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Most neck and upper back pain is caused by a combination of factors, including injury, poor posture, chiropractic subluxations, stress, and in some instances, disc problems.

Most people do not realize how much they move their neck during the day until they are unable to do so. The degree of flexibility of the neck, coupled with the fact that it has the least amount of muscular stabilization and it has to support and move your 14 - 16 pound head, means that the neck is very susceptible to injury. You can picture your neck and head much like a bowling ball being held on top of a stick by small, thin, elastic bands. It doesn't take much force to disrupt that delicate balance.

The spinal cord runs through a space in the vertebrae to send nerve impulses to every part of the body. Between each pair of cervical vertebrae, the spinal cord sends off large bundles of nerves that run down the arms and to some degree, the upper back. This means that if your arm is hurting, it may actually be a problem in the neck! Symptoms in the arms can include numbness, tingling, cold, aching, and "pins and needles".

These symptoms can be confused with carpal tunnel syndrome, a painful condition in the hands that is often found in people who work at computer keyboards or perform other repetitive motion tasks for extended periods. Problems in the neck can also contribute to headaches, muscle spasms in the shoulders and upper back, ringing in the ears, otitis media (inflammation in the middle ear, often mistaken for an ear infection in children), temporomandibular joint dysfunction (TMJ), restricted range of motion and chronic tightness in the neck and upper back.

We associate the neck and upper back together, because most of the muscles that are associated with the neck either attach to, or are located in, the upper back. These muscles include the trapezius, the levator scapulae, the cervical paraspinal muscles and the scalenes, as well as others.

The Causes of Neck and Upper Back Pain

Most neck and upper back pain is caused by a combination of factors, including injury, poor posture, chiropractic subluxations, stress, and in some instances, disc problems.


By far, the most common injury to the neck is a whiplash injury. Whiplash is caused by a sudden movement of the head, either backward, forward, or sideways, that results in the damage to the supporting muscles, ligaments and other connective tissues in the neck and upper back. Whether from a car accident, sports, or an accident at work, whiplash injuries need to be taken very seriously. Because symptoms of a whiplash injury can take weeks or months to manifest, it is easy to be fooled into thinking that you are not as injured as you really are. Too often people don't seek treatment following a car accident or sports injury because they don't feel hurt. Unfortunately, by the time more serious complications develop, some of the damage from the injury may have become permanent. Numerous studies have shown that years after whiplash victims settle their insurance claims, roughly half of them state that they still suffer with symptoms from their injuries. If you have been in a motor vehicle or any other kind of accident, don't assume that you escaped injury if you are not currently in pain. Get checked out by a good chiropractor.

Forward head posture is very common for people who are stooped over their computers all day long. If not taken care of with chiropractic care, subluxations like this can worsen over time.

Poor Posture

One of the most common causes of neck pain, and sometimes headaches, is poor posture. It's easy to get into bad posture habits without even realizing it - even an activity as "innocent" as reading in bed can ultimately lead to pain, headaches, and more serious problems. The basic rule is simple: keep your neck in a "neutral" position whenever possible. Don't bend or hunch your neck forward for long periods. Also, try not to sit in one position for a long time. If you must sit for an extended period, make sure your posture is good: Keep your head in a neutral position, make sure your back is supported, keep your knees slightly lower than your hips, and rest your arms if possible.


When most people become stressed, they unconsciously contract their muscles. In particular, the muscles in their back. This 'muscle guarding' is a survival response designed to guard against injury. In today's world where we are not exposed to physical danger most of the time, muscle guarding still occurs whenever we become emotionally stressed. The areas most affected are the muscles of the neck, upper back and low back. For most of us, the particular muscle affected by stress is the trapezius muscle, where daily stress usually leads to chronic tightness and the development of trigger points.

The two most effective ways you can reduce the physical effects of stress on your own are to increase your activity level - exercise - and by deep breathing exercises. When you decrease the physical effects of stress, you can substantially reduce the amount of tightness and pain in your upper back and neck.

ACUTE NECK SPRAIN/STRAIN (Cervical Facet Syndrome & Whiplash) – This condition comprises approximately 75% of the neck pain that we treat in our office. It may be characterized by severe pain without radiation into your arms.  Patients may have difficulty turning their head, doing basic activities of daily living and feel very stiff and immobile.  This condition can be very debilitating.   It is the same physiology as a sprained ankle.  The joints get irritated and you get swelling, inflammation and muscle rigidity.  The good news is that with proper chiropractic care, this condition will get progressively better within 7 to 10 days. Initially ice and spinal manipulation are helpful for these conditions.

BIOMECHANICAL LESION/VERTEBRAL JOINT FIXATION – This is essentially what chiropractors treat.  When the spine gets injured, it causes muscles to tighten, resulting in joints that do not move properly (fixation). In addition to local symptoms, if the nerves are affected you may experience pain that radiates down one or both arms.  As chiropractors, we administer soft tissue therapy to relax the musculature, and spinal manipulation to get the joints moving again. Our goal is to restore the normal biomechanics of the spine, which will reduce pain and improve function.

CHRONIC NECK PAIN - This type of neck pain is characterized by mid to low grade pain.  It is usually a nagging type of dull stiffness that is not debilitating. Causes may vary from arthritis, vertebral joint fixation, disc degeneration, and/or old injuries that have left scar tissue in and around the joints, ligaments, tendons and muscles.  Heat and spinal manipulation are effective for chronic neck pain. These conditions will usually take longer to heal than acute neck sprains/strains.  The longer you have had a condition, the longer it will normally take to resolve.

CERVICAL DISC HERNIATION – This condition is characterized by neck pain with pain, numbness, tingling and/or weakness in one arm.  It is caused by a disc that bulges out putting pressure on the nerves exiting the spine. The arm pain can go into your hands and is usually more severe than the neck pain. This condition can be very debilitating.  Thankfully, 85% of herniated disc conditions will heal with conservative care.  Surgery is considered only when there is significant weakness in an upper extremity or the pain is unrelenting and uncontrollable.  Ice, spinal manipulation, traction and prescription medication are the first sources of treatment.  This condition may take months to fully resolve because of the nerve involvement.

DISC DEGENERATION - This is a chronic condition that takes years to develop.  When the discs of the spine start to degenerate, they dry out and become thinner.  The result is that the vertebrae get closer together. As the vertebrae get closer together, the openings for the nerves to exit the spine become reduced. This condition is characterized by medium to low grade pain that is usually dull and achy.  Ranges of motion are reduced.  If the discs become severely degenerated, the nerves may get impinged and result in pain that radiates down the upper extremity. Initial treatment is heat, spinal manipulation and sometimes a home traction unit is recommended. Since this is a chronic condition, it may take a few months for this to fully stabilize.

 OSTEOARTHRITIS – This is also called “wear and tear” arthritis. The degree of osteoarthritis a patient gets is determined by genetics and how much abuse the joints have suffered during a patient’s lifetime.  It is characterized by joint stiffness and pain.  Most patients feel stiff and achy in the morning. The joints loosen up as the day progresses and symptoms may improve.  Later in the day, the patient’s symptoms may worsen due to ongoing stress on the joints.  Chiropractic care can help keep arthritic joints loose and flexible thereby decreasing the symptoms of osteoarthritis.  Since osteoarthritis is not curable, ongoing care is needed to keep symptoms under control.