Neck Pain

Neck pain is the 4th largest cause of disability in America, following back pain, depression, and arthralgias. About half of all people will get neck pain in their lives, and during any year, between 15% and 50% of all people will have some sort of neck pain1.  Women have neck pain more often than men, and the rate of neck pain peaks during middle age.2

There are some other variables that can be associated with neck pain. Your propensity toward experiencing neck pain can depend on your genetics, psychopathology (depression, anxiety, poor coping skills, somatization), sleep problems, smoking, and being sedentary3. Some of the reasons why obese people have neck pain is that obesity is associated with chronic systemic inflammation, stress on the structures of the neck, less muscle strength, more psychosocial issues, and “kinesiophobia”, the fear of moving or increasing activity.

Trauma such as car or sports accidents can cause acute and chronic neck pain. Office and computer workers have more neck pain. Manual laborers and health care workers have more neck pain. Neck pain has been associated with poor job satisfaction, and your perceived poor work environment4.

Neck pain can be mechanical, neuropathic, or coming in secondarily from another cause. Let me explain the differences between the three.

Mechanical neck pain is pain that you experience when you have mechanical stresses on some of the joints or soft tissue in your neck. You had a whiplash injury, and this caused the facet joints in your neck to jam together, along with an acute muscle strain. Or, you sit at your desk all day, and you allow your shoulders to roll forward, your upper back to tighten up, and your neck to protrude forward for a prolonged day of work. You might have an old disc injury where you have an early form of degenerative arthritis, a drying out disc, and the complex array of biomechanical problems that can arise from this.

Neuropathic neck pain is pain that comes from some sort of irritation or imbalance in the neurological activity in your spinal cord, your nerves that exit the holes in your spine or between muscle layers, or from more complex centrally mediated and generated pain in your brain or brainstem. For example,  spinal stenosis in the bony canal where your spinal cord lives can compress the spinal cord, and interfere with nerve impulses traveling to and from your brain. You can also have narrowing of the foramen (holes) between the bones in your neck, and the nerve roots exiting the holes can become irritated. Thoracic outlet syndrome is when your nerves can be compressed by the muscles in your tight shoulders. The more disconcerting symptoms from neuropathic pain is not pain, but numbness or tingling, and even worse, muscle weakness. They say the prevalence of neuropathic neck pain is up to 50% of all neck pain patients, but I thought that number was a little high when I read that citation5.

The type of pain from secondary causes of neck pain includes “organic” diseases. Lung pain can radiate to the neck. Heart pain can radiate to the neck and shoulder. Ominously, you might have an infection or tumor. If pain is intractable, or unable to be shaken, especially at night, if you have developed a fever along with the onset of the pain, or you feel nauseous and malaise, then this might be a sign for your doctor to investigate further.

Some acute neck pain will resolve on its own, while many of us suffer from chronic pain that comes and goes in episodes through the years. Neck pain that is from biomechanical causes can be helped by your chiropractor, and with some proactive home care, such as my kickball neck exercise routine.

If you’ve had a recent neck injury, you will want to coordinate care with your chiropractor or a competent physical therapist who specializes in spinal disorders. Whiplash associated neck pain can be very disabling and chronic if not managed correctly. Sports injuries can be the same way. injuries go through known phases of healing, and we will go through these phases in this site.

Chiropractors (DC) and other doctors (DPT, MD, DO) can help you guide your way through the nuances and protocols for treating neck pain, but ultimately, spinal hygiene is up to you at home and in your work environment. You have to mindful of your posture. You have to stretch and exercise your neck muscles. You have to maintain your body with physical fitness, good nutrition, and a healthy outlook on your health.


Cohen SP, Hooten WM. Advances in the diagnosis and management of neck pain. B. August 2017:j3221. doi: 10.1136/bmj.j3221
Fejer R, Kyvik K, Hartvigsen J. The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J. 2006;15(6):834-848. [PubMed]
Carroll L, Hogg-Johnson S, Côté P, et al. Course and prognostic factors for neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976). 2008;33(4 Suppl):S93-100. [PubMed]
Vincent H, Adams M, Vincent K, Hurley R. Musculoskeletal pain, fear avoidance behaviors, and functional decline in obesity: potential interventions to manage pain and maintain function. Reg Anesth Pain Med. 2013;38(6):481-491. [PubMed]
Cohen S. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc. 2015;90(2):284-299. [PubMed]