Neck Pain

About Neck Pain

We often refer to life’s ongoing challenges as “a pain in the neck,” and for good reason. Neck pain can be a nagging annoyance that interferes with your ability to focus mentally and perform physically. Neck pain can stem from a number of causes, and getting to the source of your neck pain is key to resolving it.

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Neck Anatomy


Your neck, or cervical spine, is made up of a network of nerves, bones, joints, and muscles. It supports your head and serves as a conduit for your spinal cord, which sends messages to and from your brain and body. In many cases, neck pain resolves itself within a few days or weeks, but ongoing pain that persists for months may require the intervention of a neck pain doctor or specialist.

Common Causes Of Neck Pain

Conventional treatment for rotator cuff injuries often involves rest, anti-inflammatory drugs, NSAIDs, physical therapy exercises, steroid injections and surgery. However, conventional approaches often fall short of restoring full function, especially for athletes.

At NYDNRehab, we use advanced technologies and therapies that eliminate the underlying causes of pain and injury, to restore the rotator cuff and shoulder joint to fluid pain-free function.

Some common causes of neck pain include:
Awkward sleeping position that places short-term pressure on muscles and nerves, causing a “stiff” neck
Athletic injuries including falls, collisions and other trauma occurring while the body is in motion at rapid velocities
Postural misalignment caused by poor postural habits or physical overuse from work or sports. Poor posture anywhere along the kinetic chain, especially the upper body, can lead to neck pain.
Prolonged poor neck position from texting, talking on the phone, using a computer or other activities that put the head in a forward position
Whiplash caused from rapid deceleration or collision in a moving vehicle
Herniated disc, where a disc becomes compressed between two vertebrae
Degenerative disc disease, due to wear and tear over time
Osteoarthritis due to eroding cartilage and inflammation
Spinal stenosis, where degeneration leads to a narrowing of the spinal canal

Diagnosis Of Neck Pain

Because neck pain can originate from a number of different causes, accurate diagnosis of your condition is critical. Once the source of pain is determined, a treatment plan can be put in place to resolve it.

To diagnose your neck pain, your therapist will conduct a thorough exam that may include some or all of the following:

Patient history

Patient history to review the exact description and location of your neck pain, daily physical activities, lifestyle behaviors, postural and sleep habits, and recent and old injuries.


Physical exam

Physical exam that may include observation of patient posture, palpation of the affected area, and assessments for range of motion, reflexes, muscle strength and sensation.


Your course of treatment will depend on information gathered from your diagnosis.

Diagnosis Of Neck Pain

Some traditional treatment options for neck pain include:

  • Corticosteroid injections to reduce inflammation
  • Cervical nerve root block injection to relieve pain
  • Muscle relaxants to relieve tension
  • Ice and/or heat therapy to reduce inflammation and ease pain
  • Surgery to remove a disc that irritates a nerve root, decompress the spinal cord or stabilize the neck

Traditional treatment for neck pain typically focuses on treating the locus of pain, but often neglects to get to and correct its root cause, meaning the condition may persist or recur.


Neck Pain Treatment By NYDNRehab Doctors

Surgery for neck pain should only be considered as a last resort. Most neck pain can be resolved with non-invasive conservative treatment. Your neck pain doctor will likely include a combination of methods in your treatment plan.

At NYDNR, our treatment approaches for ongoing neck pain include


Exercises for motor control of the upper quarter of the body


Range of motion exercises


Postural correction


Ergonomic workspace correction


Individualized home exercise program

Neck Specialists In NYC

The neck pain specialists at NYDNR, take a holistic and individualized approach to treating neck pain in nyc. We go beyond merely treating your pain, to getting to its source and resolving it. Our goal is to restore full pain-free function to your neck, so you can enjoy the very best quality of life.

neck pain manual therapy nyc
neck pain dr kalika
neck pain manual therapy

Range of Available Unique Physical Therapy Treatments at Nydnrehab

Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About the Author

Dr. Lev Kalika is clinical director of NYDNRehab, located in Manhattan. Lev Kalika is the author of multiple medical publications and research, and an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.

Neck Pain Treatment NYC
Nowadays there is significant increase in the amount of patients with neck pain. Clinical experience and scientific data shows that this recent increase is due to excessive usage of hand held devices, computers, excessive sitting and increased amounts of stress.

SYMPTOMS of Neck Pain

Many patients complain of the pain in the shoulder area where in fact what they are experiencing is lower neck pain. Muscles and joints of the lower neck are also known to refer pain into mid back or between the shoulder blades. Myofascial involvement occasionally may refer pain into the arm, elbow or even as far as the hand. The herniated disc in the cervical spine which compresses the nerve root will produce pain, numbness and tingling down the arm and into the hand. Although disc bulges, protrusions and herniations in the cervical spine are not uncommon, majority of people suffer from myofascial pain when it comes to the neck pain. The most consisted characteristic of the myofascial pain in the neck is that of the pain changing location.


Bringing together the reported data from different studies, we can claim that pain in the neck has increased by 10.4% and 21.3% in the past five years. Prevalence in general population is higher in women compered to man, however a high peak of this type of pain is observed in sitting-workers of both genders.


The cervical spine consists of seven vertebras interconnected by the discs, spinal joins and the ligaments. The top of the cervical spine is connected to the cranium (head) through intricate anatomically designed cranio-cervical junction. The muscle of the neck connect many anatomical areas together. In order to fulfill many different neuromuscular functions for mobility, stability and connection of the central nervous system to the neck the muscular and fascial system are anatomically very complex in this area of the body. The neck muscles serve as connectors for integration of very precise mobility necessary not only for movement but for integration of: vision, hearing, balance and breathing.


Reasons for neck pain may vary from many disorders of different tissues within shoulder girdle and cervical spine. Here are some of the causes:
  • improper breathing
  • poor posture
  • breast implants
  • head injuries
  •  trauma to the neck such as whiplash
  • hypermobility
  • poor muscles balance of shoulder girdle and cervical spine
  • falling asleep in an awkward position;
  • prolonged sitting position;
  • stress.
  • excessive computer work and excessive use of mobile devices
  • poor vision
  • improper exercise



The protruded, bulged or herniated disc in the cervical spine are not uncommon however most of them go away with proper conservative care in a relatively short time. Surgery is rarely necessary. However when its warranted the healing is much faster and reoperations are very rare.


Neck arthritis is not uncommon. It causes limitation in the movement of the neck and pain. However in the hands of experienced physical therapist or a chiropractor the pain can be eliminated and enough of the lost movement can be restored in order for the symptoms to subside.


The cervico-cranial syndrome is characterized by the neck pain at the junction with the skull, headaches, occasional dizziness and blurry vision. Sometimes patient may have concomitant pain in the jaw. Depending on the symptom presentation this syndrome may be called as orofacial pain or TMJ (temporo-mandibular joint) pain syndrome. Irregardless of the name the etiology of this syndrome is within the musculoskeletal system and not the problem in the mouth or the nervous system.


Pain in the cervical spine may be a symptom of more serious problems like degenerative disc disease, herniated disc, or a pinched nerve. Cervical facet joints are rare source of pain. Most of the pain experienced in the cervical spine outside disc disease is of myofascial character. In the absence of perpetuating factors myofascial pain responds well to variety of different manual therapies in combination with rehabilitative exercises , acupuncture and extracorporeal shockwave therapy. Preventive treatment for reducing the risks of this type of pain should include ergonomic work space arrangement, gentle stretching, postural exercises, Pilates specific neck and breathing exercises. Neck pain treatment should address all functionally interrelated body segments such as: whole upper extremity, shoulder girdle, rib cage, cervical spine, and even skull and TMJ. Movement dysfunction in any above described areas could affect biomechanics of the cervical spine through kinetic interlinking of muscular chains. Sitting postures, lifting, prehension, breathing as well as ergonomic conditions must be examined and addressed. The use of hand held devises must be minimized for the time of symptom duration because hand held devices perpetuate abnormal movement stereotypes affecting the upper quarter. Patient is recommended to take short breaks with performance of brief remedial postural exercises for reduction of strain to the neck imposed by desk and computer work.


At Dr. Kalika’s clinic neck pain treatment is conducted by a combination of DNS (dynamic neuromuscular stabilization) therapy, clinical Pilates, variety of manual myofascial and neuromuscular methods, acupuncture, extracorporeal shockwave therapy which concurrently address all interrelated tissues as well as motor control of the upper quarter of the human body. Home exercise program based on movement impairment examination is also very effective component of successful and long lasting relief.



In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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