Neck Pain

You wake up and cannot turn your head properly. Or you have had a dull ache at the base of your skull for weeks that will not shift. Maybe it started after a long stretch at your desk, or maybe it crept in with no obvious cause at all. Either way, it is there every day, affecting your concentration, your sleep and your ability to get through the day comfortably.

Neck pain is extraordinarily common. Global Burden of Disease data shows it affects over 200 million people worldwide, with numbers projected to rise by a third over the next two decades (Wu et al., 2024). Women are affected roughly 1.4 times more often than men, and it peaks between the ages of 50 and 74.

If you are reading this, you are probably one of them. Here is what is actually going on and what you can do about it.

What causes neck pain?

Most neck pain is mechanical, meaning it comes from the joints, muscles, discs or connective tissue of the cervical spine rather than from a serious underlying condition. The common drivers include:

Facet joint dysfunction. The small joints that link each vertebra to the next are one of the most frequent sources of neck pain. Research estimates that facet joints are responsible for 35% to 55% of chronic neck pain cases. When these joints become stiff, irritated or inflamed, they produce a deep ache that is often felt at the base of the skull, across the top of the shoulders or between the shoulder blades.

Muscle tension and trigger points. The muscles of the neck and upper back, particularly the upper trapezius, levator scapulae and suboccipital muscles, are prone to developing tight, painful knots called trigger points. These are especially common in people who spend long hours at a desk and are a frequent driver of headaches.

Disc problems. The discs between the cervical vertebrae can bulge or herniate, sometimes compressing a nerve root. This can cause pain that radiates into the shoulder, arm or hand, along with numbness or tingling. Cervical disc injuries are less common than in the lumbar spine but can be significant when they occur.

Postural load. Prolonged positions that load the neck, whether from desk work, driving or looking down at a phone, increase the sustained demand on the cervical muscles and joints. Your head weighs roughly 5kg in a neutral position, but the effective load on your cervical spine increases substantially the further forward your head sits (Hansraj, 2014).

Stress. This one is underestimated. Psychological factors play a much bigger role in neck pain than most people realise. A 2025 Mendelian randomisation study found causal relationships between depression (1.5 times increased risk), mood instability (2.7 times increased risk) and the development of neck pain (Liang et al., 2025). If your neck always flares up during stressful periods, it is not in your head. The connection is real and measurable.

Is your posture really the problem?

“Tech neck” gets a lot of attention, and there is no question that prolonged phone and screen use is associated with neck pain. A 2025 meta-analysis found that smartphone overuse carries 2.3 times the odds of developing neck symptoms (Chen et al., 2025).

But here is where it gets interesting. A separate 12-month longitudinal study by Correia and colleagues (2025) found that the actual angle of cervical flexion during phone use was not a risk factor for developing neck pain. The real predictors were poor sleep quality (1.8 times the risk) and insufficient physical activity (2.4 times the risk).

In other words, it is not the position itself that causes the problem. It is the combination of sustained load, not enough movement and not enough recovery. You can have good posture and still get neck pain if you are sedentary, stressed and sleeping badly. And you can spend hours on your phone without developing problems if you are active, fit and recovering well.

This does not mean posture is irrelevant. It means fixing your posture alone will not fix your neck pain if the other factors are not addressed.

Neck pain and headaches

A significant proportion of headaches originate from the neck. Cervicogenic headaches, where dysfunction in the upper cervical spine refers pain into the head, affect approximately 4% of the population and account for a significant proportion of chronic headache presentations (Robinson et al., 2025). Women make up over 80% of cases.

A 2025 network meta-analysis of 14 randomised controlled trials found that cervical spine manipulation ranked highest for both pain reduction and disability improvement in cervicogenic headache (Xu and Ling, 2025). If you have headaches combined with neck stiffness, particularly headaches that start at the base of the skull or feel one-sided, the neck is very likely involved.

We see this pattern regularly in practice. Treating the neck resolves the headaches.

How we treat neck pain

Neck pain responds well to treatment when the approach is matched to the cause. We use a combination of hands-on treatment, targeted technology and rehabilitation tailored to what is driving your symptoms.

Chiropractic adjustments

Spinal manipulation is one of the most thoroughly studied treatments for neck pain. A 2025 meta-analysis of 8 randomised controlled trials (965 patients) found that manipulation significantly reduced pain, improved cervical range of motion in all directions and reduced disability, with no serious adverse events reported (Diao et al., 2025). For chronic neck pain, a separate meta-analysis of 17 RCTs confirmed consistent improvements in pain and disability (Liu et al., 2023).

We assess the full cervical and thoracic spine. Restrictions in the upper back and rib cage directly affect how the neck moves and loads. Treating only the neck without addressing what is happening below it is a common reason for incomplete improvement.

Shockwave therapy

Shockwave therapy is particularly effective for the chronic muscle tension and trigger points that drive so much neck pain. A meta-analysis by Wu and colleagues (2022) found that shockwave significantly reduced pain, improved pain thresholds and reduced neck disability compared to other treatments including trigger point injection and dry needling.

A large sham-controlled trial of 320 patients confirmed a 95% treatment efficacy rate for shockwave versus 65% for sham in cervical pain, with significant improvements in pain, range of motion and disability (Li et al., 2024).

At our practice we use the EMS Swiss DolorClast Smart20 to target the upper trapezius, levator scapulae, suboccipital and thoracic trigger points that feed chronic neck pain and tension headaches.

Dry needling

Chronic neck pain almost always involves tight, knotted muscles through the cervical and upper thoracic region. Dry needling gets into those trigger points in a way that stretching often cannot. A 2023 meta-analysis found it more effective than stretching and electrotherapy for short-term pain relief, with even better results when combined with manual therapy (Hernandez-Secorun et al., 2023).

Fascial release

If you have had a stiff neck for months, the connective tissue through your chest, upper back and neck will have tightened around it. Instrument-assisted soft tissue mobilisation works through those layers and loosens restrictions that hands alone sometimes cannot reach. It is particularly useful for people whose neck stiffness has not responded fully to manipulation and stretching.

Targeted rehabilitation

Treatment gets you out of pain, but exercise is what stops it coming back. A meta-review by Rasmussen-Barr and colleagues (2023) found that resistance training, motor control exercise, yoga and Pilates all help with neck pain. There is no single best exercise. What matters is doing it consistently and gradually increasing the load.

Our rehab programmes typically include:

Deep neck flexor training to restore the stability muscles that switch off during chronic neck pain
Upper back and shoulder strengthening to reduce the postural load on the cervical spine
Mobility work to maintain range of motion through the cervical and thoracic spine
Movement habits for your desk setup, phone use and daily routine

What you can do at home

While you are being treated, a few changes at home go a long way:

Move regularly. Do not sit in one position for more than 30 to 40 minutes. Set a timer if you need to. A short walk or a few shoulder rolls is enough to reset.
Strengthen, do not just stretch. Stretching provides temporary relief but does not change the capacity of the muscles to handle load. Strengthening the neck and upper back is what produces lasting change.
Address your sleep. Poor sleep quality is a stronger predictor of neck pain than your screen posture. Prioritise sleep duration, consistency and a pillow that supports your neck in a neutral position.
Stay active. Physical inactivity more than doubles the risk of developing neck pain. It does not need to be intense. Regular walking, swimming or gym work all count.

When to get it checked

Most neck pain is mechanical and responds well to treatment. But certain symptoms should prompt an urgent assessment:

Neck pain with progressive weakness, numbness or clumsiness in your hands
Difficulty with balance or walking alongside neck symptoms
Pain following trauma (a fall, car accident or impact)
Neck pain with fever, unexplained weight loss or a history of cancer

These patterns can indicate conditions that need further investigation. We screen for these at every assessment and will refer you for imaging or specialist review if anything raises concern.

You do not have to put up with it

Neck pain is common, but it does not have to be permanent. Whether it started last week or has been bothering you for years, the right combination of hands-on treatment, targeted rehabilitation and practical changes to your daily habits can make a real difference.

If neck pain is affecting your work, your sleep or your ability to enjoy your day, get in touch or book an appointment. We will find out what is driving it and build a plan to get it sorted.

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