Neck pain: causes, what helps, and when to get checked
By Dr. Jeremiah Carlson, chiropractic physician · Jacksonville, FL · Reviewed Nov 2026
Common causes
- Muscle strain and joint irritation, often from long hours looking down at a phone or laptop
- Sleeping in an awkward position
- Whiplash from a car crash or sports collision
- Age-related changes in the discs and joints (very common and often painless)
- A pinched nerve, which can send pain, tingling, or numbness into the arm
What the research says
The 2017 neck pain clinical practice guideline published in JOSPT recommends combining manual therapy (thrust manipulation or mobilization) with exercise for many patients with neck pain, along with advice to stay active. Exercise matters: strengthening and mobility work for the neck and upper back are a core part of care, not an extra. Results vary from person to person, and no single treatment works for everyone.
Is neck manipulation safe?
Common side effects are mild and short-lived, such as soreness for a day or two. Serious complications, including a rare type of artery injury, have been reported but are uncommon, and research has not established that manipulation causes them (NCCIH). We screen for warning signs first. If you’d rather not have your neck adjusted, gentle mobilization, soft-tissue work, and exercise are good alternatives.
Is posture part of the picture? Read how we assess upper and lower crossed syndrome.
How we approach it at our clinic
- Talk and exam. Dr. Carlson takes your history and checks posture, range of motion, reflexes, strength, sensation, and orthopedic tests.
- Imaging only if it’s needed. We don’t take X-rays in our office. If your exam shows you need X-rays, an MRI, or a medical specialist, we refer you out and help coordinate it.
- A plan in plain English: what we found, what we recommend, how often, and how we’ll measure progress.
- Care that fits you, which may include chiropractic adjustments (manipulation or gentler mobilization), chiropractic physiotherapy (corrective exercise), home exercises, lifestyle and workstation advice, and, when appropriate, acupuncture, dry needling, Graston, cupping, laser therapy, or massage therapy.
Questions people ask
How long does neck pain usually last?
Many episodes of neck pain improve within a few days to a few weeks. Pain that lasts longer than 6 weeks, keeps coming back, or travels into the arm deserves an exam.
Should I use ice or heat for a stiff neck?
Either is reasonable for short-term comfort. Many people prefer heat for stiffness and ice in the first day or two after a strain. Keep sessions to about 15–20 minutes and protect your skin.
What pillow is best for neck pain?
There isn’t one best pillow. Aim for one that keeps your head level with your spine, in line with your body, whether you sleep on your back or side. Stomach sleeping tends to strain the neck.
Could my neck pain be from posture?
It can be. We often find a pattern called upper crossed syndrome: tight chest and upper-shoulder muscles with weaker deep neck flexors and mid-back muscles, which shows up as a forward head and rounded shoulders. See our posture guide.
Want Dr. Carlson to take a look?
Call our Southside clinic or request a call back. If you were in a car crash, take the 60-second check first.