1. Introduction / Plain Theory

Neck pain is an extremely common condition, affecting up to 70% of people at some point in their lives.
It can develop suddenly after strain or trauma, or gradually due to postural tension, repetitive load, or degenerative changes.

The cervical spine supports the head’s weight (around 4–5 kg) while allowing complex movement and protecting vital neural and vascular structures. Because of this dual role of mobility and stability, it is particularly sensitive to mechanical imbalance and stress.

Most neck pain is non-specific, meaning no single structure (disc, joint, muscle) can be clearly identified as the cause.
However, it often involves a combination of:

• Muscle tension and trigger points

• Facet joint restriction

• Postural strain and reduced movement coordination

• Stress-related or autonomic imbalance

Although typically benign, neck pain can become chronic or recurrent, especially when associated with stress, sedentary lifestyle, or prior injury (e.g., whiplash).

2. Typical Symptoms and Functional Impact

• Localised pain, stiffness, or tightness in the neck and shoulders

• Reduced range of motion (difficulty turning the head)

• Headaches or referred pain to the shoulders, upper back, or arms

• Dizziness, eye strain, or jaw tension (in some cases)

• Sleep disturbance or fatigue due to persistent discomfort

Functional impact:
Neck pain can affect concentration, driving, exercise, and work — especially for those in static or computer-based jobs.
Chronic tension may also lead to compensatory pain in the mid-back, jaw, or upper limbs.

Red flags:
Severe trauma, persistent neurological symptoms (numbness, weakness, or coordination issues), unexplained weight loss, fever, or night pain require immediate medical evaluation.

3. Contributing Factors / Underlying Causes

Neck pain is multifactorial, often involving both mechanical and systemic influences:

• Postural strain: forward head posture, prolonged screen use, or poor ergonomics.

• Muscle imbalance: overactivity of upper trapezius and underuse of deep stabilizers.

• Joint restriction: cervical or upper thoracic facet dysfunction.

• Stress and emotional tension: increased muscle tone and sympathetic activity.

• Degenerative changes: osteoarthritis, disc dehydration, or spondylosis.

• Whiplash or trauma: residual restriction or neural irritation.

• Referred pain: from the jaw (TMJ) or thoracic region.

Chronic neck pain often persists because of a cycle of guarding, reduced movement, and heightened sensitivity — not just structural damage.

4. Osteopathic Approach

Osteopathic treatment of neck pain aims to restore mobility, reduce strain, and support the body’s self-regulating capacity.
The approach is holistic — addressing not only the cervical spine but also related regions such as the thoracic spine, ribs, jaw, and diaphragm.

An osteopathic assessment may include:

• Postural and movement analysis to identify tension patterns.

• Gentle manual techniques (soft tissue, joint mobilisation, functional, or cranial methods) to improve motion and comfort.

• Addressing breathing mechanics, shoulder tension, and stress-related muscular activity.

• Advice on ergonomics, exercise, and relaxation strategies to maintain results.

Osteopathic care does not focus solely on the site of pain, but on restoring balance and coordination across the body’s systems — supporting both mechanical and nervous system regulation.

5. Scientific Evidence & References

Research supports manual therapy and exercise as effective first-line treatments for most forms of non-specific neck pain.
Systematic reviews show that combined approaches — addressing mobility, strength, and patient education — yield the best outcomes.
Osteopathic and gentle manipulative techniques have demonstrated positive effects on pain, mobility, and autonomic balance, with a strong safety profile when applied appropriately.

References

1. Fejer R, Kyvik KO, Hartvigsen J. The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J. 2006;15(6):834–848. Link

2. Blanpied PR, Gross AR, Elliott JM, et al. Neck pain: revision 2017 – clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health. J Orthop Sports Phys Ther. 2017;47(7):A1–A83. Link

3. Childs JD, Cleland JA, Elliott JM, et al. Neck pain: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health. J Orthop Sports Phys Ther. 2008;38(9):A1–A34. Link

4. Hoving JL, Gross AR, Gasner D, et al. Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain: a randomized, controlled trial. Ann Intern Med. 2002;136(10):713–722. Link

5. Vernon H, Humphreys BK. Manual therapy and exercise for neck pain: a systematic review. J Manipulative Physiol Ther. 2007;30(3):215–239. Link

6. Cerritelli F, Esteves JE, Martelli M, et al. The effect of osteopathic manipulative treatment on pain and autonomic function in patients with chronic neck pain: a randomized controlled trial. J Pain Res. 2021;14:1519–1530. Link

7. Franke H, Fryer G, Ostelo RWJG, et al. Osteopathic manipulative treatment for neck pain and related disorders: systematic review and meta-analysis. Pain Physician. 2020;23(3):205–216. Link

8. Xie Y, Chen Z, Yang Z, et al. Comparative safety and efficacy of manual therapy interventions for neck pain: a network meta-analysis. Front Med. 2024;15:1507255. Link