When discussing the neck, we are not considering a single joint. Rather, consider the neck as the muscles, bones, ligaments and tendons that comprise the cervical spine from the base of the skull to the seventh vertebral segment. The neck is a somewhat delicate area, housing not only the uppermost part of the spinal column but the veins and arteries that carry blood to and from the brain and the body’s major airway, the trachea or windpipe. The neck also supports the skull and allows the movement of the head. The head itself is quite a load, weighing between ten and thirteen pounds (four and a half to approximately six kilos) on average.

Cervical discs are composed of a tough outer layer called the annulus fibrosus and a jelly-like interior, the nucleus pulopsus. Collagen fibres around the inner core help to evenly distribute forces acting upon the neck. The C1 and C2 are first and smallest seven cervical vertebrae. The atlas of C1 and the axis of C2 allow for the rotation of the head from side to side. The first two cervical nerves control the head and branch off at this spinal level. Flexion, the movement of the head forwards and backwards, is facilitated at the C5 to C7 levels of the cervical spine. The C3 to C7 vertebrae more closely resemble those of the thoracic spine with each vertebral segment made up of three joints with a disc to the front and a pair of facet joints at the back. Nerves that serve the diaphragm and help regulate breathing branch from the C3 and C4 region while those that go to chest muscles such as the deltoids emerge at C5. Innervation the wrist is by fibres emerging at the C6 and those going to the triceps and hands come from the C6 and C7 levels respectively.

Neck Pain

Non specific neck pain, the kind most of us have experienced from time to time, is caused by muscular strain. Though uncomfortable, it is not a cause for concern and will usually right itself with basic self care in a day or two. Pain can be managed drug free with the use of hot water bottles or heat packs applied to the area.

Gentle stretching exercises can offer relief from neck pain. Gentle is the keyword! Do not stretch through or beyond the point where you just begin to feel pain or discomfort. Move the head in all dirctions and stretch the smaller muscles of the neck by making a double chin by drawing the jaw backwards.

If the pain is more severe then a combination of paracetamol and ibuprofen will keep the pain and inflammation in check. Should the pain continue for more than two days, be unresponsive to treatment or worsen, then check in to your local medical professional.

Preventing Neck Pain

Prevention is better than cure. Much neck and back pain can be prevented by making simple changes to the way you sit and sleep.

Pins and Needles

Numbness and needles and pins sensation in the shoulder and hands can often be the result of neck strain. It is, in fact, referred pain. Nerves that serve the shoulder and arm project from the cervical (neck) level of the spine. Injury to the neck may affect these nerves giving uncomfortable, even painful, sensations in what may seem distant parts of the body. Typically, these symptoms are found to be the result of a misalignment of the discs in the neck.


Crepitus or, as we call it in clinic, noisy neck is precisely that: a neck that makes a creaking or grinding sound on movement. It can occur in any joint but because the bones in the neck are so close the the auditory canals of the ears, it is easily detected and early treatment given.

There are a number of causes of crepitus. Some people just have a noisy neck. Crepitus without pain is rarely a cause for concern initially but because the sound is made from bone rubbing against bone the condition can be progressive and become painful over time. Trauma to the neck can result in damage to soft tissues, particularly, cartilage, leaving bone surface exposed to each other. Professionals physiotherapists will thoroughly assess your crepitus to find its cause and formulate a personalised treatment plan to reduce discomfort and slow the condition’s progress. As with all treatments, early interventions are most successful so the sooner you visit us, the better.


A sudden and vigorous movement of the head in any direction can overstretch and damage ligaments and tendons in the neck resulting in the pain and stiffness known as whiplash. Though rarely serious, whiplash can reduce mobility, cause secondary headaches and nausea. Recovery from whiplash may take a long time and the symptoms may even become worse without the right treatment. The most common cause of whiplash is road traffic accidents. Even if there is no impact, the forces on the head and neck if your vehicle has to brake hard can be sufficient to cause whiplash.


Any and all of the conditions discussed so far may cause a certain degree of dizziness. If you are experiencing this then, for your own safety and that of others’ do not drive. Should you experience dizziness from moving your head in any direction this may indicate a problem with the inner ear. However, these sensations may also be due to pressure on the vertebral artery which is located in the neck. Narrowing or pinching of that artery means a decreased blood, and therefore, oxygen supply to the brain. The result is dizziness and altered perception (seeing stars for instance). Do not delay in seeking assessment for these symptoms. Though relatively rare, and these symptoms are more likely to indicate a more benign condition, damage to the vertebral artery can be fatal and must be ruled out.

Disc Bulge or Prolapse

The vertebrae of the spine are separated by disks of fibrocartilage and glycoprotein. Without these disks filling the gaps between the vertebrae, a healthy spine would not be able to move as smoothly as it should. As well as allowing movement they provide shock absorption and allow enough room for the nerve roots to exit the spinal cord If the term disc bulge or prolapse is unfamiliar then you’ve probably heard the injury referred to as a slipped disc or herniated disc. While less common in the cervical spine than in the lumbar region, degenerative disc disease or a cervical herniated disc can be a source of intense neck, shoulder and back pain.

The injury may improve over time with rest but without appropriate treatment, weaknesses may lead to recurrence. Your physiotherapist will be able to diagnose and treat any weaknesses that may have led to or resultant from a disk bulge to reduce the risk of this happening again. They are able to provide advice and help you improve your posture and learn better techniques for lifting, carrying, even sitting and sleeping.


A relatively common cause of cervical spinal pain in older adults is osteoarthritis. The symptoms of osteoarthritis can vary from moderate even mild pain and inflammation to cartilage damage and the the degeneration of the spine itself. Swelling may cause tenderness and compress nerves. Osteophytes, bony outgrowths can reduce the range of movement. Osteoarthritis is progressive and incurable but your physiotherapist can help devise strategies to help you cope with the pain and discomfort of the condition.