The Bespoken Word

Rx: Neck Pain


Rx: Neck Pain


The cervical spine is an area of your vertebral column commonly referred to as your neck. The cervical spine consists of 7 vertebrae that begin at base of the skull continue to your upper back. Between each vertebrae are vertebral discs that absorb shock between the bones. There are also ligaments and muscles surrounding your cervical spine that support your head & allow for range of motion.

Below is a list of the muscles of the cervical spine & their function:

  • Sternocleidomastoid – extends & rotates head, flexes vertebral column
  • Scalenus – flexes & rotates neck
  • Spinalis Cervicis – extends & rotates head
  • Spinalis Capitus – extends & rotates head
  • Semispinalis Cervicis – extends & rotates vertebral column
  • Semispinalis Capitus – rotates head & pulls backward
  • Splenius Cervicis – extends vertebral column
  • Longus Colli Cervicis – flexes cervical vertebrae
  • Longus Capitus – flexes head
  • Rectus Capitus Anterior – flexes head
  • Rectus Capitus Lateralis – bends head laterally
  • Iliocostalis Cervicis – extends cervical vertebrae
  • Longissimus Cervicis – extends cervical vertebrae
  • Longissimus Capitis – rotates head & pulls backward
  • Rectus Capitus Posterior Major – extends & rotates head
  • Rectus Capitus Posterior Minor – extends head
  • Obliquus Capitus Inferior – rotates atlas

*muscle list from*


[Mechanism of Injury + Affected Tissues]

With “good” head posture the stress on your cervical spine or neck is minimized because the head’s weight is “naturally” balanced on the spine

Forward head posture (poor head posture) occurs when the heads slants forward – position of the head is in front of the midline of the body. Basically the head is placed further in front of the shoulders rather than directly in line. Imagine this posture, then add in looking down at your tablet or laptop… that’s tech neck. The more prolonged this poor posture occurs the more likely that neck pain, muscle strain and or stiffness may begin

photo from


While there are many different types & causes of neck pain, the underlying principles of treatment are pretty much the same. You want to avoid movements that are painful, while encouraging those that are not. Don’t stop moving, just move more intelligently.

Like low back pain, neck pain can come from a variety of sources. In this series we’ve focused on the most common type of neck pain our practice sees: tech neck. This is a semi-affectionate term for neck pain that is predominantly related to sitting and working at a desk 5 days a week.

Typically, people experience symptoms at the base of the neck on either side, which can refer further down the back of the shoulder. It’s not uncommon to also have pain at the top of the neck near the base of the skull. This is fairly common for people who work on laptops and frequently crane their neck to push their head forward closer to their screen.

Whatever the cause of your neck pain, it’s important to improve your desk hygiene and build a routine that will help you manage your body pain and position throughout the day to avoid tech neck.

Physical Therapy should focus on:

Modulating the pain

Mobilizing the soft tissue surrounding the joint (cervical spine, thoracic spine, & postural musculature)

Postural alignment changes made by your Physical Therapist

Strengthening the muscles surrounding the joint (cervical spine, thoracic spine, & postural musculature)

Making the proper  modifications to promote pain free activities & movements

photo from


[Healing Timeline]

In most cases neck pain is not a serious condition and can be relieved within a few days with physical therapy. But in some cases, neck pain can indicate can be very serious, which if untreated can lead to chronic pain.

If you have neck pain that continues for more than a week or 2, if its severe pain, or if it causes radicular nerve pain please seek medical attention immediately.



Neck pain ranks in the top 5 disorders in the USA

10-20% of people in the USA report incidents of neck pain

Studies show that neck pain may impact your physical, social & mental well-being

Common causes of neck pain include: muscle sprains & strains, disc herniation, osteoarthritis (OA may be present in up to  50% of all neck pain cases in individuals over 50 years old) , and/ or DDD or degenerative disc disease

Factors that may influence neck pain include: physical activity – repetitive movements causing straining, ergonomics – think… work desk and travel ergonomics

Neck pain has been linked to conditions such as heart illnesses & cancers – including lung cancer that has spread to shoulders, neck & lower back


Check out our Instagram post for a short Neck Pain rehab guide – @BespokeTreatments Rx: Neck Pain

*This does not constitute medical advice. If you have pain or injury please consult a medical profession in person