Neck pain is a common complaint among adults, but pain is a symptom, not a condition in and of itself, and simply treating and managing neck pain is more of a bandaid than a cure. Neck pain can arise from a broad range of causes, and unless we treat the root cause and not just the pain, there is little hope for long term relief.
Learn about the many potential causes of neck pain, conventional approaches to neck pain treatment, and advanced holistic therapies that can eradicate neck pain for good.
Holistic Therapy vs Conventional Neck Pain Treatment
For many people, the term “holistic healthcare” conjures images of off-beat and off-label therapies that are not based on scientific evidence – but nothing could be further from the truth. In fact, the words “holistic” and “integrative” are synonymous, and both approach human health from the perspective of treating the whole patient, with the goal of restoring pain-free function, and not just managing symptoms.
By contrast, conventional medicine takes a reductionist approach, differentiating one body part from another, and treating them as independent units. Thus, we have medical specialists whose expertise is limited to a specific system or body part, to the exclusion of the remaining whole. In many cases, a single patient may see multiple specialists, and be treated with numerous medications and surgeries that often do more harm than good.
In the case of neck pain, isolating treatment to the neck itself while ignoring other contributing factors can create a cascade of musculoskeletal issues that lead to deteriorating health, reduced mobility, and drug dependency. The goal of holistic medicine is to identify the true source of neck pain and restore pain-free functional mobility – without drugs or surgery.
Structures that Support and Act Upon the Neck
To understand neck pain, we need to have a fundamental understanding of how the neck affects and is affected by other structures and tissues, both adjacent and distal. To begin, we need to recognize that the neck is part of the spine, and that the cervical spine houses the spinal cord, home to the central nervous system. Among other functions, neural bodies provide a conduit for pain signals, informing the brain when something is amiss.
The neck consists of 7 cervical vertebrae, C1 to C7, separated by spongy discs and supported by ligaments, muscles and fascia. C1 supports the weight of the head – a whopping 8-12 pounds – while C2 allows for head and neck rotation. Vertebrae C3-C7 provide support and stability, safeguarding the spinal column from injury and nerve compression. But that is only the beginning.
Nerves exit the spinal cord via the intervertebral foramina – small openings between adjacent vertebrae – on their path to innervate their respective areas of the body. The cervical nerves form parts of the cervical and brachial plexuses, distributing motor and sensory functions across the upper body.
Here is a brief overview of the 8 cervical nerves and the regions they innervate:
- C1 exits between the skull and first vertebra, and innervates muscles that contribute to head movement.
- C2 exits between vertebrae C1 and C2 and provides sensory innervation to the scalp and neck muscles.
- C3 exits between C2 and C3, and supplies parts of the neck and levator scapulae muscles.
- C4 exits between C3 and C4, innervates parts of the neck and shoulder, and contributes to the diaphragm function via the phrenic nerve.
- C5 exits between C4 and C5 and supplies the shoulder and upper arm.
- C6 exits between C5 and C6 and innervates the forearm, wrist extensors and thumb.
- C7 exits between C6 and C7 and supplies muscles like the triceps, wrist flexors, middle finger, and posterior forearm.
- C8 nerve: Exits between C7 and the first thoracic vertebra (T1), innervating the hand muscles, pinky, and medial forearm.
Biotensegrity Promotes Neck Stability
The neck plays a key role in all physical activity, enabling head rotation to optimize vision and hearing. At the same time, muscles and fascia of the chest, shoulders and upper back provide additional support via biotensegrity – elastic tension that guides and controls movement, and mediates outside forces.
When biotensegrity is disrupted, cervical nerve roots can be compressed by inflamed discs or bony structures, or entrapped by densified fascia, causing pain, numbness and tingling, not only in the neck, but in the body’s periphery. Medical doctors rarely recognise fascia’s protective role in neck stability, yet densified fascia and myofascial trigger points are often key contributors to neck pain.
Harmonious interaction between the neck and adjacent structures requires coordinated muscle recruitment patterns to optimize motor efficiency, along with healthy fascia to facilitate tissue gliding. When harmony is disrupted due to injury, poor posture, or imbalanced myofascial tension in the neck and adjacent structures, it can cause nerve compression that manifests as neck pain.
Common Causes of Neck Pain
Neck pain can stem from multiple causes, some directly related to the neck and spine, and others involving damage or dysfunction in adjacent structures. When medical treatment for neck pain is directed only at the neck and cervical spine, critical factors can be overlooked, prolonging your pain and potentially causing further damage.
Some common causes of neck pain include:
- Poor static and dynamic posture that causes spinal misalignment
- “Text neck” – a head-forward position from use of electronic devices that compresses the cervical vertebrae
- Imbalanced muscle tension that unevenly distributes body mass, placing strain on the neck
- Awkward sleeping posture
- Densified fascia and myofascial trigger points
- Scapular dyskinesis that creates mechanical dysfunction between the neck and scapula
- Dysfunction in the shoulder complex and rotator cuff
- Traumatic injury such as whiplash
- Repetitive muscle overuse from sports, exercise or occupation
- Muscle tension from chronic stress
- Osteoarthritis
- Cervical spondylosis
- Cervical disc herniation
- Spinal stenosis
- Metabolic syndrome and chronic systemic inflammation
Accurate Diagnosis is Key to Resolving Neck Pain
Conventional neck pain diagnosis typically involves a review of symptoms and health history, and a clinical exam that includes testing for neck and shoulder range of motion, assessment of posture and spinal alignment, and special tests to identify peripheral sensations in the arms and hands.
If bone fractures, osteoarthritis or disc herniation are suspected, Xray or MRI may be recommended. However, those imaging modalities give only limited insight, and they involve exposure to radiation, which poses safety risks for some patients.
For integrative and holistic practitioners, high-resolution ultrasonography is becoming the imaging mode of choice. Not only is ultrasound imaging safe for almost all patients, but it is inexpensive compared to MRI, and delivers immediate results in real time.
High-resolution diagnostic ultrasound empowers clinicians to:
- Compare injured and uninjured sides of the body
- View nerves, muscles, fascia and bones along their entire path
- Visualize the interaction of various structures during dynamic movement
- Identify fascial densifications, adhesions, and myofascial trigger points
- Pinpoint the exact site of nerve compression or entrapment
- View multiple tissues and structures in a single session
- Elicit patient feedback during the imaging session
- Leverage sonoelastography to test tissue density
- Access superb microvascular imaging to detect early signs of tissue regeneration
High-resolution ultrasound provides an advanced tool for comprehensive diagnosis, ensuring that nothing is overlooked. It dramatically reduces the risk of being under-diagnosed or misdiagnosed, increasing your chances of successful treatment.
New smart technologies are also gaining popularity among holistic practitioners whose patients want to restore mobility without the use of drugs or surgery. Such advanced devices take the guesswork of assessment and diagnosis, and provide objective data to help guide and measure the rehabilitation process.
ShowMotion™ is an objective tool for movement analysis that uses motion tracking sensors, placed on the patient’s skin to collect data about movement quality. The patient performs a series of joint-specific movements, and the data is analyzed by ShowMotion’s proprietary software, providing valuable insights about inefficient muscle coordination patterns that reduce motor efficiency. ShowMotion is particularly useful for identifying scapular dyskinesis, a condition that can profoundly affects neck mechanics.
Advanced Neck Pain Therapies that Really Work
Multimodal Shockwave Therapy
Ultrasound guided extracorporeal shockwave therapy (ESWT) delivers radial, linear, focused and defocused shockwaves to address various tissue types. The high frequency acoustic waves relieve pain, reduce inflammation, and have a regenerative effect on damaged tissues. ESWT helps to realign collagen fibers, promotes hydration of fascial tissues, and restores tissue gliding.
Ultrasound-Guided Dry Needling
Dry needling addresses myofascial trigger points – hard knots of tightly contracted fibers that cause pain and disrupt biotensegrity. During the procedure, filament-thin non-medicated needles are inserted through the skin into the trigger point, causing a twitch response that immediately relaxes the fibers. A 2024 case study published by Kalika et al. demonstrated that ultrasound-guided dry needling effectively relieved vertigo symptoms and eliminated neck pain in a patient with a traumatic head injury.
PENS
Percutaneous neuromodulation (PENS) is a therapeutic approach that uses electrical stimuli to calm and desensitize hyperactivated nerves. It involves the insertion of several filament-thin needles under ultrasound guidance into muscle tissue adjacent to the targeted nerve. PENS stimulates the nerve with varying waves of low frequency electrical current to help restore optimal neural function.
Stecco Myofascial Release
The Stecco method of fascial manipulation was developed by orthopedic surgeon Dr. Carla Stecco. The technique involves manually applied deep friction that heats up tissues and stimulates mechanical action. Stecco fascial manipulation is an evidence-based methodology for breaking up scar tissue and releasing adhesions, to restore the integrity of fascial tissue. Patients often report immediate pain relief after a single Stecco session.
Posture Correction Therapy
Poor posture is essentially a misalignment of the body’s skeletal structures. The skeleton is held erect by tension generated by muscles and fascia – think tension provided by cords and stakes to hold a tent erect. When the body is deconditioned from lack of physical activity, or becomes imbalanced from repetitive asymmetrical actions like swinging a golf club, biotensegrity is disrupted, causing postural misalignment. Posture correction therapy restores optimal biotensegrity through targeted exercises, stretches, and neuromuscular training, to realign the skeletal system and relieve strain and pressure on the cervical spine.
Orthobiologics Present a New Frontier in Neck Pain Therapy
Orthobiologic injection therapies use natural/neutral solutions, injected with precision under ultrasound guidance. The injected solutions stimulate cellular repair by either nourishing or irritating the targeted cells, causing a regenerative response. Injections are invaluable for liberating nerves and blood vessels entrapped by densified fascia, to restore gliding.
Platelet Rich Plasma (PRP)
PRP therapy extracts a high concentration of platelets from a sample of the patient’s own whole blood. When injected into damaged tissues, PRP initiates tissue repair by releasing biologically active agents such as growth factors, cytokines, lysosomes and adhesion proteins.
Matrix PRP
For tendon ruptures, Matrix takes PRP therapy to the next level by creating a collagenous bridge between the walls of the tear and the rest of the tendon. Matrix is a highly concentrated PRP, diluted and mixed with fibrinogen. At the injection site, the solution becomes a gel-like collagenous substance that adheres to the walls of the tear and fills the space between them, creating a fibrin matrix that helps to stabilize growth factors and attract stem cells to the treatment site.
Platelet Releasate Therapy
Platelet releasate therapy involves injecting platelet releasate – a mixture of growth factors and biomolecules – into injured muscles and tendons. The solution activates leukocytes and endothelial cells, and stimulates blood vessel growth, to increase the flow of oxygen, nutrients and growth factors to the damaged tissues.
Alpha-2-Macroglobulin (A2M)
Alpha 2 macroglobulin (A2M) is a naturally occurring blood plasma protein that acts as a carrier for numerous proteins and growth factors. As a protease inhibitor, A2M reduces inflammation in arthritic joints and helps to deactivate a variety of proteinases that typically degrade cartilage.
Prolotherapy and Prolozone
Prolotherapy uses a biologically neutral solution to irritate stubborn tissues, triggering the body’s innate healing mechanisms to grow new normal tendon, ligament and muscle fibers. Prolotherapy is often used for slow-to-heal tendon and ligament ruptures, where low vascularity inhibits tissue healing.
Prolozone takes Prolotherapy to the next level by adding a combination of procaine, anti-inflammatory medications, vitamins, and minerals, followed by a mixture of ozone/oxygen gas, injected into targeted joints or tissues. When performed under ultrasound guidance, Prolozone therapy quickly reduces pain and inflammation while jump-starting the healing process.
Hyaluronic Acid Injections
Hyaluronic acid is a natural component of joint synovial fluid, and a key component of fascia. Its slippery gel-like properties provide lubrication that reduces friction, enabling joints, muscles and fascia to move freely without pain. Hyaluronic acid injections can help to reduce friction in arthritic joints, and revitalize fascia’s functional properties.
Interfascial Plane and Nerve Hydrodissection
Neck pain often involves damaged fascial tissue that has thickened and become sticky, often adhering to other structures. The hydrodissection procedure injects a saline solution into densified fascial layers under ultrasound guidance, separating the layers and releasing entrapped nerves and blood vessels.
Say Goodbye to Your Pain in the Neck
Neck pain may be common, but chronic persistent neck pain should not be taken lightly – it could signal a degenerative condition that can seriously impair your mobility. Don’t settle for pain management solutions that ignore the true cause of neck pain. Look for a holistic or integrative practitioner who leverages evidence-based techniques and advanced technologies, to halt the degenerative process and put you back on the road to pain-free functional mobility.
About the Author
Dr. Lev Kalika, DC clinical director of NYDNRehab, is an internationally recognized expert in diagnostic and musculoskeletal ultrasonography, with multiple research papers to his credit. Dr. Kalika has studied with some of the world’s most prestigious experts in diagnostic, fascia, and nerve ultrasonography, and has presented his research at multiple international conferences. Dr. Kalika studied directly under Dr. Ben Kibler, world-renowned orthopedic surgeon and pioneer of scapular dyskinesis. For orthobiologic procedures, Dr. Kalika partners with Dr. Yuri Brosgol, MD, a seasoned expert in treating myofascial pain.
Also Read: Understanding the Causes of Neck Pain: How to Find Long-Term Relief
