Neck Pain

Why your neck hurts

Your cervical spine has a tough job. It holds up a head that weighs 10 to 12 pounds, allows you to look in every direction, and protects the spinal cord and nerve roots that supply your arms and hands. When something goes wrong in the neck, you feel it — and sometimes you feel it in places you wouldn't expect.

Most neck pain isn't caused by one bad event. It accumulates from posture, work habits, stress, and how the rest of your spine is moving. Your neck often compensates for restrictions in the thoracic spine, the upper ribs, and even the jaw.

Common causes

Somatic dysfunction. The most frequent finding in my clinic. Cervical segments that have lost their normal motion — either too stiff in one direction or hypermobile in another because adjacent segments aren't doing their part. The muscles around them tighten up as a protective response, and that tension becomes the primary source of pain.

Cervical disc disease. Discs in the neck can bulge or herniate just like in the low back. When a disc presses on a nerve root, you may feel pain, numbness, or tingling that radiates down the arm into the hand. The pattern of symptoms often tells us which level is involved before we even look at imaging.

Facet joint irritation. The small paired joints on the back of each vertebra allow rotation and extension. When they become inflamed, they tend to cause localized neck pain that's worse with looking up or turning. Facet-mediated pain often refers to the base of the skull, the shoulder blade, or the upper trapezius.

Myofascial pain. Trigger points in the cervical and upper back muscles are extremely common, especially in people who sit at a desk, drive for a living, or carry stress in their shoulders. The upper trapezius, levator scapulae, and suboccipital muscles are frequent offenders.

Cervicogenic headache. Some headaches actually originate in the neck. Dysfunction in the upper cervical spine — particularly C1, C2, and C3 — can refer pain up over the head and behind the eyes. If your headache comes with neck stiffness, it's worth having the cervical spine evaluated.

How we approach it

I start with a structural exam of the cervical spine, the thoracic inlet, the upper ribs, and the cranial base. Neck pain is rarely just the neck. If your first rib is restricted, your thoracic spine is stiff, or your suboccipital muscles are locked up, treating the cervical segments alone won't hold.

OMM is usually the first step — restoring motion where it's been lost and reducing the protective muscle guarding that's amplifying your pain. For persistent cases or when there's concern about nerve involvement, we can add ultrasound-guided injections targeted to specific joints or nerve roots. If there's any question about whether a nerve is truly compromised, EMG and nerve conduction studies give us a definitive answer.

When to seek care

Come in if your neck pain has lasted more than a couple of weeks, if it radiates into your arm or hand, if you notice weakness in your grip, or if you're getting headaches that start at the base of your skull. Neck pain that wakes you up at night or doesn't improve with basic self-care deserves an evaluation.

What you can do right now

Check your workstation. Your screen should be at eye level, not below it. If you're looking down at a laptop for hours a day, your neck is paying the price.

Move your thoracic spine. Seated rotations, gentle extensions over a foam roller, and shoulder blade squeezes all help take load off the neck by restoring motion to the segments below it.

Don't sleep on your stomach. It forces your neck into extreme rotation for hours. A supportive pillow that keeps your cervical spine neutral on your side or back is one of the best investments you can make.