Neck Pain Explained: Types, Causes, and How Physiotherapy Can Help

Neck pain is extremely common and can affect anyone — from desk workers and parents to athletes and tradespeople. It may appear as stiffness, aching, sharp pain, headaches, or symptoms radiating into the arm.

Despite how common it is, neck pain is often misunderstood. Many people worry about discs, posture, arthritis, or permanent damage — especially after reading scan reports or online information.

This guide explains the different types of neck pain, what usually causes them, when physiotherapy is helpful, and when medical review is important.

Why Neck Pain Happens

The neck is a highly mobile structure designed to support the head while allowing movement in all directions. Because of this mobility, it is also sensitive to changes in load, posture, fatigue, stress, and recovery.

In most cases, neck pain does not come from one structure being “damaged”. Instead, it reflects a combination of tissue sensitivity, reduced capacity, and nervous system involvement.

The Main Types of Neck Pain

1) Mechanical Neck Pain (Most Common)

Mechanical neck pain changes with movement, posture, or activity. It is the most common type of neck pain seen in physiotherapy clinics.

• Stiffness or aching
• Pain with turning or sustained positions
• Symptoms that fluctuate day to day
• Often improves with appropriate movement

Mechanical neck pain responds very well to physiotherapy.

2) Neck Pain with Headaches (Cervicogenic Headache)

Some headaches originate from the neck rather than the head itself. These are known as cervicogenic headaches.

Common features include pain that:

• Starts at the base of the skull
• Spreads toward the temples or behind the eyes
• Is aggravated by neck movement or sustained posture

Physiotherapy can help by improving neck mobility, reducing sensitivity, and addressing contributing movement patterns.

3) Nerve-Related Neck Pain (Cervical Radiculopathy)

Nerve-related neck pain occurs when a cervical nerve becomes irritated or sensitised. This is sometimes referred to as a “pinched nerve”.

Symptoms may include:

• Pain radiating into the arm or shoulder blade
• Tingling or numbness
• Weakness in certain movements
• Neck pain combined with arm symptoms

Importantly, nerve symptoms do not automatically mean permanent damage or surgery. Many cases improve with conservative management.

4) Non-Mechanical or Inflammatory Neck Pain (Uncommon)

Less commonly, neck pain may not change with movement or posture. This type requires careful assessment and medical input.

Warning signs may include constant pain, severe night pain, significant morning stiffness, fever, or unexplained weight loss.

Do You Need Imaging for Neck Pain?

In most cases, imaging such as X-rays or MRI is not needed early on. Scans often show age-related changes that are common in people without pain.

Imaging is usually recommended only if:

• There has been significant trauma
• Progressive neurological symptoms are present
• Red flags are identified
• Symptoms are not improving as expected

How Physiotherapy Helps Neck Pain

Physiotherapy focuses on restoring confident movement and reducing sensitivity, rather than simply “fixing” posture or treating one structure.

• Reducing pain and stiffness
• Improving mobility and strength
• Guiding safe return to work, exercise, and sport
• Reducing recurrence of flare-ups
• Education and reassurance

Should You Rest or Keep Moving?

For most neck pain, gentle movement is better than prolonged rest. Complete avoidance often increases stiffness, sensitivity, and fear.

The goal is to move within tolerance and gradually build confidence.

When Neck Pain Needs Urgent Medical Review

Seek medical assessment if neck pain is associated with:

• Significant trauma
• Progressive weakness or numbness
• Loss of coordination
• Severe, unrelenting night pain
• Fever or signs of infection
• Unexplained weight loss

Key Takeaways

• Most neck pain is mechanical and treatable
• Pain does not automatically mean damage
• Imaging is often unnecessary
• Movement is usually safe and helpful
• Physiotherapy addresses causes, not just symptoms

FAQ

Final Word

Neck pain can be uncomfortable and worrying, but it is rarely dangerous. Understanding what type of neck pain you have — and how it behaves — is the first step toward confident recovery.

Physiotherapy is not about “fixing” your neck. It’s about helping you trust and use it again.