Neck pain
Neck pain can appear suddenly, for example on waking with a stiff neck, or build up gradually with work posture and accumulated tension. It may stay in the neck or spread to the shoulder, between the shoulder blades or down the arm, and is sometimes accompanied by headaches.
Some episodes improve in a few days or weeks. Others persist or come back regularly. Several structures can be involved: the joints of the neck, the muscles, a nerve root, or a combination of these. Identifying them is the purpose of the assessment.
Dr. François Hains, chiropractor, devoted his master's research in community health at the Université de Montréal to the reliability of clinical examination and diagnosis in chronic neck pain.
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When to see a doctor without waiting
Some signs call for prompt medical assessment rather than a chiropractic appointment. See a doctor right away, or go to the emergency department, if neck pain comes with any of the following:
- A sudden, severe headache unlike any you have had before
- Dizziness, double vision, difficulty speaking or swallowing
- Numbness, tingling or weakness in both arms, or in the legs
- Clumsiness of the hands or difficulty walking
- Pain in the chest or jaw, or shortness of breath
- Fever, unexplained weight loss, a history of cancer, or pain following a fall or accident
What an assessment involves
Screening for warning signs
Before anything else, the examination aims to rule out signs that may point to a condition requiring medical investigation. If one is present, you will be referred to a doctor.
The history of your pain
How it began, where it is felt, whether it spreads to the shoulder, arm or head, what aggravates and relieves it, and your work and sleep posture.
The neurological examination
Strength, reflexes and sensation in the arms and hands, to check whether a nerve root may be involved.
The neck, shoulders and upper back
Movement, joints and muscles of the neck and surrounding regions, including points of muscular tension that can refer pain to the head or shoulder.
A plan discussed with you
If chiropractic care is indicated, your chiropractor explains the options and the reasoning behind them, and gives you an estimate of how long care should last and how many visits to expect. If it is not, he will tell you and direct you to the appropriate professional.
Care, when indicated
Depending on what the assessment shows and on your preferences, care may include myofascial therapy by ischemic compression applied to points of muscular tension, spinal mobilisation or manipulation, and an exercise programme adapted to your situation. Advice on work posture and daily activities is also part of it.
Progress is reassessed at planned intervals. If your condition does not evolve as expected, or if further tests appear necessary, your chiropractor will refer you to your doctor.
If your neck pain followed a car or workplace accident, see the page on whiplash and neck sprain.
Common questions
Can headaches come from the neck?
Some headaches are associated with problems in the neck or with muscular tension. The assessment aims to determine whether that is the case. A sudden, severe headache, or one unlike those you usually have, calls for medical assessment.
Do I need an X-ray?
Imaging is not requested routinely. It is considered when clinical signs warrant it or when the condition does not evolve as expected. If you already have imaging results or reports, bring them to your first visit.
How many visits will I need?
It depends on your situation. After the assessment, your chiropractor will give you an estimate of how long care should last and how many visits to expect.
Talk to us about your pain
Reach our team directly. No online form needed.