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Neck Pain Physiotherapy

Neck Pain Physiotherapy

Your cervical spine, commonly known as the neck,  is an extremely robust structure, as evidenced by it having to hold the weight of your head (5–6 kg as an adult) for most of the day. That being said, pain is one of the leading causes of disability in adults, with up to 20% experiencing neck issues, according to the Royal Australian College of General Practitioners

There is a growing problem with neck pain in our community today. Physiotherapists have a range of non-surgical treatments to help ease and resolve your pain. The physiotherapy management team at Thrive Physio Plus Adelaide is your local physiotherapist in the Unley Council area. Our goal is pain relief. We aim help relieve you of your symptoms quickly and get you back on the road to recovery in the shortest timeframe possible.

What are some of the common causes of neck pain?

There can be many causes of cervical spine pain, with some being more common than others. Headaches (tension headaches) are also commonly caused by the neck, which we cover in this post here. Below are the most common causes of neck pain that we see in Adelaide locals, starting with the most common:

Muscular neck pain

This is the most common type of neck pain and typically presents with a dull, diffuse ache in the neck muscles. This can sometimes travel into your shoulder blade region or shoulder as well, and masquerade as shoulder pain (you can read more about this here). On assessment, pain caused by neck or shoulder muscles often presents with a reduced neck range of motion and can feel like a stretching or pulling sensation.

This type of pain is often brought about by your neck muscles being exposed to greater loads than they can cope with, often coupled with muscle weakness. This is often over an extended period of time, due to poor posture, sustained postures (e.g. sitting), physical jobs, or repetitive movements. 

There is also a subcategory that involves muscle spasms. This happens in a more acute setting and is often accompanied by a moment of onset. For example, lifting something that is too heavy and feeling a twinge in your neck. Muscle spasms can also accompany a wry neck or neck strain. This type of muscle spasm comes about as a result of the body attempting to protect the spine from further damage or irritation.

There are many muscles in the neck that can cause pain
Facet joint pain

There are 7 vertebrae in the neck that are connected together and form facet joints, which can become damaged or irritated and cause pain. This can occur as a result of a motor vehicle accident causing a whiplash injury, as well as due to degenerative changes in the spine such as osteoarthritis. Similarly to muscular pain, facet joint pain can also come about due to being overloaded over an extended period of time or acutely, such as a wry neck.

Facet pain usually feels sharper in nature, and is accompanied by a reduction in neck range of motion. However, different from muscular pain, it is usually predominately restricted to one side or a particular movement.

Neck facet joints are where the vertebrae of the spine join together
Acute wry neck

Is a neck complaint where there is a sudden onset of severe pain and restricted neck movement caused by muscle spasms. This is commonly due to either a:

  1. Facet joint irritation
  2. Vertebral disc irritation

Facet joint wry neck commonly presents with pain in the upper neck, whilst discogenic wry neck is more common in the lower part of the neck and even into the upper back and shoulder. Both of these are non-life-threatening conditions and have a favourable natural history. 

Nerve pain (also known as radicular or neuropathic)

The spinal cord runs down the spinal column in the neck and exits out of the side of the spine in what are nerve roots. These nerve roots run all the way down into your shoulder, arm, and fingers.

These nerve roots that exit your spine can become irritated, usually from a disc bulge, inflammation of surrounding tissues, or spine joint osteoarthritis, and can cause pain. The pain often feels sharp and shooting and can be sporadic in nature. 

Pain is often accompanied by pins and needles, numbers, and or muscle weakness, which can radiate into the shoulder arm, and fingers. 

What does a physiotherapist do for neck pain?

According to this study (and many others), Physiotherapy is an evidenced-based therapy for the treatment of neck pain, which chiefly involves manual therapy (massage, dry needling, manipulation and joint mobilisations), education, and exercise. At Thrive Physio Plus, we like to stick by what the evidence tells us works, which is why we use a combination of these when treating all types of neck pain, to ensure you’re getting the best, most up-to-date treatment options.

Starting with education, we will answer the critical questions you have about your neck pain, including what is causing your neck pain, how long it will take to resolve, what you can do to help, and how to prevent it in the future. This ensures you leave the consult with a sound understanding of what is happening in your neck, and have a clear path forward.

Manual therapy and exercise are also crucial in ensuring you make a full recovery and can be broken down into three main phases:

Phase 1 – Reduce pain and restore movement

In the early stages of physiotherapy treatment, the priority is to make you as comfortable as possible as quickly as possible. This phase has a great emphasis on using manual therapy techniques to reduce pain and improve your range of motion. Manual therapy is an effective tool that physiotherapists use to initiate their recovery process. 

Neck massage and trigger point therapy are effective in reducing neck pain

Most important, however, is commencing exercise that helps reduce pain and improves range of motion, which are given as a home exercise program. This ensures that you feel empowered to continue to work on and improve your neck pain outside of the treatment room walls. 

Common exercises we use for treating neck pain are shown in the video below:

With the help of manual therapy and gentle exercises over a period of days, you should notice that your pain settles and your movement improves. 

Phase 2 – Improve strength, endurance and capacity of the neck

Exercises that work on improving the strength, endurance and if needed, the flexibility of your neck is key for the long-term recovery of neck pain. This study found that shoulder blade and neck-specific exercises are helpful in treating chronic neck pain. 

This should be commenced as early as pain allows and includes exercises that work the muscles of the neck themselves, as well as the surrounding supporting musculature in the upper back and shoulder. 

For optimal results, these should be completed 2x per week, ideally 3-4x per week for a period of 6-8 weeks at least. It is important that these exercises are challenging for you, which usually means working to a 7-8 out of 10 intensity. This ensures that your muscles are being given an adequate stimulus to adapt and become stronger!

Phase 3 – Prevent recurrence

This is essentially an extension of the second phase. In this phase, you’ll work closely with your physiotherapist to create a treatment plan that implements healthy habits for your neck. This can include things like finding a form of exercise that you enjoy and can stick with, maintaining an optimal desk setup at work, reducing poor posture and discussing good manual handling and lifting techniques.

A popular form of exercise used for the treatment of neck pain is Pilates. At Thrive Physio Plus, we offer Physio-supervised exercise sessions which are perfect for rehabilitating and preventing future neck pain and include pilates exercises using reformers and other equipment. These sessions ensure a smooth transition from being in pain in the early stages to ensuring you’re doing all that you can to prevent your neck pain from returning. 

If Pilates or supervised sessions aren’t appealing to you, working with your Physiotherapist to create a home program or gym-based program will also be beneficial. 

You can read our top 5 tips and favourite exercise for neck and back pain here.

When should you see a Physiotherapist?

Physiotherapists are first-contact practitioners, which means you don’t need a GP referral to see us. We often recommend that a perfect time to see a Physiotherapist is when your pain or restriction is still mild. This usually means the recovery time back to 100% is shorter than if you were to wait for the pain to become severe before seeking help.

Common triggers that indicate you should see a Physiotherapist include:

  • Pain that persists longer than a few days.
  • Severe pain.
  • Chronic neck pain (pain that has been there for more than 3 months).
  • Discomfort that interrupts your sleep.
  • If nerve symptoms are present (tingling, numbness or weakness in your upper limb).
  • Discomfort that prevents you from engaging in your chosen activity or social life.

Your neck pain physiotherapy assessment

Our initial consultations are 60 minutes, longer than the industry average, which gives us the time to comprehensively assess your neck and discover all of the potential contributing factors. A neck assessment with us will include:

  • A thorough history to ensure we have the confidence to tell you that it is nothing serious or sinister, or to refer you to our network of trusted health practitioners.
  • Range of motion assessment of the cervical spine and thoracic spine.
  • Neck, shoulder, and upper back strength assessment.
  • Assessment of the muscles of your neck, upper back, and shoulder to identify tight muscles and trigger points.
  • If you’re active, we’ll perform a movement screening that is specific to your chosen activity.

Performing an in-depth assessment ensures we understand the root cause of your neck pain and get started on the right path from day one.

Neck Physiotherapy Assessment involves observing how your neck moves in different directions

The types of treatments used to relieve neck pain

We understand how painful neck issues can be, and the disruption they can cause to daily life. Therefore our aim in your Physiotherapy session with us is simple, utilise the treatments that will relieve your pain in the shortest time frame possible. 

These can include:

  • Massage and trigger point therapy
  • Dry needling
  • Neck joint mobilitsation
  • Neck joint manipulation
  • Cervical and thoracic mobility exercises
  • Light resistance exercises of the thoracic spine and shoulder
Dry needling can be effective in reducing muscular neck pain

This study found that mobilisation, manipulation, and clinical massage are effective treatments for the management of neck pain, and this study here found that exercise is also effective. 

You can expect a combination of the above treatments in your initial visit with us, and we’ll be sure to take into account your preferences as well. 

What Next?

Thrive Physio Plus offers a 60-minute neck pain initial consultation with an expert physiotherapist at our Highgate clinic. We see local Adelaidians in the Unley council area, eastern and southern suburbs with neck and shoulder pain daily!

Let us help you – call us on 8490 0777 or book your initial consultation here today.


What are some good neck pain physiotherapy exercises?

Good neck pain exercises include arm openings, cat/camels, and threading the needle. Also, any resisted exercise that works the muscles of the shoulder, the upper back muscles, and the neck is good for neck pain. These can include seated rows, lat pull-downs, and shoulder raises.

Is physiotherapy good for a stiff neck?

Physiotherapy is a highly effective and evidence-based treatment for pain and stiffness of the neck. Treatment involves manual therapy, including massage and joint mobilisation, as well as strengthening exercises, and mobility exercises designed to reduce stiffness and increase neck range of motion.

Can neck pain cause symptoms in other parts of my body?

Neck pain can cause pain to travel into your upper back and shoulder, as well as cause tension headaches. Symptoms caused by nerve root irritation in the neck can travel into the arm and fingers. 

What does neck pain feel like?

Neck pain can feel sharp or dull in nature and is usually present in the neck region. It is commonly accompanied by a reduced range of motion or a feeling of stiffness or tightness with movement.

How do you know if it’s a serious problem or not?

For the majority of people, neck pain is not a serious problem. However, symptoms that may warrant further investigation are severe pins and needles, numbness, or arm weakness. Also, severe headaches without a history of them are cause for further investigation. 

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