Understanding Neck Pain & Stiffness: An Osteopath’s Perspective Dr Andrew Welsh, PhD

Understanding-Neck-Pain
Understanding Neck Pain & Stiffness

Neck pain is a common issue that affects many people, often disrupting daily activities like working, driving, or even sleeping comfortably. In our modern, fast-paced lives, with prolonged screen time and increased stress, neck discomfort has become more common at our clinic. At Eclipse Health & Osteopathy, we take a whole-body approach to neck pain, focusing not just on the neck itself but also on related areas that might be contributing to the issue, as well as factors that may a play a role in limited movement, like the aging process, postures and repetitive strains.

What is Neck Pain & Stiffness?

Neck pain can range from mild stiffness to severe discomfort, affecting your ability to move your head freely. You might notice symptoms like muscle tightness, headaches, shoulder pain, or even tingling in the arms. While poor posture is a common cause, neck pain can also result from injuries, stress, or underlying medical conditions.

Neck pain can be classified as either acute (short-term) or chronic (long-lasting). Acute neck pain often results from muscle strain or sudden movements, while chronic pain may be related to ongoing posture issues, degenerative changes, or stress-related muscle tension.

In today’s busy and often stressful world, with limited opportunities for rest and recovery, stress can also play a significant role in neck pain. Clenching your jaw, tensing your shoulders, or sitting hunched over for extended periods can contribute to muscle tightness and discomfort.

The Value of the Osteopathic Approach

We focus on treating the whole person, not just the area of pain. Our goal is to help reduce discomfort and improve how your neck and body work together. We use gentle, hands-on techniques to ease tension, restore movement, and support your body’s natural balance.

Our approach may include:

  • Gentle stretches and exercises with the goal often being to improve neck mobility and strengthen supporting muscles (Gross et al., 2016).
  • Hands-on therapy commonly aiming to release muscle tension and promote better joint function (Bronfort et al., 2012).
  • Posture advice to help reduce strain on the neck and shoulders. A combination of manual therapy and stabilising exercises has been shown to improve forward head posture and rounded shoulders, reducing strain on the neck over time (Fathollahnejad et al., 2019).
  • Relaxation techniques to support overall wellbeing and help manage stress-related tension. Adding relaxation training to stabilisation exercises has been shown to lead to significant improvements in pain intensity, pressure pain threshold, cervical range of motion, and movement-related fear in individuals with chronic neck pain (Özer Kaya & Toprak Çelenay, 2019). Post-isometric relaxation techniques (often referred to as gently “push-and-relax”) have also been found to effectively reduce pain and disability in those with non-specific neck pain (Khan et al., 2022).
  • Measurement of movement using goniometry to assist in examination, treatment, and reassessment of progress (Norkin & White, 2016).

Measuring neck ROM

Understanding-Neck-Pain

(© 2025 Dr Andrew Welsh, PhD)

The Importance of Measuring Movement

To better understand how your neck is functioning, we use goniometry, a method of measuring joint movement. This allows us to assess range of motion (ROM) at the beginning of treatment and track improvements over time.

According to Norkin & White (2016, p. 452-454), certain ranges of motion are necessary for daily activities. For example:

  • 40–50 degrees of cervical flexion (bringing the chin to the chest) is required for activities like looking down to tie shoelaces.
  • 60–70 degrees of cervical rotation (turning the head) is essential for driving and checking blind spots.
  • 40–50 degrees of cervical extension (tilting the head back) is needed for looking up at the ceiling.

Considering these approximate functional ROM requirements helps us to consider how to help each person to restore the movement they require to complete their daily tasks. In this way, we are not simply “rubbing sore spots” but trying to improve our capacity to perform activities and quality of life.

It is also common for people to believe that stiffness and reduced mobility are simply a normal part of aging. Multiple studies have researched this question, and while many agree that some neck movements tend to stiffen over the later decades of life, it is a little more complicated than that, with two studies finding that rotation (looking over your left and right shoulder) increases near the top of the neck as we reach older ages, perhaps to compensate for the common stiffening in the lower levels of our neck (Norkin & White, 2016). Importantly, research suggests that between the ages of 15 and 45, the neck range of motion does not significantly decline (Tommasi et al., 2009). In fact, flexion and extension movements (looking down and up)  were found to be very similar between younger and middle-aged adults, with only minor, non-significant differences (Norkin & White, 2016). So, for people in this age-bracket, on average, these findings challenge the belief that one must accept increasing stiffness or discomfort due to age alone. Instead, these findings highlight the importance of identifying other contributing factors, such as posture, muscular imbalances, and lifestyle habits, which may be more relevant to neck mobility and discomfort. This is what we aim to help people explore at Eclipse Health & Osteopathy.

How Hands-On Therapy May Help

Research has shown that hands-on therapy can benefit people experiencing neck pain. Techniques like gentle spinal mobilisation, soft tissue massage, and muscle relaxation can help ease pain and improve range of motion (Bronfort et al., 2012).

Several studies have compared the effectiveness of different manual therapy techniques—such as manipulation, mobilisation, muscle energy techniques (MET), and proprioceptive neuromuscular facilitation (PNF)—in alleviating neck pain and improving range of motion (ROM) (Sbardella et al., 2021).

  • Manipulation vs. Mobilisation: A Cochrane review evaluated the effects of manipulation and mobilisation for neck pain. Both treatment interventions produced similar pain relief and functional improvement outcomes, but further research is required (Gross et al., 2010).
  • Muscle Energy Technique (MET): A systematic review by Sbardella et al. (2021) assessed the efficacy of MET in reducing neck pain and improving cervical ROM. The analysis indicated that MET could effectively decrease pain and enhance ROM in individuals with both acute and chronic neck pain.
  • Proprioceptive Neuromuscular Facilitation (PNF): A recent study compared the effectiveness of PNF therapy to manual therapy in patients with chronic mechanical neck pain. The findings suggested that PNF was more effective in reducing pain and improving ROM and functional disability than manual therapy (Khan et al., 2022).
  • MET vs. PNF: A randomised controlled trial compared the efficacy of MET and PNF in individuals with chronic mechanical neck pain. Both techniques were effective in reducing pain and improving ROM; however, the study did not find a significant difference between the two methods, suggesting that either could be beneficial depending on individual patient needs (Khan et al., 2022).

 

Considering Osteopathy for Neck Pain?

If you are experiencing neck pain and looking for a holistic approach, osteopathy may be a beneficial option. At Eclipse Health & Osteopathy, we focus on helping you regain comfort and function by addressing the root causes of your discomfort. Our hands-on approach aims to improve mobility, ease tension, and support overall well-being.

Get in touch with us today to discuss how we can support your journey to better health.

 

References

  1. Bronfort, G., Evans, R., Anderson, A. V., Svendsen, K. H., Bracha, Y., & Grimm, R. H. (2012). Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomised trial. Annals of Internal Medicine, 156(1 Pt 1), 1–10. https://doi.org/10.7326/0003-4819-156-1-201201030-00002
  2. Fathollahnejad, K., Letafatkar, A., & Hadadnezhad, M. (2019). The effect of manual therapy and stabilising exercises on forward head and rounded shoulder postures: a six-week intervention with a one-month follow-up study. BMC Musculoskeletal Disorders, 20, 86. https://doi.org/10.1186/s12891-019-2438-y
  3. Gross, A., Miller, J., D’Sylva, J., Burnie, S. J., Goldsmith, C. H., Graham, N., Haines, T., Brønfort, G., Hoving, J. L., & COG (2010). Manipulation or mobilisation for neck pain: a Cochrane Review. Manual therapy, 15(4), 315–333. https://doi.org/10.1016/j.math.2010.04.002
  4. Gross, A. R., Paquin, J. P., Dupont, G., Blanchette, S., Lalonde, P., Christie, T., Graham, N., Kay, T. M., Burnie, S. J., Gelley, G., Goldsmith, C. H., Forget, M., Santaguida, P. L., Yee, A. J., Radisic, G. G., Hoving, J. L., Bronfort, G., & Cervical Overview Group (2016). Exercises for mechanical neck disorders: A Cochrane review update. Manual Therapy, 24, 25–45. https://doi.org/10.1016/j.math.2016.04.005
  5. Khan, Z. K., Ahmed, S. I., Baig, A. A. M., et al. (2022). Effect of post-isometric relaxation versus myofascial release therapy on pain, functional disability, ROM, and QoL in the management of non-specific neck pain: A randomised controlled trial. BMC Musculoskeletal Disorders, 23, 567. https://doi.org/10.1186/s12891-022-05516-1
  6. Norkin, C. C., & White, D. J. (2016). Measurement of Joint Motion: A Guide to Goniometry (5th ed.). FA Davis.
  7. Özer Kaya, D., & Toprak Çelenay, Ş. (2019). Effectiveness of relaxation training in addition to stabilisation exercises in chronic neck pain: A randomised clinical trial. Turkish Journal of Physiotherapy and Rehabilitation, 30(3), 145-153. https://doi.org/10.21653/tjpr.665131
  8. Sbardella, S., La Russa, C., Bernetti, A., Mangone, M., Guarnera, A., Pezzi, L., Paoloni, M., Agostini, F., Santilli, V., Saggini, R., & Paolucci, T. (2021). Muscle Energy Technique in the Rehabilitative Treatment for Acute and Chronic Non-Specific Neck Pain: A Systematic Review. Healthcare (Basel, Switzerland), 9(6), 746. https://doi.org/10.3390/healthcare9060746
  9. Tommasi, D. G., Foppiani, A. C., Galante, D., Lovecchio, N., & Sforza, C. (2009). Active head and cervical range of motion: effect of age in healthy females. Spine, 34(20), 2098-2103. https://doi.org/10.1097/BRS.0b013e3181afe826
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Whiplash Associated Disorder

Whiplash Associated Disorder

Whiplash Associated Disorder is when soft tissue damage (stretch, tearing or rupture) to the ligaments, muscles, intervertebral discs, and other tissues surrounding the cervical spine leads can lead to a variety of symptoms. This typically occurs after a rapid acceleration/deceleration of the neck with some twisting involved. During the trauma damage can occur to the muscles at the front and back of the neck. The movement that causes this is hyperextension (hyper = increase) and hyperflexion.

Symptoms of whiplash associated disorder include neurological referral to the upper extremities, local swelling and redness, headaches, decreased sleep and range of motion. Dizziness can also occur that can be accompanied by ear ringing and double vision.

There are three grades of whiplash disorder. Grade one is when there is mild swelling and stretch, no instability, mild pain at end of range and recovery occurs within two to fourteen days. Grade two involves mild to moderate swelling and instability, ligament damage and recovery occurs between fourteen days and two months. Finally grade three is when there is severe swelling with clear bruising. Possible fracture with instability and ligament damage, complete loss of motion and recovery takes one to three months.

Whiplash most commonly occurs in women in their late 30’s and early 40’s and commonly occurs during motor vehicle accidents, skating and surfing incidents.

Assessment:

Testing of all range of motion of the neck is important to identify any joint sprains or ligament/muscle strains and they are often identified during range of motion. Tests aimed at identifying nerve tension, referral pain and joint injury are also performed. Neurological testing of the nerves of the upper limb (arm) and the head are also performed regardless of whether the patient is experiencing neurological symptoms (numbness, tingling weakness) or is feeling dazed. Imaging such as CT scans can be helpful in showing decreased cervical lordosis (angle of the neck). MRI can also show impact on the soft tissue (muscle, ligament).

Review of evidence for management

Manual Therapy has been shown to decrease muscular tension, increase biomechanical function and prevent contractures. It is not recommended to manipulate in the acute stages of injury however mobilisation of the area to increase blood flow to tissues and impact neuromuscular link to decrease guarding and therefore tissue tension. Once past the acute stage of whiplash depending on the severity manipulation may be considered.

Passive methods such as the use of ice, heat, tens machines and manual therapy assist in preventing chronic pain and disability. They can also decrease inflammation as well as stretch and strengthen muscles of the cervical spine. Your therapist may provide activities that aim to improve strength, endurance, posture, body mechanics and flexibility. It is recommended the patient attend sessions 3 times per week for 4-8 weeks.

Preventatively if patients are involved in a high intensity sport it is recommended that patients stretch before and after activity especially if they are involved in high intensity sport.

Long term therapy includes regaining quality and full quantity of range of motion as well as postural teachings to ensure stabilisation, decreased loading and increased ergonomics.

If you would like too receive treatment for whiplash please call 07 5613 3505 or book through our website.

References

Bickley, R., Belyea, C.M., Harpstrite, J.K., Min, K.S. (2021). Surfing Injuries: A Review for the Orthopaedic Surgeon.  Journal of Bone and Joint Surgery, 9 (4). Pp 1-9. https://doi.org/10.2106/JBJS.RVW.20.00152

Freeman, M.D., Talavera, F., Klein, M.J., Hunter Jr., O.K., Childers, M.K. (2021, April 9). Cervical Sprain and Strain Treatment & Management. Medscape. Cervical Sprain and Strain Treatment & Management: Rehabilitation Program, Medical Issues/Complications, Surgical Intervention (medscape.com)

Matsushita, E. (2019). Oupatient physical therapy for a patient with chronic neck

pain secondary to whiplash associated disorder. [PhD Thesis, California State University] 5712m7024 (calstate.edu)

McArthur, K., Jorgensen, D., Climstein, M., Furness, J. (2020). Epidemiology of Acute Injuries in Surfing: Type, Location, Mechanism, Severity, and Incidence: A Systematic Review. Sports, 8(2), pp 25. https://doi.org/10.3390/sports8020025

Meir R.A, Zhou, S., Rolfe, M.I., Gilleard, W.L., Coutts, R.A. An investigation of surf participation and injury prevalence in Australian surfers: a self-reported retrospective analysis. New Zea- land J Sports Med. 2012;39(2):52-8. (PDF) An investigation of surf participation and injury prevalence in Australian surfers: a self-reported retrospective analysis (researchgate.net)

Parravicini, G. (PT, DO) & Ghiringhelli, M. (PT, DO) (2021). Osteopathic Cranial Manipulation for a Patient With Whiplash-Associated Disorder: A Case Report. Journal of Chiropractic Medicine, 20(3), pp. 163-169. https://doi.org/10.1016/j.jcm.2021.12.003

 

Vizniak, N.A., (2019). Evidence-Informed Orthopaedic Conditions. 3rd edition. Prohealthsys.

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Common Causes Of Neck Pain and How an Osteopath Can Help

Common Causes Of Neck Pain and How an Osteopath Can Help

Common Causes of Neck Pain and How an Osteopath Can Help

Neck pain is a common condition that affects numerous individuals at some point in their lives. It can be caused by various factors, ranging from poor posture and muscle strain to trauma and underlying medical conditions. If you’re suffering from neck pain, it’s crucial to understand the potential causes and seek appropriate treatment. In this article, we will explore some common causes of neck pain and how an osteopath can help alleviate your discomfort.

Poor Posture and Muscular Imbalances

One of the leading contributors to neck pain is poor posture. Many of us spend hours sitting hunched over a computer or crane our necks downwards to look at our smartphones, unknowingly placing tremendous strain on the neck and upper back muscles. This prolonged stress can lead to muscular imbalances and tension, ultimately resulting in neck pain.

Additionally, sedentary lifestyles and lack of physical activity can weaken the neck muscles, making them more susceptible to injury and pain. Osteopaths are skilled professionals who can assess your posture and identify muscular imbalances that may be causing your discomfort. Through targeted manual techniques, they can help restore balance, relieve tension, and alleviate neck pain.

Workplace Ergonomics

Many individuals spend a significant portion of their day sitting at a desk, often in environments with poor ergonomic setups. Inadequate support for the neck and back, poorly positioned monitors, and improper chair and desk heights can all contribute to neck pain. Over time, these improper workplace ergonomics can generate excessive strain, leading to discomfort and stiffness in the neck area.

An osteopath can advise you on proper workplace ergonomics, such as optimal seat height, desk positioning, and monitor placement to minimize the strain on your neck. They may also suggest stretches or exercises that you can incorporate into your daily routine to reinforce good posture and alleviate neck pain.

Stress and Emotional Tension

It’s no secret that chronic stress and emotional tension can wreak havoc on our bodies. Stress often manifests physically, and the neck is a common area to experience the effects. Stress-induced neck pain can result in muscle tightness and knots that further exacerbate the discomfort.

Osteopaths understand the interconnectedness of the body, mind, and emotions. They can employ various manual techniques, including soft tissue manipulation and gentle joint mobilization, to address not only the physical symptoms but also the underlying emotional tension contributing to neck pain. By promoting relaxation and releasing muscular tension, osteopaths can provide relief from stress-related neck pain.

Trauma and Whiplash Injuries

Sudden trauma, such as car accidents or falls, can cause significant damage to the delicate structures of the neck. Whiplash is a common injury that occurs when the head is jerked forward and then forcefully snapped back, straining the muscles, ligaments, or tendons in the neck.

If you’ve experienced trauma or suspect a whiplash injury, it is essential to seek immediate medical attention. Osteopaths can play a crucial role in the rehabilitation process by restoring proper alignment, reducing inflammation, and promoting tissue healing. Through gentle manipulations and specialized techniques, they can help relieve pain, restore range of motion, and aid in the recovery of whiplash-related neck injuries.

Medical Conditions and Degenerative Changes

Sometimes, neck pain may be a symptom of an underlying medical condition or degenerative changes in the spine. Conditions such as osteoarthritis, cervical disc herniation, spinal stenosis, and fibromyalgia can all cause chronic neck pain.

An osteopath can work in collaboration with your healthcare team to manage these conditions using a holistic approach. They focus on enhancing overall well-being by addressing the musculoskeletal components that contribute to your neck pain. Osteopathic treatment can help you optimize joint mobility, alleviate muscle tension, and reduce the impact of underlying medical conditions on your daily life.

Neck pain can be a debilitating condition that negatively affects your overall quality of life. Identifying the causes of neck pain is the first step towards effective treatment and relief. Osteopaths are skilled healthcare professionals who can provide personalized treatment plans catered to your specific needs. Whether your neck pain is a result of poor posture, workplace ergonomics, stress, trauma, or an underlying medical condition, an osteopath can help alleviate your discomfort and restore optimal neck function. Don’t let neck pain hold you back; consult an osteopath today for an accurate diagnosis and a customized treatment plan.

The Osteopaths at Eclipse Health and Osteopathy are all very experienced in assessing and treating neck pain. We offer techniques that range from extremely gentle and indirect to spinal adjustment. 

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