Neck pain: causes, warning signs and non-surgical treatment

What causes neck pain?

Most neck pain comes from the muscles, joints, discs or nerves of the neck. Common causes include:

• Muscle strain and tension, including tight, tender spots in the neck and shoulder muscles (trigger points)
• Age-related changes in the joints and discs of the neck (cervical spondylosis)
• A disc or bone spur pressing on a nerve, causing pain, tingling or numbness in the arm (cervical radiculopathy)
• Narrowing of the spinal canal in the neck (cervical spinal stenosis)
• Long hours in one position, such as at a desk, on a phone or on a two-wheeler (tech neck)
• Injury, such as a sudden jolt in a road accident

Neck problems can also cause headaches.

Symptoms

• pain or stiffness in your neck, often worse when you hold one position
• reduced movement, such as difficulty turning your head
• pain spreading to your shoulders or between your shoulder blades
• headaches, often starting at the back of the head
• pain, pins and needles, numbness or weakness spreading into your arm or hand, if a nerve is irritated

When neck pain needs urgent help

How neck pain is diagnosed

At your Maana Spine assessment, your physiotherapist asks about your symptoms, work and daily routine, checks how your neck and upper back move, tests the strength, sensation and reflexes in your arms, and uses special tests to see whether a nerve is irritated. Any MRI, X-ray or lab reports you bring are reviewed.

You'll get a physiotherapy diagnosis and a personalised plan. You don't need a scan to book; if one would help, your physiotherapist will recommend an MRI or X-ray.

→ What happens at your spine assessment

What the research says

Exercise and hands-on care. The 2017 neck pain guideline from the American Physical Therapy Association recommends exercise and hands-on (manual) therapy for many types of neck pain. For pain spreading into the arm, it suggests that intermittent neck traction may help when combined with manual therapy and strengthening exercises.

Decompression for the neck. A 2019 double-blind trial of 40 people with a disc problem at the C5-C6 level found pain improved in both groups, while function and disc measurements improved more with traction designed to keep the neck's natural curve. Research on the neck is thinner than for the lower back, so decompression is always one part of a wider plan.

Shockwave therapy (ESWT) for trigger points. Reviews show ESWT reduces pain from neck and upper-back (trapezius) trigger points more than sham treatment. Evidence that it beats other active treatments, such as dry needling, is weaker.

Will I need surgery?

Most neck pain doesn't need surgery. Non-surgical care is a reasonable first step for most people, and surgery stays available. If you have signs of pressure on the spinal cord or worsening weakness, or your assessment suggests you should see a surgeon, we'll tell you honestly.

Practical tips for neck pain

• Keep moving gently. Gentle neck movement usually helps more than keeping your neck still.
• Break up long spells in one position. Change position and move your neck and shoulders regularly at work, on your phone and on long rides.
• Set up your screen so you can see it without craning forward for long periods.
• Check your pillow. Choose one that keeps your neck comfortable and supported.

These are general tips, not a substitute for an assessment.

When to book a spine assessment

Book an assessment if your neck pain has lasted more than a couple of weeks, keeps coming back, spreads into your arm, causes headaches, or limits your work or sleep. Spine assessments are available at all five Maana Spine clinics in Kochi, Kozhikode, Thiruvananthapuram, Aluva and Perinthalmanna. The consultation fee is ₹250, and no doctor's referral is needed.

Book a Spine Assessment · or call or WhatsApp +91 99950 09403