If you’re reading this article you (or someone you love) are either suffering from neck pain or investigating ways to treat or get relief from a sore neck. Alternatively, the movement of your head and neck may be limited. This article is written to help you understand the structure of your neck (neck joints, discs, ligaments, nerves, blood vessels and muscles) and how tension or imbalance in the structure causes different types of neck pain.
A sore neck can be the result of damage to the underlying structures, but the intensity (sharp or dull ache) and area of your pain (symptoms) can point to a related injury e.g. shoulder injury or spinal nerve damage. This article gives a detailed list of symptoms (ranging from Mild to Severe) to help you judge the urgency of getting treatment for the pain in your neck.
Treatment requires us to distinguishes between four types of neck pain; accident/injury with trauma, acute/sudden neck pain with no trauma, slow progressing neck pain and chronic neck pain. This article includes examples to assist you in communicating (with a health care professional) the type of neck pain you face.
This article concludes with a description of what you can expect from a physiotherapy session (at Cilliers & Swart Physiotherapist) and a brief summary of our physiotherapists’ experience in treating patients with neck pain.
Structures in the neck
Your neck joins your head to your body. Your neck enables you to move your head and eyes to see and avoid obstacles in your way, or to turn to investigate a noise you hear. Explaining the cause of your neck pain, requires a look at the different structures which make up your neck and how they impact each other. These structures include neck joints, discs, ligaments, nerves, blood vessels and muscles. You can get neck pain from an injury or damage to any of these structures. Now, let us explore each one individually.
Do you experience pain in your neck when moving your head? Looking down at your phone? Checking your blind spots while driving? Or looking up at a signpost?
Each person’s case is unique and we want to address your specific needs. If you would like us to investigate or provide some insight, we invite you to contact us by clicking the link below.
Neck joints (also known as cervical vertebrae)
Cervical pain can be caused by damage or injury to any of the seven cervical vertebrae. These seven vertebrae are counted from the bottom of your skull (C1 & C2) to the middle of your torso (where the thoracic vertebrae start). The structure of the C1 and C2 vertebrae are unique, compared to the other vertebrae. C1 and C2 join to form a pivot joint, which allows you to rotate your head from side to side, for example; when following the ball during a tennis match. The vertebrae of C3 to C7 look similar in shape, these vertebrae assist you in looking up or down or bending your neck to touch shoulder with your ear. All the joints (C1 to C7) need to work in harmony and naturally form a curve, called the cervical lordosis. Injury, damage or displacement (in the curve) of any one of these joints can cause a sore neck.
Interesting fact: The C1 cervical vertebrae is named “Atlas” after the Titan warrior who is condemned to carry the heavens on his shoulders by Zeus, in Greek mythology.
Between each of the previously mentioned cervical vertebra is a disc (except for C1 and C2). These discs are circular in shape and have a tough (stringy) outer layer to protect a soft gel-like inner. When your neck joints are put under pressure (or twist and bend in tricky positions), these discs absorb the tension and act as shock absorbers. Neck discs are prone to tearing. A bulging neck disc can limit the space meant for nerves, essentially pinching the nerve. A pinched nerve is commonly known as a “slipped disc” and can be very dangerous.
The cervical vertebrae and neighbouring discs are connected to each other with different ligaments to help stabilise your head and body as you move. When ligaments are too loose, they struggle to steady your movements. Stretching and compressing ligaments can cause damage and result in pain. The most common sudden neck pain injuries (regarding ligaments) include Whiplash, falling or tackling. Together, the neck joints (bony bits), discs and ligaments keep the spinal cord safe by controlling your range of movement.
Spinal cord & nerves
A round channel is seen when looking at your spine from above. This ‘hole’ runs from your brain to your lower back and provides the space needed for your nerves (grouped together to form your spinal cord). Above (C1 to C7) or below (C7) each vertebra the nerves branch out, forming nerve roots. These nerve roots merge and divert to supply and relay messages of sensation from limbs (like your arms) to the brain.
These nerves can be scratched or irritated by surrounding structures. For example, a bulging neck disc can take up space meant for nearby nerves, essentially pinching the nerve. A pinched nerve in your neck should be treated promptly to prevent lasting effects.
Neck blood vessels
Alongside the vertebrae run important blood vessels supplying your brain with oxygen rich blood. Interrupting the blood supply is potentially devastating. Blockages in the vessels or pooling of blood (in the tissues) can put pressure on the other neck structures causing pain. Blood vessels nearest to your skin’s surface are in the area just below your jawbone, where you can feel your pulse (if you press gently with your index finger).
Sudden neck pain can be the result of a muscle spasm. Neck muscles attach to the skull and vertebrae in layers. Muscles pull together or stretch in harmony to create movement. Neck muscles spasm for protection or because of sudden or prolonged tension. When neck muscles are injured through neck muscle strain (e.g. whiplash during a car accident). Cilliers & Swart Physiotherapists diagnose and treat your neck muscle injury.
We encourage you to contact us and get professional help in diagnosing and treating your neck pain – especially if you take into consideration the many underlying structures (which make up your neck) covered in this section.
Causes of neck pain
Neck pain is a symptom, first and foremost – not a disease or illness. A sore neck can be the result of traumatic (e.g. a direct forceful blow to the neck) or a-traumatic (sleeping in an uncomfortable position) event. Causes of neck pain vary depending on the damage or injury to the underlying structures. These structures include neck joints, discs, ligaments, nerves, blood vessels and muscles (see the previous section). The moment of injury is important for example, neck pain produced from years of bad posture compared to neck pain from a sudden unexpected force (like whiplash). However, most patients describe their pain developing suddenly with no memory of injury or associated event.
You will hear into these kinds of stories concerning patients and neck pain:
- flipping their hair back while drying it
- turning their head quickly to admire a passing jogger or car
- painting their ceiling
- washing and hanging their curtains
- falling asleep on a couch in an uncomfortable position
- caught badly in a scrum
- recovering from a car accident
- coughing for long periods at a time
- twisting and bumping their head into their shoulder while standing
The intensity of the pain can vary, from a sharp pain to prolonged chronic pain. No matter what your story is, we can help you get relief from your neck pain.
Your shoulder could be involved
Neck pain is usually associated with some form of shoulder dysfunction. Neck pain usually arises when neck and shoulders don’t function in harmony. This makes it tricky to determine whether a patient has a neck problem, a shoulder problem, or both.
Symptoms of a neck injury
A neck injury can cause pain in other parts of your body. Pain from cervical disc injuries is carried over to the shoulder and shoulder blade area. This happens when a neck disc bulges from an injury and compresses the nerve root. For example, a pain in our arm can be related to its nerve being pinched by the neck disc (where the root of the nerve emerges from the spinal cord).
In the case of injured cervical facet joints, you will experience pain related to specific areas. Your neck pain can also be on one side only. The joints can lock and become extremely painful to the point that turning your head is no longer an option. Alternatively, a muscle spasm may be part of your neck pain. Neck injuries are also known to cause headaches.
Describing neck pain
- A sharp pain in your neck
- You’re unable to turn your head
- Extreme stiffness in your neck
- Pain spreading to your shoulder blades
- Moving your head is painful
Types of Neck Pain
Accident or injury – with trauma
Stiffness after a few hours after a fast movement of the neck, fall or direct force to the head. The most common cause is usually a fall or accident where the head is rapidly forced into a forward position further than the neck’s normal range of movement. This unnatural forceful movement triggers the muscles to react by contracting while in an over stretched position causing small tears in the muscles of the neck. This is not to mention the squash and crushing of the small joints between the neck vertebrae.
This type of neck pain usually gets worse and develops into sharp stinging pain, especially when the Cervical facet joints are involved. These are small hand-like joints that connects the neck vertebrae to one another, they need to slide and glide over each other to move your neck in all the directions.
When these surfaces are crushed together they injure the tissue around and inside those joint, your body attempts to heal the injured tissue by sending inflammatory sells into these joint, that in turn causes severe swelling in a confined space which results in loss of normal movement of your neck which results in you not being able to turn your head.
Acute (sudden neck pain – with NO trauma)
Waking up with sudden neck pain especially when turning your head, looking to one side?
In most cases there is a pinching or locking feeling at the end of the range. This can be attributed to a lock facet joint, meaning the joint connections between the Cervical vertebrae are injured. One one side of your neck the joint surfaces are being squashed together because you kept your neck in a extreme position for a long time(like falling asleep on your stomach with your head turned to the one side).
On the other side of the neck, the joint capsule is trapped between the joint surfaces, meaning you will have no pain in certain positions, but when you turn your head to a certain position you will feel a sharp stinging pain shoot through your neck. Usually one side is more painful than the other. Stiffness in the neck muscles increase as the day progress until you can barely move your head in any direction.
Physiotherapist are very effective at treating this, it involves spinal joint mobilization to release the joint capsule, relieve the muscle tightness and restore normal movement of the joints.
Slow progressing neck pain
Prolonged postures and maintaining a certain position for long periods of time. Ever sat at the computer and lost track of time while browsing and working? Stop, be aware of your posture right now: Are your elbows supported, are you looking up or down at your screen? Are your hips facing forward or slightly rotated (putting strain on your upper back? To which side are you tilting your head? left or right? All of this makes a difference… If you continue to put more strain on certain structures you will wear out certain joints more than the opposite side, and your pain will get worse.
This type of pain mostly increase and stays for longer periods (Pain from 3/10 to 7/10 and going from pain only in the afternoon to pain throughout the entire day) It may even start affecting other areas like moving down to your shoulder blades or upwards to give you headaches.
Chronic neck pain
Constant or fluctuating headaches are usually a side effect of this main problem. Bearable but irritating burning pain or dull ache over the skull to the eye sockets.
The primary problem is a long standing instability in the building blocks of the neck, by either the structure(bones), cables (ligaments), and mechanics (muscle activity, balance and activation timing) The most important factor to remember is that this type of neck pain consist of more than one problem.
Physiotherapists are trained to systematically address each structure and problem individually in order to relieve pain, correcting posture, providing stability to the neck and altering your movement patterns. If you are feeling constant neck pain, please don’t leave your neck pain for a few days and hope it gets better… You will only cause yourself more discomfort and agony.
Physio:”So how long have you had the pain?”
That’s when you know it’s going to be a long process.
Symptoms of neck pain
Structures causing sharp neck pain
- Mild to moderate dull or aching pain with stretch
- Intermittent pain aggravated by looking down and/or to the opposite side
- Neck movements restricted by painful stretch sensation
- Pain is not well defined but generally doesn’t radiate down arm
- Mild to severe sharp pain with certain movements
- Intermittent or constant pain aggravated by looking up and/or to the same side
- Neck movements restricted by pain and locking sensation
- Pain area is very specific and well defined
- Constant mild to severe sharp pain
- Constant pain aggravated with neck movements to same side possibly radiating down the arm
- Neck movements restricted by sharp, electrical type pain in specific movement
- Pain is not well defined but radiates down a specific nerve course
- Constant mild to severe dull pain.
- Minor incident results in severe pain
- Constant pain aggravated with neck movements to end of range possibly radiating down the arm
- Neck movements are generally restricted in all directions
- Pain area is well defined and radiates down arm with possible sensation and weakness
There are a lot of structures in the neck that may be responsible for your specific symptoms. We are able to accurately evaluate your neck and find the structures responsible for the pain you are experiencing. If X rays or scans are necessary, we will see to it that you are referred to the right place.
Physiotherapy treatment focuses firstly identifying the structures that produce the pain. We will guide you to avoid or limit certain activities or movements. During the initial phases when the pain is severe, we can use Electrotherapy to block the pain impulse and desensitize the nerve endings, Ultrasound and Laser can help relieve the pain and accelerate the healing. We use Acupunctureor Dry Needling to help the healing of the surrounding tissue cells and we use different types of Strapping and Taping to unload and redistribute the forces in your neck.
Massage, Soft tissue mobilization and muscle Stretches helps to break down fascia restrictions and improve flexibility of the muscles. Myofascial release of some dominant Cervical mobilizer muscles are quite painful, but the result speaks for itself.
We very rarely advocate using a neck brace, due to the secondary complications and bigger problems it could cause, rather than help. We will gradually progress neck and postural training exercises as your pain improve, we monitor this very closely so we can make sure it won’t happen again.
Physiotherapy will aim to reduce your pain and will be different for each person, depending on the cause of your problem. One problem may cause a next, for example a locked joint will cause a lot of protective muscle spasm. Therefore; treatment will focus on mobilising the joint and relieving the muscle spasm to ultimately reduce the pain.
Our professional experience on severe neck pain
Treating sudden and severe neck pain is the second most common symptom that we see in our practice. We have compared our approach to other protocols realized we can treat neck pain fast and effectively if the underlying cause is determined before it becomes chronic. Rarely its cause for serious alarm, but it needs to be looked at. Muscle strain and inflation of the joints can give you considerable amount of discomfort but the faster we attend to it the faster the relief.
The bigger problem with neck pain however lies in reoccurring or chronic neck pain, which could be due to poor posture and habitual movements. When these neck pain ‘episodes’ becomes more frequent and more intense, you should have it checked out.
Other Causes of Neck Pain
Why is your neck pain lasting longer than expected?
You believed the pain would go away over time (on its own) but it didn’t
You went to the Doctor who told you to rest and take painkillers. The painkillers helped to relieve the immediate pain but didn’t help your injured neck. As soon as the painkillers wore off, the neck pain returned
A family member (or friend) told you that “Everybody experiences neck pain as they grow older,” and that you should just accepted it
In the past you went to other Healthcare Professionals (or a Physiotherapist) but nothing they said or did seemed to help
YouTube exercises and home remedies didn’t help relieve the pain, or in some cases made the neck pain ten times worse
You thought it would be a good idea to rest because your neck was so sore. However, afterwards your neck felt even more stiff and tight than before
You went for massages, hoping they would relieve the pain. The massages felt pleasant and relaxing, but didn’t do anything to fix your neck pain in the long term
Experiencing these situations or applying similar advice and not getting results is a good thing. Why? Because these experiences help you know what doesn’t work for you. It means that you are closer to finding out what does work for you!
We invite you to book an appointment with a Physiotherapist (at our Pretoria practice). During an appointment we assess your symptoms, diagnose the cause, educate you about what is happening in your body and then start treatment. See our FAQ for more in depth information about what to expect from a physiotherapy session.
Alternatively, click the link below to book a FREE phone call. The phone call is complimentary and there is no obligation to book any appointments with us after the call is over. This is an opportunity to get an expert’s advice about your situation. Our goal is to help you make an informed decision about what to do next concerning your neck pain.
Choose a Cilliers & Swart Physiotherapist to aid you in getting neck pain relief
What can we do for you?
We quickly put an end to pain and stiffness – often within a couple of sessions
We help you find out what is going on in your body and help you understand the root cause of your neck pain
Pain can rob you of sleep or rest. We make it easier for you to return to your normal sleeping patterns and positions so that your energy and potential for recovery increases
Cilliers & Swart Physiotherapists closely manage and treat your problem. We also provide you with related exercises to speed up your recovery
Using painkillers in the long-term can be harmful to your health. We help you lower or completely stop your need for painkillers to manage pain
Our physiotherapists safeguard you against dangerous and costly surgeries and painful injections
We reduce visits to specialists or doctors who only order you to take more pills
Neck pain can limit the activities you enjoy with your family and friends. Our experts help you get back to spending quality time on the activities you (and your loved ones) like
We can get you to sit comfortably and walk longer than 15 minutes, in both cases without feeling that your neck is weak, in pain or about to collapse
In short, we help you get back to living life free from chronic neck pain. For information about costs and availability, click the button below:
4 steps to get rid of neck pain quickly.
Decide to get help.
Many people put off going for treatment, that by the time they receive treatment the injury has worsened over time or caused other problems. Don’t think that neck pain will ‘just go away with time’. It might sound brave to ‘put up with pain’ over an extended period of time, but the lack of treatment could end up costing you more in terms of time (for recovery) and resources (money) the longer you wait.
Do the RIGHT exercises.
One of the best things to help ease your neck pain is the appropriate series of progressed exercises (as advised by your Physiotherapist or Health Professional). The right kind of activities can reduce your pain and increase your range of movement. Above all, exercises ensure that problems don’t come back. However, the wrong kind of exercises have the potential to increase the pain in your neck even more.
Avoid sitting still for long periods.
Ever tried to get up from the sofa after resting for a while, but you struggle because your neck feels painful and tight? That’s because one of the worst things you can do is to ‘rest’ in a sitting position for too long. Too much rest and sitting in awkward positions makes your neck stiff and tight. As a safety measure we recommend specific strengthening exercises for better posture. We can help you get active by combining these exercises with our Physiotherapists’ hands-on treatment.
Get hands-on Physiotherapy treatment.
Physiotherapy is proven to improve the lives of people suffering from neck pain. Neck pain could be affecting your physical performance in a professional or private capacity. It could even threaten your independence or get in the way of spending quality time with family and friends. Physiotherapy can enable you to live the life you desire as quickly as possible.
If you would like to know how the Physiotherapy team at Cilliers & Swart can help you, we invite you to book a FREE, no-obligation, risk-free “Call me back” phone call.
Note: This free call is a service we offer to people who are nervous or unsure. You might not know if Physiotherapy is the right treatment for you. If you are unsure, please fill out our online form. We will contact you to find out what is wrong and how we can help. There is no financial obligation or risk on your part. You have nothing to lose except your pain.