Neck pain.
What is causing your neck pain?
Neck pain is one of the most common musculoskeletal complaints in Australia, affecting approximately one in five adults at any given time. Like lower back pain, it is a symptom rather than a diagnosis — and the treatment that works for one cause may do nothing for another. Identifying what is actually driving the pain is the most important step in effective management.
Neck pain may present as a sharp pain, dull muscular ache, headache with a neck origin, neck stiffness, or instability. Factors contributing to neck pain may stem from spinal issues such as joint problems, myofascial strains or intervertebral disc pathologies, or other contributing factors such as general upper body strength and conditioning, prolonged computer or phone use, injury, wear and tear, and certain medical conditions.
Common causes of neck pain
When to seek urgent care
Most neck pain is benign in the serious pathology sense. However certain features require prompt medical assessment: neck pain following significant trauma (fall from height, motor vehicle accident, contact sport collision), rapidly progressive arm or leg weakness, bilateral arm or leg symptoms, bladder or bowel dysfunction, neck pain with fever and severe headache, and neck pain in the context of known cancer or inflammatory arthritis. If any of these are present, see a GP or emergency department rather than a physiotherapist as the first step.
How is neck pain diagnosed?
A thorough physiotherapy assessment — combining a detailed history with physical examination including cervical movement assessment, neurological testing, specific provocation tests for facet joints and nerve roots, and upper limb tension testing — identifies the most likely pain source. Imaging tests including X-rays, MRI or CT scans may be recommended to get detailed images of the neck's structures, though imaging is not routinely required for most acute neck pain and findings must always be interpreted in the clinical context.
How can physiotherapy help?
Physiotherapy is among the most evidence-based first-line treatments for neck pain and is strongly recommended by major clinical guidelines for all common cervical presentations.
Manual therapy techniques like joint mobilisation or manipulation improve neck mobility, restore muscle tone and reduce pain. Guided exercises strengthen muscles, improve posture and enhance flexibility. Postural training educates patients on better postures for daily activities to reduce strain.
Deep cervical flexor retraining — rebuilding the strength and coordination of the longus colli and longus capitis — is the exercise intervention with the strongest evidence across most cervical conditions. These muscles are consistently inhibited in people with chronic neck pain, and their rehabilitation significantly reduces pain and recurrence. Real time ultrasound makes their activation teachable in a way that verbal instruction alone cannot achieve.
Thoracic mobility and scapular control work addresses the postural contributors to cervical loading — the most important and most frequently neglected component of cervical rehabilitation. Clinical Pilates provides structured thoracic extension, scapular control and deep cervical stabiliser training in a controlled environment. Dry needling of the cervical and periscapular musculature assists with pain management and trigger point release.
Neural mobilisation addresses the nerve sensitisation that underlies arm symptoms in radiculopathy and the headache in cervicogenic presentations. Cervical traction provides short-term relief from nerve root compression.
For patients whose neck pain arose from a motor vehicle accident or workplace injury, CTP and WorkCover funded physiotherapy is available.
Our physiotherapists Yulia Khasyanova, Mauricio Bara and Emma Cameron all have experience in cervical spine conditions and neck pain management and are members of the Australian Physiotherapy Association.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
Neck pain is one of the most common musculoskeletal complaints in Australia, affecting approximately one in five adults at any given time. Like lower back pain, it is a symptom rather than a diagnosis — and the treatment that works for one cause may do nothing for another. Identifying what is actually driving the pain is the most important step in effective management.
Neck pain may present as a sharp pain, dull muscular ache, headache with a neck origin, neck stiffness, or instability. Factors contributing to neck pain may stem from spinal issues such as joint problems, myofascial strains or intervertebral disc pathologies, or other contributing factors such as general upper body strength and conditioning, prolonged computer or phone use, injury, wear and tear, and certain medical conditions.
Common causes of neck pain
- Cervical facet joint syndrome — pain arising from the small joints at the back of the cervical vertebrae — is one of the most common and most underdiagnosed causes of chronic neck pain. Research suggests facet joints account for 54 to 67% of chronic neck pain following whiplash injury. The pain is typically worse with extension and rotation and may refer to the occiput, shoulder and periscapular region in characteristic patterns.
- Cervical disc herniation — where disc material compresses a cervical nerve root — produces cervical radiculopathy: arm pain, numbness, tingling or weakness radiating from the neck in a distribution corresponding to the affected nerve root level.
- Cervical spondylosis — age-related degenerative changes in the cervical discs and facet joints — is extremely common and a frequent contributor to both local neck pain and radiculopathy in middle-aged and older adults.
- Cervical myelopathy — spinal cord compression from severe cervical stenosis — produces broader neurological symptoms including hand clumsiness, gait disturbance and bilateral limb symptoms. This is the most serious cervical condition and requires urgent specialist assessment.
- Whiplash — acceleration-deceleration injury of the cervical spine — produces acute neck pain, headache and stiffness following motor vehicle accidents or contact sport. Whiplash injuries frequently involve facet joint damage at C2-3 and C5-6 and are one of the most common presentations in physiotherapy practice.
- Cervicogenic headache — headache arising from upper cervical structures — is frequently misdiagnosed as migraine. The hallmark is unilateral headache that worsens with neck movement and is reproduced by pressure over the upper cervical joints.
- Muscle strain and myofascial pain — the most common acute cause of neck pain — from sudden awkward movement, prolonged static posture, or accumulated physical stress. Trigger points in the upper trapezius, levator scapulae and suboccipital muscles are consistently present in people with chronic neck pain and contribute both to local pain and to referred headache.
- Cervical instability and atlantoaxial instability — particularly relevant in people with hypermobility or connective tissue disorders — produce symptoms of neck instability, head heaviness and neurological features from inadequate passive restraint of the upper cervical joints.
When to seek urgent care
Most neck pain is benign in the serious pathology sense. However certain features require prompt medical assessment: neck pain following significant trauma (fall from height, motor vehicle accident, contact sport collision), rapidly progressive arm or leg weakness, bilateral arm or leg symptoms, bladder or bowel dysfunction, neck pain with fever and severe headache, and neck pain in the context of known cancer or inflammatory arthritis. If any of these are present, see a GP or emergency department rather than a physiotherapist as the first step.
How is neck pain diagnosed?
A thorough physiotherapy assessment — combining a detailed history with physical examination including cervical movement assessment, neurological testing, specific provocation tests for facet joints and nerve roots, and upper limb tension testing — identifies the most likely pain source. Imaging tests including X-rays, MRI or CT scans may be recommended to get detailed images of the neck's structures, though imaging is not routinely required for most acute neck pain and findings must always be interpreted in the clinical context.
How can physiotherapy help?
Physiotherapy is among the most evidence-based first-line treatments for neck pain and is strongly recommended by major clinical guidelines for all common cervical presentations.
Manual therapy techniques like joint mobilisation or manipulation improve neck mobility, restore muscle tone and reduce pain. Guided exercises strengthen muscles, improve posture and enhance flexibility. Postural training educates patients on better postures for daily activities to reduce strain.
Deep cervical flexor retraining — rebuilding the strength and coordination of the longus colli and longus capitis — is the exercise intervention with the strongest evidence across most cervical conditions. These muscles are consistently inhibited in people with chronic neck pain, and their rehabilitation significantly reduces pain and recurrence. Real time ultrasound makes their activation teachable in a way that verbal instruction alone cannot achieve.
Thoracic mobility and scapular control work addresses the postural contributors to cervical loading — the most important and most frequently neglected component of cervical rehabilitation. Clinical Pilates provides structured thoracic extension, scapular control and deep cervical stabiliser training in a controlled environment. Dry needling of the cervical and periscapular musculature assists with pain management and trigger point release.
Neural mobilisation addresses the nerve sensitisation that underlies arm symptoms in radiculopathy and the headache in cervicogenic presentations. Cervical traction provides short-term relief from nerve root compression.
For patients whose neck pain arose from a motor vehicle accident or workplace injury, CTP and WorkCover funded physiotherapy is available.
Our physiotherapists Yulia Khasyanova, Mauricio Bara and Emma Cameron all have experience in cervical spine conditions and neck pain management and are members of the Australian Physiotherapy Association.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
