Your Neck Pain Probably Isn’t Coming From Your Neck
Your neck pain probably isn’t coming from your neck. Now stay with me — because this is the thing that keeps people stuck for years.
In a previous article I gave you the three causes: the disc, the facet joints, and stenosis. But those are just what’s damaged. Something damaged them. And there are four mechanical causes of neck pain that do it. All four quietly overload your neck, every single day — and if you don’t fix them, the pain comes back every time, no matter what treatment you have, because you’re treating what hurts instead of what’s causing it. So let me take you through all four properly: what each one is, and exactly how it leads to the damage. As always, this is a guide, not a diagnosis.
Cause 1 — A Forward Head Posture
The first one is a forward head posture, and this is the big one. You know the position — head pushed forward, chin poking out. Sat at a laptop, looking at a phone, driving.
Here’s why it matters, and this is the bit people don’t understand. Your head is heavy. And when it sits forward of your shoulders, instead of stacked on top of them, it has to be held up. The way your body holds it up is by tipping the head back slightly and closing down the joints at the back of your neck — your facet joints. So a forward head posture jams those facet joints together, closes them down, compresses them. Hold that position for eight hours a day, for years, and those joints get irritated, they wear, they degenerate.
That’s the chain: forward head posture, closing down the facet joints, facet joint wear and pain. So if you’ve got that catching, one-sided, blocked feeling in your neck, this is very often what’s been driving it all along.
Cause 2 — Weak Deep Neck Flexors
The second is weak deep neck flexors. Most people have never heard of these, but they’re crucial. The deep neck flexors are the small, deep muscles at the front of your neck. Think of them as the core of your neck — its stability system. Just like your deep core muscles stabilise your lower back, these stabilise your neck.
And here’s the problem. In a lot of people, they’re weak. Really weak. So what happens when your neck’s core is weak? You get instability. The neck isn’t properly controlled through movement and load. And when the neck isn’t controlled, that load has to go somewhere — it goes through the structures, through the discs.
So weak deep neck flexors lead to instability, and that instability irritates the discs. That’s your second chain: weak core of the neck, instability, disc irritation and pain. So if you’re getting that pain travelling down into the arm, this is one of the very first places I’d look.
Cause 3 — Tight Shoulders
The third one is tight shoulders — a lack of shoulder mobility. This is exactly the same principle as the hips and the lower back. If your hips don’t move properly, your lower back has to compensate and do the moving for them. Same thing up top: if your shoulders don’t move properly, your neck has to compensate.
Think about reaching up above your head, or reaching behind you. If the shoulder can’t get there, the movement has to come from somewhere, so the neck starts doing the shoulder’s job. Every single day, every repetition. And a neck that’s constantly compensating for stiff shoulders is a neck that’s constantly being overloaded. So if you’ve got tight, restricted shoulders, be highly suspicious that your neck is paying the price for them.
Cause 4 — A Stiff Mid Back
The fourth one is the mid back — your thoracic spine. This one gets missed all the time, and it’s a huge driver. Your mid back sits directly underneath your neck, and a lot of the muscles that control your neck actually attach down into the mid back. So the two are completely connected.
If your mid back is stiff — if it doesn’t rotate and extend properly — the same thing happens again. The movement has to come from somewhere, and the neck picks up the slack. You want to turn and look behind you; some of that should come from your mid back, and if it can’t, your neck has to do all of it. And there’s more to it: a stiff, rounded mid back pushes you into that forward head posture we started with. So a stiff mid back doesn’t just make your neck compensate — it drags your head forward too, and now you’ve got both problems at once. It’s a double hit.
The Thread Through All Four
So there are your four mechanical drivers. A forward head posture, closing down and wearing those facet joints. Weak deep neck flexors, leading to instability and disc irritation. Tight shoulders, forcing the neck to compensate for movement it should never have to do. And a stiff mid back, making the neck do its job and pushing your head forward at the same time.
Now notice the thread running through all of them. Every single one forces your neck to do a job it was never meant to do — to move more than it should, to hold more than it should, to take load it shouldn’t. And do that for long enough, and that’s when the disc goes, that’s when the facet joints wear. The structures are the symptom. These mechanical causes are the cause. Which is exactly why just treating the neck so often doesn’t work long term — if you don’t fix what’s overloading it, it just keeps happening.
So if your neck pain keeps coming back, no matter what you try, this is where the answer usually lies. Get your posture, your deep neck flexors, your shoulders and your mid back looked at, and you start solving the actual problem instead of just chasing the pain.
Joe Sharp
BSc (Hons) Physiotherapy
Request A Free Discovery Call & Ask All The Questions You Need
