There are conditions that may result in neck pain and/or headaches that are medical emergencies and not candidates for PT. These are cervical artery dissections (stroke), upper cervical instability and cervical myelopathy.
Neck pain often times occurs with headaches which maybe on one side or both sides of the head and are precipitated/aggravated by neck movements and/or sustained positions/postures.
While neck pain is the most common sign, patients frequently have dizziness, nausea, headaches, concentration difficulties in addition to neck pain. This often occurs following motor vehicle accidents (whiplash) and sports injuries, even when several years ago.
We often see patients with both neck pain and difficulty moving (often turning) their necks. The first question we ask is whether this person truly stiff or are their muscles guarding as a protective mechanism, limiting neck motion?
For the spine, there is not always a clear black and white answer of the specific anatomical structure causing neck symptoms and patients often get hung up on wanting a firm anatomical diagnosis.
It is common that we see patients who have neck pain that starts from their neck and goes all the way down their arm. Patients often describe this pain as sharp, shooting or lancinating. In some cases, numbness, tingling and pins & needles will be present.