Some back and neck pain needs a doctor today, not a chiropractor. Some back and neck pain is not a case for a chiropractor and needs a doctor the same day. Go to an emergency room, not to us, if you have numbness in the groin or inner thighs, if you have lost control of your bladder or bowels, if a leg is becoming weak rather than just painful, if the pain followed a serious fall or a car crash, if you have a fever with back pain, if you have unexplained weight loss alongside it, if you have a history of cancer, or if a headache came on suddenly and is the worst you have ever had. We would rather you rang your doctor and never rang us at all.
The neck holds up a head that weighs roughly as much as a bowling ball, and it does it while you spend nine hours looking down at a screen thirty degrees below eye level. Most of the neck pain we see is exactly that arithmetic catching up: stiff joints in the middle of the neck, overworked muscle from the shoulder blade to the base of the skull, and a headache that starts underneath the skull and wraps forward behind one eye. It is genuinely painful, it is rarely sinister, and it responds well to being treated.
The other big group is the neck that went suddenly — you turned to reverse the car, or you woke with it already stuck. That is usually a joint that has become irritated and a great deal of muscle guarding around it. It looks alarming, the head is often held tilted, and it typically improves quickly with hands-on work and early gentle movement. Necks that follow a collision are a separate job with their own timeline and paperwork, and they are covered on the whiplash care page.
This is also the page where we have the risk conversation, because the neck is where people worry and where they are right to want a straight answer. Neck manipulation is generally safe and serious complications are rare, but rare is not never. We screen for the circumstances that make it unwise, we tell you when we think a neck should be left alone, and we treat necks perfectly well without any high-velocity technique whenever the patient would rather we did. Asking for that is not a difficult conversation here.
Where neck pain actually comes from
Four patterns, and the examination is largely about deciding which of them is in front of us.
Sustained posture
The commonest by a distance. Hours with the head forward and down loads the joints at the back of the neck and the muscles between the shoulder blades continuously, with no break in which anything recovers. It builds over weeks and then announces itself on a Tuesday. Treating the neck helps; changing the nine hours is what keeps it away. The desk and workstation care page is about that.
A joint that has locked
You turned your head, something caught, and now it will not go that way at all. The head is often held slightly tilted and turning it is sharply painful in one direction and fine in the other. It is mechanical, it is not dangerous, and it usually settles considerably within a week or two with hands-on work and gentle movement.
A nerve root irritated in the neck
Pain, pins and needles, numbness or weakness travelling into the shoulder, arm or hand suggests a nerve root is being irritated where it leaves the neck. This needs proper neurological examination rather than treating blind. Most settle with conservative care over a few months; progressive weakness is the sign that changes the plan and prompts imaging.
After a collision
A neck injured in a car crash behaves differently: more diffuse, slower to settle, and often worse on day two or three than on the day itself. It also needs documenting properly from the first visit, because the notes matter later. That is its own page — the whiplash care and auto accident care pages cover it.
The risk conversation, in plain words
This is the part clinics leave out, and it is the part patients most want. Ask any of it at your appointment.
What usually happens
The common side effects of neck treatment are mild and short-lived: soreness, stiffness, occasionally a mild headache or tiredness for a day or so. Roughly speaking this is what the day after unfamiliar exercise feels like. It is not a sign of harm and it settles on its own. We tell you to expect it rather than letting you discover it and worry.
The rare serious risk
The complication people ask about is a tear in one of the arteries in the neck, which can cause a stroke. It is rare. Estimates vary and the research is genuinely contested — some of it argues the association is because people with a tear already in progress seek treatment for the neck pain it causes. We are not going to pretend that argument is settled in either direction.
How we screen for it
History first: sudden severe headache unlike your usual, neck pain unlike your usual, recent trauma, connective tissue disorders, recent infection, dizziness, visual disturbance, difficulty speaking or swallowing, or unsteadiness. Any of those and the neck is not manipulated, full stop. This is part of why a first appointment is an hour of questions.
Your right to decline it
You can have every part of this treatment without high-velocity manipulation. Mobilisation, instrument-assisted technique, soft-tissue work and exercise treat necks perfectly well, and for a good number of people they are the better choice anyway. Say so once and it is in your notes. Nobody will raise it again or try to talk you round.
What we do about it
Hands, and then the part that actually keeps it away.
Get the stiff segment moving
By whichever technique suits you and the neck in question: mobilisation, a drop-piece table, an adjusting instrument, or a hands-on adjustment if that is appropriate and wanted. The aim is a neck that turns further and hurts less, which is what makes everything else on this list possible.
Release what has been holding on
Soft-tissue work through the muscles running from the shoulder blade to the base of the skull. For a lot of stiff, aching necks this is where most of the relief actually comes from, and it is frequently more useful than the joint work it accompanies. It takes longer, which is why some necks are booked as an extended visit.
Deep neck strength
The small muscles at the front of the neck that hold the head up quietly all day are almost always weak and endurance-poor in people with long-running neck pain. Training them is dull, takes about four minutes, and has better evidence behind it than most of what gets sold for necks. It is on nearly every home programme we write.
Fix the nine hours
Screen height, chair, where the phone lives, how often you get up, and what you do with your neck on the train. Treating a neck weekly while it spends fifty hours a week in the position that caused it is a way of running a clinic, not a way of fixing a neck. A workstation assessment is on the fees page.
Neck Pain in western Queens
A neck that will not turn, a shoulder that aches with it, and a headache creeping up the back of the skull. Treatable — and treatable without high-velocity manipulation if that is what you would prefer.
Every course of care here starts the same way: a full hour, a proper history, an examination, and then a plain statement of what we think is going on and how confident we are about it. You are told what we propose, roughly how many visits it ought to take and what should have changed by when — and we agree a date to stop and look at whether it worked. If the honest answer at any point is that this needs somebody else, you get that instead, and we write to them the same week.
Chiropractic care is not a substitute for medical diagnosis. Chiropractic care is not a substitute for medical diagnosis, and nothing on this website is medical advice for your particular problem. We are not physicians: we do not prescribe medication, we do not perform surgery, and we do not treat disease. What we do is examine how your spine and joints move, work on them by hand, and give you something to do between visits. If your problem turns out to be outside that, we say so and refer you — which happens often enough that you should expect it as a normal outcome rather than a failure.
What chiropractic does not treat. We treat musculoskeletal problems: the spine, the joints, the muscles and the nerves that are irritated by them. We do not claim that adjusting a spine treats asthma, allergies, ear infections, colic, digestive disease, high blood pressure, infertility, immune function or any other internal illness. Chiropractors who make those claims are making them without good evidence, and you should be wary of anybody who does. If somebody has told you that spinal care will fix a condition on that list, we will tell you honestly that it will not.
Questions
Neck Pain — the questions we are asked most
Is having your neck adjusted dangerous?
It is generally safe, and serious complications are rare — but they are not impossible, and you deserve that answer rather than a reassuring one. The risk people ask about is an arterial tear causing a stroke. We screen carefully for the circumstances that make manipulation unwise, we will tell you when we think a neck should be left alone, and we can treat your neck without any high-velocity technique. The risks and safety page covers this at length.
Can you treat my neck without cracking it?
Yes, entirely, and you will not have to argue for it. Mobilisation, instrument-assisted adjusting, soft-tissue work, traction and exercise treat necks perfectly well, and for plenty of people they are the better option regardless. Tell whoever sees you at the start of the appointment; it goes in your notes and it is not raised again. Nobody here is going to try to talk you round to something you have declined.
Will chiropractic help my migraines?
It depends entirely on what is causing them, and the honest answer is that we can help with some headaches and not with others. Headaches that come from the neck respond reasonably well to neck treatment. True migraine is a neurological condition and belongs with your doctor — we do not claim to treat it, though we may still be able to help with a stiff neck that is making your attacks more frequent. The headache care page tells the two apart.
My arm is tingling. Is that serious?
It means a nerve is likely being irritated somewhere, most often where a root leaves the neck, and it needs examining properly rather than treating blind. Most cases settle with conservative care over weeks to months. The thing that changes the plan is weakness rather than sensation — a grip that is failing, an arm that cannot be held up — particularly if it is worse this week than last. That prompts imaging and a referral.
I slept badly and now I cannot turn my head. What should I do?
Keep it gently moving within the range you have rather than immobilising it, use heat if that feels better, and avoid the temptation to keep testing the painful direction to see whether it still hurts. Most of these settle substantially within one to two weeks, and treatment tends to shorten that. Ring us — these are usually straightforward. If it followed a fall or a collision, say so when you book.
Is my posture the reason my neck hurts?
Partly, though not in the way it is usually sold. There is no single correct posture, and people with perfectly ordinary posture get neck pain while people with dreadful posture often do not. What matters far more is how long you hold any one position without a break. The best posture really is the next one, and a timer that gets you up every half hour does more for a neck than an expensive chair.
Related
Often seen alongside this
Spine & Nerve Pain
Chiropractic Adjustment
The technique the whole trade is named after: a short, shallow, quick movement through a stiff joint. It takes a fraction of a second, it is usually a relief rather than a pain, and it is not the only thing we do.
Read more
Spine & Nerve Pain
Lower Back Pain
The single most common reason anybody rings this clinic. Most of it is a joint and the muscle around it, most of it improves inside a few weeks, and most of it does not need a scan.
Read more
Spine & Nerve Pain
Sciatica & Leg Pain
Pain, pins and needles or numbness running from the back into the leg. Usually an irritated nerve root, usually settling over weeks to months, and occasionally a reason to be examined urgently.
Read moreA fee agreed before the visit, not after it
Book an appointment
Pick a chiropractor and an hour from the calendar — it shows only the times each of them genuinely has free. A first visit is a full hour and costs $95 for the examination on its own, or $145 if we treat you at the same appointment. You decide which after the examination, not before.