What is causing my neck pain?
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. While MRIs may show lots of scary words, they are notorious for false positives and often show findings that are likely irrelevant, leading to unnecessary surgeries. The false positive finding means they show findings that are present in the vast majority of the population, including folks with no neck pain.
Due to this inability to identify an exact structure causing neck pain, even with an MRI, patients are best treated on a “signs and symptoms” approach. We look for characteristics in your presentation that show you are more likely to respond successfully to certain interventions and exercises.
For more details on the “signs and symptoms approach,” please see the following articles:
- Neck pain and mobility deficits
- Neck pain and motor control impairments
- Neck pain with headaches
- Neck and arm pain
- “Neck Pain Guidelines: Revision 2017: Using The Evidence To Guide Physical Therapist Practice,.”. Vol 47, no. 7, 2017, pp. 511-512. Journal Of Orthopaedic & Sports Physical Therapy (JOSPT), https://doi.org/10.2519/jospt.2017.0507.
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.