The first, and one of the most common, is a disc herniation. Just like in your lower back, you’ve got discs between the bones of your neck — cushions that let it move and take load. And a disc in the neck can bulge or herniate, just the same.

But here’s what matters to you: how it shows up. The big giveaway with a neck disc is that it doesn’t stay in your neck. It travels — down into the shoulder blade, into the arm, sometimes all the way into the hand. Pain, pins and needles, or numbness following a line down the arm. That’s the disc pressing on, or irritating, a nerve as it exits the neck.

And people with a disc often really struggle with looking down — at the phone, reading, working at a laptop. That sustained position is the one that winds it up. So pain travelling into the arm, worse with looking down, points towards a disc.

The second is the facet joints. These are the small joints at the back of your neck that let it turn and bend. They can get irritated, or they can get worn and degenerative over time. Either way, the picture is similar.

And they behave almost the opposite way to a disc. So instead of looking down being the problem, it’s looking up and turning your head that catches. You get that sharp, local pinching feeling right in the neck, and people describe it as a blocked, stuck feeling, like the neck just won’t go that way. It’s usually one-sided, and it usually stays local — in the neck, maybe into the top of the shoulder — rather than travelling down the arm like the disc does. There’s often stiffness first thing in the morning too, that eases as you get moving.

So sharp catching when you look up or turn, one-sided, staying local, points towards a facet joint problem.

So there are your three most common causes. A disc herniation: pain travelling into the arm, worse looking down. Facet joints: sharp catching when looking up or turning, one-sided, stays local, stiff in the morning. Stenosis: gradual, worse holding your head up, eased by bringing it down, and can give symptoms into the arms.

You might already be hearing the one that sounds like you. But remember, these overlap, they can happen together, and this is a guide, not a diagnosis. If your pain is persistent, getting properly assessed is what turns “I think it might be this” into a clear answer and a plan.

And there’s one more thing worth knowing. These three are all about the structures — the pathology. But very often it’s the way you sit, move and hold yourself that’s actually driving the problem in the first place. Something made that disc bulge. Something wore that facet joint. Something loaded that neck year after year. That mechanical side is the real root cause, and it’s the natural next thing to understand once you know which structure is involved.

Joe Sharp
BSc (Hons) Physiotherapy