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

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

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

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
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
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
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
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
Norkin, C. C., & White, D. J. (2016). Measurement of Joint Motion: A Guide to Goniometry (5th ed.). FA Davis.
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
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
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