Neck Pain: Why It Happens and Why It Can Keep Coming Back
Updated: Aug 16
Neck pain is incredibly common.
For some people, it's a stiff or aching neck after a long day at work. For others, it can affect sleep, exercise, driving or simply being able to turn their head comfortably.
And then there's something I hear regularly in clinic:
"Why does my neck pain keep coming back?"
Often, there isn't one simple answer.
Your neck doesn't work in isolation, and symptoms can be influenced by everything from how much you're moving and the demands of your day to strength, sleep, stress and previous injuries.
Understanding what's contributing to your neck pain can be much more useful than simply trying to find one stretch, posture or treatment that will stop it from ever hurting again.
This information is general and isn't a substitute for an individual assessment.
What does neck pain feel like?
Neck pain can present differently from person to person.
You might notice:
An ache across your neck or shoulders
Stiffness or reduced movement
Difficulty turning your head
Discomfort looking up or down
Pain after working at a desk
Stiffness after driving
Pain or stiffness when you wake up
Muscle tension around the neck and shoulders
Symptoms that settle and then repeatedly return
Some people experience symptoms only occasionally, while for others neck pain can start to interfere with work, sleep or activities they enjoy.
What causes neck pain?
There isn't one single cause of neck pain.
Sometimes there's an obvious trigger, such as an injury, an unusually heavy training session or spending considerably longer than usual at a computer.
Other times, symptoms develop gradually.
Factors that can contribute include:
Long periods in the same position
Changes in activity or exercise
Reduced movement throughout the day
Muscle strength and endurance
Stress and muscle tension
Jaw clenching
Sleep and recovery
Previous injuries, including whiplash
Age-related changes
The demands of work, sport or everyday life
Often, several factors are involved rather than one thing being "wrong" with your neck.
Is poor posture causing my neck pain?
This is something I'm asked a lot.
Many people worry that years of "bad posture" have damaged their neck.
The reality is more reassuring: there isn't one perfect posture that everyone needs to maintain.
Your body is designed to move and tolerate lots of different positions.
For many people, the bigger issue isn't necessarily which position they're sitting in—it's how long they stay there.
You can have an excellent desk setup and still feel stiff after sitting almost completely still for several hours.
Rather than constantly correcting yourself or trying to sit perfectly upright all day, aim to change position regularly.
Stand up. Walk around. Move your shoulders. Gently turn your neck.
Your next posture is often more important than your "perfect" posture.
If you spend a lot of your day at a computer, I've also put together some simple desk stretches and movement exercises that you can use to break up longer periods of sitting.
Why does my neck pain keep coming back?
This is where things can become frustrating.
You have treatment, do some stretches or simply wait, your neck feels better…and then several weeks or months later the pain returns.
A pattern I often see looks something like:
Busy period → less movement → increased demands → neck becomes sore → symptoms settle → normal routine resumes → neck pain gradually returns.
That doesn't necessarily mean you've injured your neck again.
It may simply mean that the factors contributing to your symptoms have gradually built up again.
That's why managing recurring neck pain isn't only about reducing symptoms when they appear.
Looking at strength, movement, recovery and the demands you're placing on your body can be important in helping your neck become more resilient.
Does my neck need stretching or strengthening?
Possibly both—but it depends on you.
Neck pain is often described as being caused by "tight muscles", so stretching tends to be the first thing people try.
But feeling tight doesn't necessarily mean you simply need more flexibility.
Your neck, shoulders and upper back also need enough strength and endurance to manage everything you ask them to do.
For someone working at a computer, that might mean tolerating several hours of desk work.
For someone who trains regularly, it might mean managing heavier loads or repetitive movements.
For a parent, it might mean carrying children, bags and everything else that comes with a busy day.
This is why rehabilitation often involves strengthening alongside mobility work.
There isn't one set of "best neck exercises" that everyone should do, the right exercises depend on what we find during your assessment.
Can stress affect neck pain?
Absolutely, but that doesn't mean the pain is "just stress" or that it's all in your head.
When we're stressed, many of us unconsciously increase muscle tension around our neck, shoulders and jaw.
Some people also clench or grind their teeth without realising they're doing it.
Combine that with poorer sleep, long working days or reduced activity and it's easy to see why symptoms can sometimes increase during particularly stressful periods.
If you notice yourself holding a lot of tension, relaxation techniques can be useful alongside movement and exercise.
You could try my body scan and mindfulness practice as a simple place to start.
Could my pillow be causing my neck pain?
If your neck is particularly stiff or uncomfortable when you wake up, it's reasonable to look at your sleeping position and pillow.
But there isn't one "best pillow for neck pain".
Your body shape, shoulder width and sleeping position all affect the height and support you need.
Before spending money on an expensive specialist pillow, it's worth looking at whether your current pillow supports your head and neck comfortably.
I've put together a separate guide on choosing the right pillow and mattress, including pillow height, sleeping positions, orthopaedic pillows and mattresses.
Can neck pain cause headaches?
Sometimes.
Certain headaches can originate from structures around the neck and are known as cervicogenic headaches.
However, headaches have many different causes, and having neck pain alongside a headache doesn't automatically mean the neck is responsible.
I've written a separate guide to neck pain and headaches, including what cervicogenic headaches can feel like and when headaches need further assessment.
How is neck pain assessed?
A good neck assessment involves more than simply looking at where it hurts.
I'll spend time understanding:
How your symptoms started
What makes them better or worse
Your work and everyday activities
Exercise and hobbies
Previous injuries
Your general health
Whether you've experienced similar episodes before
Depending on your symptoms, I may then assess things such as:
Neck movement
Upper-back mobility
Shoulder movement
Muscle strength
Neurological function where appropriate
Movements or activities that reproduce your symptoms
This helps us understand what may be contributing and whether chiropractic care is appropriate for you.
What can I do to help neck pain?
There's no single solution that works for everyone, but some general principles can be useful.
Try to:
Keep moving rather than becoming overly protective of your neck
Change position regularly during the day
Take movement breaks during prolonged desk work or driving. If you're unsure about your positioning, my guide to setting up your desk and car seat comfortably has some practical adjustments you can try.
Continue with normal activities where comfortable
Gradually build strength and activity
Prioritise sleep and recovery
Consider whether stress or jaw tension is contributing
Avoid repeatedly testing painful movements throughout the day
If something consistently aggravates your symptoms, temporarily modifying it can be sensible while things settle.
The aim isn't necessarily to avoid everything that causes discomfort forever—it's to gradually build your confidence and capacity again.
How may chiropractic care help with neck pain?
Treatment will depend on what we find during your assessment.
Where appropriate, your care may include:
Chiropractic treatment
Gentle joint mobilisation
Soft tissue techniques
Strength and mobility exercises
Advice around work, exercise and everyday activities
Rehabilitation to improve strength and confidence
Hands-on treatment can be useful, but it's only one part of the picture.
My aim isn't to make you dependent on regular treatment. I want you to understand what's contributing to your symptoms and have the tools and confidence to manage your neck in the longer term.
When should I get neck pain assessed?
Consider getting your neck assessed if:
Pain has persisted for several weeks
Your symptoms keep returning
Pain is affecting your sleep
You're struggling with work, driving or exercise
You're avoiding activities because you're worried about your neck
You're experiencing persistent symptoms into your arm
You have numbness, tingling or weakness
You're concerned about your symptoms
Some presentations require medical assessment rather than, or before, chiropractic care. Significant trauma, new or progressive neurological symptoms, severe or unusual headaches, fever or feeling systemically unwell are examples of symptoms that shouldn't simply be assumed to be musculoskeletal neck pain.
Frequently asked questions about neck pain
Should I rest if my neck hurts?
Complete rest usually isn't necessary for uncomplicated neck pain. Keeping gently active and gradually returning to your normal activities is generally preferable to avoiding movement altogether.
Should I stretch my neck every day?
Not necessarily. Stretching can feel good for some people, but if your symptoms relate more to strength, endurance or another factor, repeatedly stretching may not address what's contributing.
Is my neck pain caused by my desk?
Your desk may be one factor, but it's rarely as simple as having a "bad" workstation. How long you remain in one position, how frequently you move and your overall activity levels can be just as important.
What's the best sleeping position for neck pain?
I generally prefer side or back sleeping rather than sleeping on your stomach, as stomach sleeping usually requires your neck to remain rotated for prolonged periods.
Your pillow should support your head comfortably without pushing it excessively upwards or allowing it to drop down.
For more detail, read my guide to choosing the right pillow and mattress.
Can neck pain cause headaches?
It can. Some headaches originate from the neck, but not every headache experienced alongside neck pain is neck-driven.
You can read more in my guide to neck pain and headaches.
Looking for help with neck pain in South Queensferry?
If you're struggling with neck pain, whether it's a new problem or something that keeps coming back, I'd be happy to help you understand what may be contributing.
I see patients from South Queensferry, Dalmeny, Kirkliston, Winchburgh, North Queensferry and the surrounding areas.
You can book a full assessment online, or if you're unsure whether chiropractic care is appropriate for you, you're welcome to arrange a free 15-minute consultation first.
About the author
Vicky Pittman, MChiro – Chiropractor
Vicky is a GCC-registered chiropractor and owner of Queensferry Chiropractic, with over 15 years of clinical experience. She qualified as a chiropractor in 2011 after previously completing a BSc (Hons) in Sports Therapy.
She works with patients from South Queensferry, Dalmeny, Kirkliston, Winchburgh, North Queensferry and the surrounding areas, helping people manage musculoskeletal pain, recover from injury and stay active.
Vicky has a particular interest in sports and exercise rehabilitation, pregnancy and postpartum care, and supporting women through midlife and menopause.
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