Are you a “pain in the neck”? – Trends in Mechanical Neck Pain

Mechanical Neck Pain Treatment

In general, neck pain is a result of trauma / injury, poor posture (sitting, standing, while we sleep, through activity), degeneration, and various diseases.

The primary types of neck pain tend to fit into four categories: mechanical (musculotendinous, ligamentous, and joint), referred (pain arising from a different source), radicular (nerve root irritation), and myelopathic (relating to the spinal cord).

In this post, I will outline an interesting trend that relates to mechanical neck pain. Again, mechanical neck pain arises from dysfunction of muscle, tendon, ligament, bone, or joint.

In a comparison study by Yoshida and colleagues (1), when compared to individuals without neck pain, those with neck pain had hypomobility (too little) in cervical vertebrae 3, 4, and thoracic vertebrae 1 and 2 and hypermobility (too much) in cervical vertebrae 5, 6, and 7.

This is a trend found in individuals who have less active lifestyles, are required to sit for prolonged periods for work or recreation, or had a previous injury associated with the head or vertebrae in the upper neck. This presents as pain local to the mid-lower neck, stiff with motion, and often headaches.

How do we address this?

A guided combination of strength for the neck and mobility for the upper and mid back, through help from a physical therapist and exercises for self-maintenance, can help reduce and resolve this form of neck pain. See 2 exercises outlined below to start!


  1. Mobility to the upper/mid back: Turtle rotations
    – On knees, round low back, stack elbows in front of one another
    Turtle rotations
    – Keeping low back round, elbow bent, rotate as far as you can following your elbow with your eyes
    elbow with your eyes
  2. Stability to the lower neck: Neck raise
    – Lay on stomach with forehead rested on the back of your hands
    Neck raise
    -Keeping a chin tuck, gently raise your head keeping your neck long
    keep your neck long


Yoshida R, Yasuda T, Kuruma H. Analysis of cervical and upper thoracic spinal segmental rotation angles during end-range neck rotation: Comparison with and without neck pain. Journal of Manual & Manipulative Therapy. 2022;30(6):328-333. doi:10.1080/10669817.2022.2056309.


Curtis Cramblett, PT, CFMT, CSCS, May 8, 2023

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