Acute Neck Pain

Neck Pain

Treating neck pain often causes practitioners confusion and hesitation about where to start treatment.

Many physical therapists, doctors, and chiropractors rush into treatment as soon as they hear a patient has neck pain. At Acupuncture Pain and Stress Center, our approach is defined by using a thorough diagnosis to guide our treatment.

The aggravating mechanism of injury may have occurred up to a week before the onset of pain, so we always start by asking questions to uncover any subtle movements or emotional stressors that may have contributed to the issue. Even when we have a hunch about the best course of action, running through the proper diagnostic tests is crucial for achieving quick results. Sometimes, no single issue stands out after the initial tests. While this might throw many practitioners off, for us, it simply means we need to dig deeper.

One of the things I hear most from patients is, "How do you always know exactly where it's tender?" My answer is always the same: "Proper and thorough diagnosis."

What do I need to be thinking about before my treatment?

At the beginning of every treatment, we will discuss any limitations in physical activity or mobility you've experienced. It is helpful to think about this in the days leading up to your appointment. The inability to participate in previously enjoyed activities and the constant discomfort can contribute to a negative outlook and, in some cases, even lead to depressive symptoms. Persistent pain and limitations on daily life also commonly lead to feelings of frustration, anxiety, and stress.

These emotional states might not seem related, but our emotions change our breathing patterns. Our breathing, in turn, changes the way our rib cage moves. Since many neck muscles connect to the rib cage, being "stuck" in a particular emotion can definitely contribute to neck pain.

Common tissues that need treating

Once we have a clear understanding of your story, these key tissues are often treated to restore range of motion, reduce irritation on the nerve root, and allow the neck to heal efficiently:

Scalenes: These are often a focus if stress is a factor because they attach to the upper rib cage. You use these muscles for side bending, the movement you make when you tilt your ear toward your shoulder.
SCM: This muscle needs good length for both extension (looking up or arching your neck backward while lying on your stomach) and rotation (turning your head from side to side).
Sub-occipitals: These are often tight after an extension-based injury and can restrict upper cervical flexion—the "yes" nodding motion where your chin moves slightly down and your head bows forward.

Proper Rehab for Lasting Results

Once we see a response to our hands-on techniques, we will reinforce it with a personalized rehabilitation plan. This won't be a generic piece of paper handed to you. Instead, we'll focus on the specific tissue that responded during your session. A suboccipital isometric, early-stage breathwork, or other relevant light isometrics might be a starting point, and these exercises will vary based on what we discovered in the diagnosis and treatment stages. The most important thing is that between appointments, you are actively working on the tissues we treated.

Neck vs Upper Limb – What to Prioritize?

This is where many practitioners get stuck, or even stop before they get here.

If the diagnosis reveals that neck muscle issues or emotional triggers are the main problem, then that is where we start. We work to regain neck range of motion (ROM), then progress to upper limb rehab.

Almost always, patients develop unhelpful shoulder or arm compensation strategies as a result of their neck pain.

If we stop before we get to this point, there's a good chance your results will only be short-term. My goal is for you not to need me (unless you injure yourself in a new way), and to achieve that, we need to make sure your neck isn't working harder than it needs to.

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— Jim Eleczko