making it easier to manage pain and reduce inflammation.⁸

Dry Needling

Dry needling involves using very thin needles to target trigger points in your muscles. This helps release tight muscles and reduce pain. It’s especially effective if you have muscle knots or spasms contributing to your neck pain. Unlike acupuncture, dry needling focuses on muscle release rather than energy flow⁶.

Strapping and Taping

Strapping and taping techniques can provide extra support and stability to your neck while you’re recovering. Taping helps reduce muscle strain by guiding your neck into better positions. It’s especially useful if your neck pain is caused by poor posture or repetitive movements.

Exercise

A personalized exercise program is one of the most important parts of your treatment. Exercises strengthen the muscles that support your neck, improve your flexibility, and correct your posture. I’ll guide you through specific movements that are designed to reduce pain and prevent future injuries. The key to success with this is consistency⁴.

Conclusion

Dealing with neck pain can be frustrating, but with the right treatment plan, you don’t have to let it take over your life. As your physiotherapist, I’m here to guide you every step of the way. I’ve seen many people recover from neck pain through dedication to their treatment, and I know you can too.

You’re not alone in this journey, and I’ll be here to adjust your treatment plan as needed to ensure you’re on the right track.

About the Author

Daniel da Cruz is a licensed physiotherapist in Sandton, South Africa, with a clinical focus on neck and upper-back (cervical spine) conditions. He helps desk-based professionals and active adults recover from issues like nonspecific neck pain, cervical radiculopathy, and post-whiplash symptoms using evidence-based exercise, targeted manual therapy, and ergonomic coaching.

Daniel’s goal is simple: reduce pain, restore confident neck movement, and keep you performing in everyday life and sport.

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References

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5. Hill, L., Aboud, D., Elliott, J., Sterling, M., Steffens, D., & Hancock, M. J. (2018). Do findings identified on magnetic resonance imaging predict future neck pain? A systematic review. The Spine Journal, 18(5), 880-891. https://doi.org/10.1016/j.spinee.2018.01.025
6. Sterling, M., de Zoete, R. M. J., Coppieters, I., & Farrell, S. F. (2019). Best evidence rehabilitation for chronic pain part 4: Neck pain. Journal of Clinical Medicine, 8(8), 1219. https://doi.org/10.3390/jcm8081219
7. Hidalgo, B., Hall, T., Bossert, J., Dugeny, A., Cagnie, B., & Pitance, L. (2017). The efficacy of manual therapy and exercise for treating non-specific neck pain: A systematic review. Journal of Back and Musculoskeletal Rehabilitation, 30(6), 1149-1169. https://doi.org/10.3233/BMR-169615
8. Chow, R., Johnson, M. I., Lopes-Martins, R., & Bjordal, J. (2009). Efficacy of low-level laser therapy in the management of neck pain: A systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. The Lancet, 374(9705), 1897-1908. https://doi.org/10.1016/S0140-6736(09)61522-1