The neck contains seven vertebrae, discs, small joints, muscles and nerves. These structures support the head while allowing a wide range of movement. Pain can come from a local joint or muscle problem, from an irritated disc or nerve, or occasionally from a condition outside the neck.
Why neck pain develops
Common triggers include a sudden jolt, sleeping in an unusual position, long periods at a desk, repeated overhead work and an abrupt change in training. Stress and poor sleep can also increase muscle tension and sensitivity, although they are rarely the only explanation.
Age-related changes on an X-ray or scan are common and do not automatically identify the cause of pain. The examination needs to connect any imaging findings with the person’s symptoms and physical signs.
Diagnosing neck pain
We ask about the onset, location and behaviour of symptoms, previous injuries and general health. The physical examination can include neck and shoulder movement, strength, sensation, reflexes and tests that help identify nerve irritation.
Pain, pins and needles or numbness travelling into the arm may be associated with a nerve root in the neck, but similar symptoms can arise from the shoulder, elbow or wrist. A whole-limb assessment helps distinguish these possibilities.
Treatment and self-management
For suitable mechanical neck pain, treatment may include joint mobilisation or manipulation, soft-tissue work and exercises for movement and strength. We also discuss practical changes to workstation setup, driving, sleep and return to activity.
The aim is not to create dependence on treatment. A plan should give you an understanding of the problem and useful ways to manage it between appointments. Progress and neurological symptoms are reviewed so the plan can be changed or a referral made when necessary.
Seek urgent medical help for neck pain with new severe weakness, loss of coordination, problems walking, loss of bladder or bowel control, fever, unexplained weight loss, major trauma or sudden severe headache and neurological symptoms.