What is a red flag for neck pain?

Fever and headache with a very stiff neck, neck or arm pain with chest symptoms like shortness of breath or sweating, and being unable to move an arm after an injury all need emergency care. Arm numbness or weakness, trouble walking or balancing, loss of bladder or bowel control, and pain that wakes you at night need a prompt medical evaluation. Physical therapy is the wrong first stop for any of these.

How long does whiplash take to heal?

According to the American Academy of Orthopaedic Surgeons, most neck sprain and strain symptoms go away in 4 to 6 weeks, while more severe injuries take longer. Symptoms can also appear hours after a crash or the next day. Get a medical evaluation after any car accident, even if you feel fine at first.

Do I need a referral for physical therapy after a car accident in New York?

Yes, if No-Fault is paying. New York No-Fault covers physical therapy pursuant to a referral, so see your physician first. You should also give your auto insurer written notice within 30 days of the accident.

What helps a stiff neck?

Gentle movement usually helps more than holding still: slow up-and-down, side-to-side and ear-to-shoulder motions. Ice for the first two to three days, then heat, plus a pillow that supports your neck, can ease things. If it isn't improving after a week of self-care, or you have arm symptoms, get it evaluated.

Neck Pain Physical Therapy in Buffalo, NY | Lake Erie Physical Therapy

Neck pain tends to arrive one of two ways. It creeps in over weeks of laptops, phones and long drives, or it shows up the morning after someone rear-ends you on the Kensington. Neck pain physical therapy can help with both, but the starting point differs, so we’ll take them one at a time. Either way, the aim at Lake Erie Physical Therapy is the same: find the movements that ease your neck, then build the strength and habits that support it.

The slow kind: screens, phones and pillows

According to MedlinePlus, everyday activities are most often to blame for neck strain: bending over a desk for an hour or more, a monitor set too high or too low, slumping while you read or watch TV, sleeping in an awkward position, and jarring neck movements during exercise. Arthritis in the neck (spondylosis), disc problems and sprains are other causes. APTA’s guide to neck pain notes that it most often affects adults between 40 and 70, and that most people feel better from an episode within 6 to 12 weeks.

This kind of neck pain often brings a stiff neck when you check your blind spot, an ache across the shoulder blades, and sometimes headaches that start at the base of the skull. If headaches are a big part of it, see our page on neck-related headaches. If pain, tingling or numbness travels into your arm, read about pinched nerves.

The sudden kind: whiplash after a car accident

Whiplash is a neck sprain or strain caused by the head whipping rapidly back and forth, commonly in rear-end collisions. The American Academy of Orthopaedic Surgeons points out that symptoms may not start until hours later or the next day, which is why you should be evaluated by a doctor after a neck injury even if you feel fine.

Common whiplash symptoms include:

Neck pain that worsens with movement and peaks a day or so after the crash
Muscle spasm and pain across the upper shoulders
Headache at the back of the head
Fatigue, irritability, and trouble sleeping or concentrating
Numbness, tingling or weakness in the arms

Most neck sprain symptoms go away within 4 to 6 weeks, though more severe injuries take longer.

A note on New York No-Fault: No-Fault covers physical therapy with a referral, so start with your physician, and give your auto insurer written notice within 30 days of the accident. Our car accident and No-Fault page walks through the paperwork.

Neck pain physical therapy at Lake Erie PT

Your first visit

After a detailed history, we test how your neck responds to repeated movements and sustained positions using the McKenzie Method (MDT): tucking your chin, tilting your head back, turning and side-bending, while we watch what happens to your neck, shoulder blade, arm or head symptoms. Some necks show a clear preferred direction in the first session. When that happens, you leave with a movement you can use at your desk, in the car or before bed. If you have arm symptoms, we also check strength, sensation and reflexes. Both co-owners, Dr. Will Tso, PT, DPT, Cert. MDT, and Dr. Ryan Mitchell, PT, DPT, build neck care around this kind of testing.

What treatment usually includes

Hands-on manual therapy for stiff joints and guarded muscles
Mechanical traction or pain-relieving modalities when your exam suggests they’ll help
Strength and endurance work for the deep neck and upper back muscles
Workstation, phone and sleep adjustments that fit your actual day
Education with spine models and pictures, so you know what to do during a flare

We’ll estimate how many visits you need after the first one and revise that estimate as you respond.

When neck pain needs a physician first

Physical therapy is not a substitute for a medical diagnosis. Call 911 or get to an emergency department for:

Fever and headache with a neck so stiff you can’t touch your chin to your chest
Neck or arm pain with shortness of breath, sweating, nausea, vomiting or jaw pain, which can signal a heart attack
A fall, blow or crash after which you can’t move an arm or hand

See a physician promptly for numbness, tingling or weakness in an arm or hand; trouble walking or keeping your balance; loss of bladder or bowel control; trouble swallowing or breathing; a lump or swollen glands in the neck; or pain that is worse lying down, wakes you at night, or doesn’t respond to regular doses of over-the-counter pain medicine. After any car accident, see a doctor before starting therapy.

Small changes that help between visits

Set your screen so you aren’t looking up or down at it for hours.
Get up from the desk at least once an hour.
Sleep on a firm mattress with a pillow that supports your neck.
Use ice for the first 48 to 72 hours of a new flare, then heat.
Keep moving gently: slow up-and-down, side-to-side and ear-to-shoulder motions.
If a week of self-care hasn’t helped, get evaluated.

With most plans, neck pain that isn’t from a car accident doesn’t need a referral to start: New York’s direct access law allows up to 10 visits or 30 days, whichever comes first. Call (716) 332-4838 or request a visit online. Our Buffalo clinic is about a 4-minute walk from the Allen/Medical Campus Metro Rail station.

Sources

Written by the Lake Erie Physical Therapy clinical team. This page is general information, not a diagnosis; your physical therapist will assess your situation in person.

Physical Therapy for Neck Pain