Most neck pain is mechanical
Most neck pain is what we call mechanical neck pain. The joints and muscles of the neck or upper back are not moving as they should. Patients describe it as a stiff neck, a cricked neck, a wry neck or a pulled muscle and it can be sharp enough to stop you doing something as simple and day-to-day as turning your head to reverse the car. Painful as may be, it is rarely a sign of anything serious.
The trigger that set it off is usually ordinary: a night in an awkward position or an unfamiliar bed on holiday, long hours at a desk, driving without adjusting your seat and headrest properly or just the steady creep of stress into the shoulders. The advice I give follows current UK guidance: keep the neck moving rather than resting it, sort out the desk set-up and then treat the joints and muscles that have stiffened.
When the neck causes headaches
The neck and head are closely connected. Cervicogenic headache, meaning headache arising from the neck, typically starts at the base of the skull and spreads up one side of the head, usually with neck stiffness on the same side. It behaves differently from a migraine or a tension-type headache and tends to be brought on or made worse by particular neck movements and sustained postures. Part of my assessment is working out which type of headache you actually have, because that determines whether chiropractic care is appropriate or whether your GP is the better first call.
Migraine: what chiropractic can and cannot do
Migraine is a different condition all together and I am clear about the limits here. I do not treat the migraine attack itself. What I may be able to help with are neck-related migraine triggers. There is research evidence that spinal manipulation may help reduce how often migraines occur as part of a migraine prevention approach and for people whose migraines seem to have a neck-related trigger it can be worth exploring alongside the advice of their GP.
What happens at an assessment
If your neck pain is the everyday mechanical kind, the starting point is a proper assessment. Every session begins with a thorough case history and examination, so treatment is based on what is actually going on in your neck at that time. Our FAQ page answers many of the questions I am asked most often and I have written separately on how many chiropractic sessions it usually takes to feel better.
When to see a doctor first
Most neck pain and most headaches are not a sign of anything sinister, but some situations need a doctor. Neck pain that follows a car accident or other significant injury; a sudden and severe headache unlike any you have had before; headache with fever, rash, confusion or problems with speech or vision; a completely new headache pattern if you are over 50; or neck pain with worsening arm weakness, numbness or dizziness. In those cases contact your GP, call 111 or go to A&E. If I find anything during your examination that does not belong in a chiropractic clinic, I will tell you and refer you on. I have also written on how safe it is to see a chiropractor, which is a reassuring read.
