Neck pain often creeps up gradually — from desk posture, training load, or simply sleeping awkwardly — but it doesn’t have to become a constant companion. Around a third of adults experience neck pain significant enough to limit their activity in any given year, making it one of the most common musculoskeletal complaints we see. Our physiotherapists assess the joints, muscles, and movement patterns of your neck and upper back to find the actual source of your pain, rather than just treating the general area.
Understanding neck pain
The neck (cervical spine) supports the weight of your head — roughly 4.5–5kg in a neutral position — through a stack of small, mobile joints and a network of postural muscles. Because of this, neck pain is highly sensitive to posture, muscular endurance, and how load is distributed across a working day, in addition to any specific injury.
Common causes we assess
- Postural neck pain — from prolonged desk work, screen use, or driving, often worse by the end of the day
- Cervicogenic headaches — headaches referred from the upper neck joints, typically starting at the base of the skull
- Whiplash-associated disorders — following a motor vehicle accident or sudden jolt, sometimes with delayed onset of symptoms
- Facet joint irritation — small joint-related pain, often worse with rotation or extension
- Muscle tension and trigger points — commonly in the upper trapezius and levator scapulae, linked to stress, posture, or training load
- Degenerative changes — age-related changes to the discs and joints, which don’t always correlate with pain severity
Symptoms we commonly see
- Stiffness, particularly first thing in the morning or after sustained postures
- A dull ache across the base of the neck and into the shoulders
- Headaches originating from the back of the head
- Reduced rotation, making it harder to check over your shoulder (e.g. reversing a car)
- Occasional pain or tingling radiating into the shoulder or arm
Our evidence-based approach
Systematic reviews support manual therapy combined with targeted exercise as an effective approach for mechanical neck pain and associated headaches, with deep neck flexor and postural strengthening showing particular benefit for recurrent presentations. Our approach typically includes:
- Assessment of neck and upper back movement, strength, and posture under real-world conditions — not just lying on a treatment table
- Hands-on treatment, including joint mobilisation and soft tissue work, to manage pain and restore range in the early stages
- Deep neck flexor and postural strengthening, which the evidence links to reduced recurrence of neck pain and headaches
- Dry needling, which has moderate short-term evidence for reducing pain and muscle tension around trigger points in the neck and shoulder
- Practical workstation and load advice to reduce the cumulative postural strain that often drives recurring symptoms
What to expect: recovery timeline
- Acute postural neck pain: often improves within 2–4 weeks
- Cervicogenic headaches: typically require 6–8 weeks of consistent treatment targeting the upper neck
- Whiplash-associated disorders: recovery varies significantly, from several weeks to a few months, depending on severity and how early appropriate treatment begins
- Recurrent neck pain: usually needs an ongoing strength and postural endurance program to reduce the frequency and severity of flare-ups
When to seek help urgently
Most neck pain is safe to manage conservatively. Seek urgent medical assessment for neck pain following significant trauma, pain accompanied by severe headache and neck stiffness with fever, or new numbness, weakness, or coordination changes in the arms or legs.