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Complaints

Neck Complaints

Neck pain is a very common complaint nowadays. In 2021, approximately 1.9 million people in the Netherlands visited their GP with a diagnosis of neck and back issues. These complaints are widespread, partly because many people spend over 40 hours a week sitting, which reduces the mobility of the body. The muscles that support you while sitting at a desk remain active for long periods, and if the body cannot tolerate the load, the muscles and surrounding structures begin sending signals that the stress is too much. These signals lead to tight and painful muscles in the neck and upper back.

Complaints

Neck

There are two types of muscles around the neck: the local stabilizers and the global movers.
  • Local Stabilizers: These smaller muscles are closely attached to the spine and neck, and their primary role is stabilizing the spine. They help keep the neck stable both in static positions and during dynamic movements, such as bending forward and backward, rotating, and tilting the neck. Key local stabilizers include the longus capitus, rectus capitus, and longus cervicus.
  • Global Movers: These are larger muscles responsible for bigger movements, such as flexion, extension, rotation, and side bending of the neck. Some global movers include the trapezius, sternocleidomastoid, and levator scapulae.

Often, when people experience neck pain, their local stabilizers weaken due to poor posture, such as when the chin is pushed forward. This posture causes the deep neck flexors (local stabilizers at the front of the neck) to lengthen excessively, leading to their weakening. Once the local stabilizers become inactive, the global movers take over. However, since these muscles are designed for larger movements, they tire quickly when activated for extended periods, causing tension and pain in the neck.


Additionally, the forward chin posture compresses muscles at the base of the skull, which can trigger headaches around the eyes. This occurs because the extensor muscles at the back of the neck, responsible for neck extension (moving the neck backwards), become overactive. This overactivity in the extensors can explain pain at the base of the skull.


Some people may also experience other issues like headaches, dizziness, jaw problems, or ringing in the ears. These symptoms are often linked to the overactivity of the upper neck extensors and the inactivity of the deep neck flexors. Treatment for the upper neck, through manual therapy or exercises, can significantly improve symptoms like jaw pain, ear ringing, and headaches.

  • Load Management: Take regular breaks every 45 minutes to 1 hour to avoid prolonged periods of immobility (sitting, standing, etc.). In the physiotherapy world, we often say, “the next posture is the best posture.” Changing positions and moving frequently is one of the best things you can do for your body.
  • Posture: When sitting or standing for extended periods, lightly engage your muscles instead of relying solely on your joints for stability. Start by ensuring you have a stable base—begin with your feet. Place more weight on the outer part of your feet and heels while slightly bending your knees and rotating your hips (tuck your tailbone in). This engages your core muscles (quads, hamstrings, and glutes). Next, squeeze your shoulder blades together, holding tension between them. Finally, gently tuck your chin as if you're giving a subtle nod, holding it in that position.
  • Strengthening Your Back Muscles and Deep Neck Flexors: Strengthening these muscles helps increase your capacity to hold proper posture for longer periods and perform daily activities with less discomfort. Key upper back muscles to focus on include the rhomboids, lower trapezius, and latissimus dorsi. Strengthening your deep neck flexors will help you maintain a retracted neck (slight chin tuck) during long periods of sitting or gym exercises without triggering neck pain.

At Wijs, we emphasize empowering our patients with knowledge about their body and symptoms. Our goal is for you to understand what is happening, how to make a difference, and what to do if neck pain arises again in the future.


During your first session, we will explain the mechanics of neck pain, and through treatment, we will guide you in self-management exercises and give you maintenance advice. Initially, we will work on controlling your symptoms by increasing the range of motion in your neck, using release techniques and posture guidance.


In the next phase of treatment, we focus on long-term solutions by strengthening weak areas. We will target the deep neck flexors and upper back muscles, gradually increasing the intensity of activities that previously caused discomfort, enabling you to return to your normal activities with greater ease.