Neck pain is a very common condition in the general population as a result of a traumatic event such as a car accident, sports injury or non traumatic event such as prolong sitting, cellphone use, or just bad posture. 

The area of the neck corresponds to the cervical spine and consists of 37 joints. The cervical spine is very vulnerable to trauma and pain, including neck, Upper back, shoulder blade, shoulder, elbow, or hand pain.


The neck is composed of seven bones stack together. These bones are called vertebrae bones. The neck bones are called cervical spine refer to as cervical 1 to cervical 7 or C1 to C7. The top of the cervical spine C1 articulates with the skull and the bottom C7 with the upper back of thoracic vertebra.


Vertebrates are separated by a cushioning gell-like material called discs. These discs are shock absorber, stabilize the neck and make the neck movements smoother.

An excess of pressure on a disc can bulge, protrude, or slip, the gel-like material out of its center causing neck pain, or in the worse case a rupture can occur causing cervical radiculopathy symptoms.


Ligaments are bands of connective tissue. Cervical ligaments connect bone to bone and keep the cervical spine column in place. The ligament function is to stabilize the neck during movement and limit actions outside of the normal range. Neck ligaments can get injured during a car accident which produce a whiplash injury, including cervical sprain.


The neck or cervical spine is the origin and insertion from muscles that support the head and upper back in place.
These muscles provide postural support, stabilize the head, and are responsible of the neck and head movements.

There are two types of muscles called the superficial and deeper muscles which are always working together to produce an specific movement.

Superficial Muscles:

Superficial muscles are easy to see, feel and connect the skull with the shoulder:

  • Trapezius
  • Sternocleidomastoid

Superficial muscles that connect the shoulder blade with the back:

  • Levator Scapulae
  • Rhomboids
  • Scalenus

Deeper Muscles:

This muscles are more connected to the bone structures such as the skull, and vertebrae bones.

  • Long Posterior Semispinalis Capitis
  • Longissimus capitis

Another deeper layer of muscles connect the cervical bones with the thoracic bones:

  • Splenius Cervicis
  • Longissimus Cervicis
  • Splenius Cervicis

Overuse or repetitive movements of these muscles can produce neck or cervical strains, muscle tension, and headaches.

Role of the Neck

  • The neck protects the spinal cord that exits from the brain and innervate the arms and upper back.
  • Support the weight of the head that usually goes from 10 to 13 pounds.
  • Allow the head to move to look up, down, over the shoulder or to the side.

Movements of the Neck

The neck is the most mobile part of the whole spine.
There are four movements that occur in this area.


The neck flexes bends forward when the chin moves toward the chest. Cervical flexion occurs at C5-C6.This movement occurs when the eyes look down or while sitting in sloughed position to watch T.V.


The neck extends or bends backward when the chin goes up. Cervical extension occurs at C6-C7. This movement occurs with looking up to the sky or with putting a light bulb on the ceiling.


The neck rotates when the head and neck turn to one side. Cervical rotations occurs at C1-C2 and the rest vertebrae continue rotating from C3-C7. A good example is looking over the shoulder while driving.

Lateral Neck Flexion or Side Bending

The neck sides bend when the right ear goes to the right shoulder or vice versa. Lateral neck flexion occurs from C2 to C7. A good example is holding the cellphone with the ear and the shoulder instead of the hand.

Causes of Neck Stiffness

  • Sitting in Front of the T.V or in Front of the Computer for Too Long Without Taking Any Rest Breaks.
  • Sleeping Incorrectly in a Wrong Position or With the Wrong Pillow.
  • Carrying a Heavy Purse, or a Heavy Shoulder Bag.
  • Cellphone Use.
  • Reading.
  • Driving for Long Time.
  • Gardening.
  • Reaching Overhead From Standing Position.
  • Lifting Weights With Improper Form.
Neck Pain Causes

Neck Pain Causes

Cervical Strain 

Cervical Strain is related to an injury to the neck muscles and upper back muscles. Neck or cervical muscles can be injured by constant stress, physical and emotional stress of daily life, repetitive movements, poor sleeping habits, or poor posture.

Cervical Strain Symptoms

  • Neck Pain that Worsen with the Movement.
  • Pain in Shoulder or Upper Back.
  • Stiffness and Tightness in Neck, Upper Back Muscles, or/and Shoulder (s).
  • Headaches in the Back of the Head.
  • Difficulty Concentrating and/or with Sleeping.

Cervical Spondylosis 

Cervical spondylosis is a age-related wear and tear of the cervical spine that affects the vertebral bones, the cervical discs, nerves roots, and/or spinal cord. This condition is also called: neck arthritis, or neck osteoarthritis. More than 85% of people are affected after the age of 60 with cervical Spondylosis according to Mayo Clinic. However, cervical degenerative changes can start in some 30-year-olds according to Radiographic or X-rays evidence. The cervical disc shrink gradually. In Addition, overgrowth of bone occur at the edge of the cervical bones. This new bone or spurs can produce pressure on adjacent structures and cause pain.

Neck Pain Symptoms

Cervical Spondylosis Symptoms

  • Gradual Onset of Pain or Numbness/Tingling of Neck, Shoulder or Arm.
  • Neck Pain is Worse with Certain Positions.
  • Difficulty with Sleeping
  • Morning Stiffness of the Neck, which Improves Gradually Throughout the Day.
  • Decrease Neck Movements.
  • Headaches.


Headaches are a common condition that affect women four times more than men.
The International Head Society has found 14 types of headaches being the most common the cervicogenic or occipital headache. Cervicogenic headaches affect about 25% of the adult population with the main complaint of chronic and recurrent pain.

Cervicogenic or Occipital Headache Symptoms

  • Pain in any Part of the Head.
  • Neck Stiffness with turning to look over the shoulder
  • Shoulder or Arm Discomfort.
  • Retro-Ocular Pain (Pain Behind the Eye).
  • Inability to Concentrate.
  • Worse Pain in the Neck and Based of the Head.
  • Pain sometimes going to the Forehead, Eye, and Ear.
  • Pain exacerbated with Movement and Prolong Sitting.
  • Tenderness of Neck Muscles.
  • Pain tends to be more intense in One Side of the Neck
  • Pain Going Down to Shoulder and Arm.
  • Headache starting in the Neck.
  • Dull Achy Pain in the Neck.

Whiplash Injury 

It is a sudden forward/backward movement of the neck that can produces a sprain in the neck, including ligaments, joints, and muscles. More than one million whiplash injuries related to car accidents occur every year in the United States.

Neck Pain Symptoms

Mechanism of Injury:  

  • Car Accidents Also Called Motor Vehicle Accidents (MVA).
  • Sport Injuries Involving a Heavy Landing or Blow to the Body and the Neck that Control the Movement of the Head.
  • Falls, Landing on the Shoulder.
  • Pulls on the Arms.
  • Trauma to the Body or Neck.


  • A Loss of Movement in Neck Specially with Turning Head to Look Over the Shoulder.
  • Muscle Spasms.
  • Pain/Numbness in Arm or Hand.
  • Neck Stiffness.
  • The Back of the Neck Feels Tender.
  • Ear Pain.
  • Jaw Pain.

Cervical Disc Injuries

Cervical radiculopathy is when a nerve root is irritated by something pressing on it, as a result of a bulging neck disc, arthritis, or a cyst. The most common level for cervical nerve root injuries include C7 by 60%, C6 by 25%, and in lower grade C4-C5 disk.

Mechanism of Injury

  • Repetitive Lifting of More than 25%.
  • Driving or Working with Vibrating Equipment.
  • Poor Posture.

Symptoms for Cervical Disc Injuries

Cervical disc symptoms are very common in the younger population. On the other hand, radicular symptoms including the neck, arm, and hand are common on the middle age group due to neck disk degeneration.

  • Neck Pain Before Arm Pain.
  • Dull Ache to Severe Burning Pain.
  • Pain Between Shoulder Blade and Spine.
  • Pain in Upper and Into the Hand.
  • Pain is Aggravated with Looking Up, and Looking Over the Shoulder.

Symptoms for Cervical Radiculopathy

Cervical Nerve Root (C3)

  • Pain on Top of the Neck Going to the Back of the Ear.

Cervical Nerve Root (C4)

  • Numbness From the Neck to the Top Shoulder.
  • Difficulty with Breathing with Exertion if the Diaphragm is compromised.

Cervical Nerve Root (C5)

  • Numbness Starting From the Top of the Shoulder Going Out to the Middle Arm on the Lateral Side.
  • No Pain with Movement of the Arm.

Cervical Nerve Root (C6)

  • Pain and Numbness Starting on the on the Neck Going Down to the Lateral Side of the Arm and Lateral Forearm,
  • Pain and Numbness on the Tip of the Thumb, Index Finger and Between the Thumb and Index Finger Web.

Cervical Nerve Root (C7). (The Most Common One)

  • Pain on the Back of the Shoulder, and Shoulder Blade.
  • Pain on the Triceps, All Way Down to the Middle Finger.

Cervical Nerve Root (C8)

  • The Medial Area of the Arm, Forearm, All way Down to the Ring, and Pinky Finger.
  • Numbness on the Ring and Pinky Finger.
  • Difficulty with Using the Hand for Activities of Daily Living.

General Radiculopathy Symptoms

  • Stiff Neck.
  • Head Tilted Away From the Painful Side Area.
  • Increased Pain on the Posterior Part of the Neck with Looking Back, Over the shoulder, or Tilting the Head to the Side.

How To Assess Neck Pain?

The Physical Therapist perform a serie of tests to find out the root of the problem. The physical therapist will asks questions related to neck such as:

  • When Did the Neck Pain Start?
  • What Kind of Movements Make Neck Pain Worse?
  • Are The Pain Constant or Comes and Goes?

The Physical Therapist will perform a detailed assessment of the body to find physical issues related to the neck pain such as:

  • Muscle Tightness
  • Joint Stiffness
  • Poor Posture
  • Muscle Tenderness
  • Muscle Weakness
  • Diminished or Loss of Skin Sensation in Some Areas

Physical Therapy starts right away if one or more symptoms described above were found to quickly start the recovering process and bring the patient back to their normal activities of daily living.

In some cases, the physical therapist will refer the patient back to their primary physician if more severe problems where found and need medical imaging and testing such as X-rays or MRI.

What a Professional Physical Therapist Can Do for You?

  • Relief Neck pain without medication.
  • Avoid Neck Surgery with Customized and Individualized Neck Program to Reduce Pain.
  • Enhance Posture
  • Improve Flexibility.
  • Be able to Move Easier and Effortless.
  • Strengthen the Weaker Muscles.
  • Learn an Individualized Home Program Customized to Your Needs.
  • Reach Your Goals Safely and Faster.

Physical Therapy Treatment:

  • Postural Training
  • Therapeutic Exercise
  • Manual Therapy
  • Rest
  • Stretches
  • Home Exercise Program
  • Neck Specific Strengthening Exercises
  • Ergonomic Changes at Work
Neck Pain Physical Therapy Exercises

Neck Pain Prevention:

  • Regular Sleep
  • Stress Coping Techniques
  • Healthy Eating Habits
  • Daily Meditation
  • Daily Relaxation Routines
  • Avoid Trigger Factors such as: Family or Work Related Stress, and Emotional Issues.

Protect Your Neck From Pain With This Useful Tips:

Use proper body mechanics

When lifting
  • Keep your Back Straight and Don’t Twist at the Waist.
  • Bend From the Hips and Knees, Instead of the Waist.
  • Bring the Object Close to Your Body at Your waist Level Using your Arms.
Sitting at the Desk
  • Sit With Your Back Straight And With Support in the Lower Back Area.
  • Take Five Minutes Breaks Every 25 minutes.
  • The Top of Your Computer Should Be At Your Eye Level.
  • Any Document You are Reading Should be At the Same Level as The Computer Screen.
When Standing, or Walking
  • Keep Your Back Straight.
  • Look Ahead, Instead of Looking Down.
  • Wear Shoes. Shoes Give Support, a Firm Foundation, and Improve Stability While Standing.
Neck Pain Proper Body Mechanics
When Using A Cell Phone
  • Don’t Use Your Cell Phone for Prolong Computer Work.
  • Raise Your Cell Phone at Eye Level Instead of Bending Your Head to Look Down.
  • Lie on Your Back to Help Your Back and Neck to Relax.
  • Take Rest Break, Move, Change Positions, and Stretch.
Neck Pain Proper Body Mechanics

If you have more queries on Neck Pain and management, or your neck feels tired, and sore, we can help you. Call us now at (805) 203-9940 to find out the causes and physical therapy exercises suggestive for you. Our professional team is here for you to reach your goals, be happier and have a better quality of life.