Neck Pain

The neck is the most flexible part of spine and has the responsibility of supporting the weight and movement of head. Neck pain occurs due to alterations in biomechanical position.

Typical Neck Injuries

Common causes for neck pain can be from postural issues, trauma such as whiplash injuries, which are the most common injury in motor vehicle accidents, and degenerative diseases like cervical spondylosis. Whiplash injuries affect 83% of people involved in motor vehicle accidents. Though the exact mechanism of injury is not known, the definition is “an acceleration-deceleration mechanism of energy transferred to the neck usually as a result of a motor vehicle crash”, according to the International Association for the Study of Pain. Some clinical symptoms are neck stiffness and pain, headaches, visual disturbances, altered sensation and even psychological distress. 

Cervical spondylosis is where the intervertebral disc dehydrates and arthritis develops at the vertebra with age. Another age-related disease is cervical stenosis which is where the canal which houses the spinal cord gets narrowed, compressing the nerves causing symptoms. Along with that, the ligaments surrounding the vertebrae also thicken and become less stretchable. These degenerative diseases can happen in a combination, not necessarily as a singular event and also can be brought about by traumatic injuries like a whiplash injury.  

Another common cause of neck pain is cervical disc herniations. The mechanism of disc herniations is well known as the compression of nerves by a bulging disc along with inflammation.

These injuries may develop over time but can also happen in acute settings where there is a sudden onset. If not treated quickly, prolonged symptoms will persist and develop into a chronic injury.


Neck injury management is initially focused on reducing symptoms. 

As symptoms reduce, the therapist will begin with exercises. The prescribed exercises aim to improve range of motion (pain-free) and activate the muscles surrounding the cervical spine. As the cervical spine (neck) experiences less/no pain, the exercises will change to focus on improving the overall health of the neck. 

At Terramed, we focus especially on home exercise/education programs (HEP), which include educating patients on specific rest positions that prevent unnecessary strain on the neck. 


Helpful with acute neck injuries such as neck strain helps to reduce inflammation. 

Hot pack/heat therapy

For chronic neck injuries such as neck pain, neck spondylosis and stiff neck.

Soft tissue mobilization/massage

Relaxes the spasm/tight muscle, which helps to move the neck through full range with less/no pain.

Electrical muscle/nerve stimulation

Relieves pain by sending electrical impulses gently through the skin and gives deep massage effects.

Therapeutic Ultrasound

is applied on the injured area (both acute & chronic). Helps to ease pain and enhance healing.

Cervical traction

Done by machine or manual technique. May help to take away pressure and create space in between the spinal discs compressing the cervical nerve. 

Sport Therapy for Neck Pain

The neck is the most flexible part of spine and has the responsibility of supporting the weight and movement of head. Neck pain occurs due to alterations in biomechanical position. Constant repetition of improper posture such as leaning the head forward leads to large and undue forces on neck muscles and joints, which are susceptible to neck strain, tension, and fatigue. While neck pain is short-term, long-term exposure to poor head and neck posture can often lead to headaches and even degeneration of the bones, discs, and joints of the spine. 

 Poor posture at any level may lead to muscle imbalances. Uppercross syndrome (UCS) is a postural distortion pattern resulting in muscle imbalances, referring to the crossing X pattern of the overactive muscles with the countercrossing of the underactive muscles of upperbody region. The overactive muscles form a diagonal pattern from the posterior neck with the upper trapezius and levators down and across to the anterior neck and shoulder with the sternocleidomastoid (SCM), pectoralis major and minor. The other side of the X now depicts the underactive muscles, with the deep cervical flexors down toward the mid/lower trapezius, rhomboids and serratus anterior. The lengthening of tight muscles and strengthening of weak muscles can help to restore correct posture. 

Prevention & Reconditioning 

The key to preventing neck related injury & pain is having a stable neck. Having a stable neck would mean that you have a strong balance of postural neck muscles. Most people subconsciously tend to rely on their superficial neck muscles and neglect the use of the deeper supporting muscles which predisposes them to future neck injury. Weak postural muscles increase stress placed on the cervical spine which can lead to neck pain. In this topic we will explain the importance of training the deeper postural neck muscles for overall neck health and a few ways to train them.

The deep neck flexor muscles in particular are commonly neglected. These muscles sit deep in the front of the neck, behind the trachea. Due to the short length of the muscle and their close proximity with the spine, they have an important role in providing neck stability.

The chin tuck is an underrated exercise which helps strengthen the deep neck flexors hence pulling the neck into better postural alignment.

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