Avin Patel

Neck Pain

As with lower back pain, there are a number of causes for neck pain that your osteopath can help with.

Neck pain: muscles, joints, discs, and ligaments commonly involved

Muscle pain

One major cause of neck pain is tight or strained muscles. Any prolonged position will be uncomfortable for muscles in the short term. If this position becomes a usual position over days and weeks, the muscles will adapt for efficiency. This means shortening, or tightening the muscles that are rarely stretched.

There is an increased demand on muscles when the head is not held in a neutral position. Looking down at a phone or low computer screen puts as much of a requirement through the neck as if your head was twice as heavy- or more.

Muscles will also react to other causes of pain as the body tries to protect itself. Most people with neck pain will also have some tightness in the neck, regardless of the original cause. This can lead to headaches.

Joint pain

Off to the side of each vertebra is a joint that connects it to the one above, and another that connects it below. These joints are small but they can be quite painful if irritated. Sometimes they might lock up in response to a problem with another structure in the neck, which can cause muscle tightness that perpetuates the cycle. The tight muscle keeps the joint stiff, so the discomfort causes the muscle to stay tight. We have a range of techniques from gentle cranial techniques and acupuncture to quick manipulations.

Neck pain from arthritis

Osteoarthritis and rheumatoid arthritis can both affect the small joints of the neck. Even when it’s uncomfortable, one of the best things you can do to manage this is keep it moving. It can be really helpful to see your osteopath for guidance with this. When we are in pain, we might worry about causing damage if we push through the pain. Osteopaths can help you find a good balance of movement and discomfort to manage the symptoms of your arthritis.

Intervertebral discs

Like back pain can be caused by a problem with a disc, the same is true in the neck. If the fibrous outer layer of a disc is weakened (which is not unusual), the soft layer inside can push against it and cause a small bulge. Discs themselves are not as sensitive as things like muscles. It is possible to have a disc bulge without any symptoms at all.

If the bulge pushes on a nerve, it can cause pins and needles, numbness, weakness, or pain. The lower nerves leaving the neck actually supply the arms, so a “trapped nerve” in the neck could be the cause of symptoms in the hand. Only the first few nerves in the neck supply the head, and when they’re irritated they can cause headaches.

Disc problems sound worse than they are. We work to find the original cause of a bulge, which may be something further afield like stiffness in the upper back. By addressing issues that have caused the disc to overwork in the first place, we give the disc space to heal and reduce the chance of it happening again.

Ligament sprains

This can be as simple as a cricked neck, or the cause may have been more traumatic. Mild ligament sprains are classified as an injury where under 10% of the ligament’s fibres have been damaged. They tend to resolve within a month, but you’re welcome to make an appointment to try and speed up recovery or work out why it happened in the first place.

More significant ligament sprains can take a few months to heal. Blood supply to ligaments is poor, which limits their capacity to recover quickly. However your osteopath can work around the whole area to help keep fluids moving and give the injury the best environment possible to heal.

It is important to keep moving your neck even after an injury. Neck braces and collars are not recommended for the vast majority of neck sprains. Loading the tissue within a safe limit will encourage the fibres to knit back together stronger.

Managing neck pain

All four of these structures are within your osteopath’s remit. We have a range of techniques to suit any patient with any problem: we don’t just “click necks”! If you prefer a more gentle approach, we can provide that too.

An important part of your treatment plan will include self management. Alongside your diagnosis and prognosis, we can advise you on how to manage between appointments with an exercise plan and other advice.

See how we can help with your neck pain, book in now.

Cervicogenic Headaches

Headaches are classified by their cause, and “cervicogenic” just means “originating in the neck“.

Cervicogenic headaches: muscles involved and distribution of pain

Cervicogenic headaches are very different to migraines as they do not come with nausea, aura, or visual disturbance. They also differ from other headaches in that:

  • They are not particularly intense
  • There is no association with medication use
  • Feelings of congestion in the nose or ear, or a running eye or nose are not present

There are a few different ways that this kind of headache can be explained:

Muscular pull

At the very top of your spine there are four small muscles that attach to the skull. They work with larger muscles and some blend into the tissues of the scalp. When they are tight they can pull on the scalp and cause pain right over the top or side of the head. Calming down the muscles will typically give relief.

Referred pain

The muscles and other tissues can have a less direct effect leading to pain. Nerves that supply the back of the neck and scalp areas can misinterpret pain signals. Therefore the brain believes there’s pain in the head rather than just the area of the neck that’s sending out signals.

First Aid for cervicogenic headaches

This kind of headache often doesn’t last long and can often be well managed at home.

Are your neck muscles being tightened by prolonged sitting in one position? Using a laptop on the sofa or in bed often leads to holding your head in such a way that the muscles have to work hard. Changing position or resting briefly may be enough to let the muscles relax.

Putting a warm or cool compress on the back of the head and neck for a few minutes encourages the muscles to ease off.

Osteopathy for cervicogenic headaches

If you frequently suffer from cervicogenic headaches, there may be an underlying cause that needs to be addressed. Because the cause of this pain is the neck, your osteopath might assess your neck, shoulders, and upper back. If you have any problems in these areas such as recent injury or surgery that may make you hold yourself differently, this will be relevant.

Sometimes there is a problem with ligaments, joints, or discs in the neck that causes cervicogenic headaches. Again, your osteopath can seek these causes out and get to the bottom of them.

Stress and anxiety can also cause tightening through the shoulders and neck. Although your osteopath can’t help with stress itself, we can help retrain your breathing. This means making sure that the main respiratory muscles are working efficiently and taking the load off the smaller muscles in the shoulders.

A combination of exercise and osteopathy has been proven to significantly benefit patients who suffer from cervicogenic headaches. These effects are particularly long lasting in those who continue their exercises.

Book an appointment to get to the root cause of your headaches


The sciatic nerve runs from the lower back down the back of the thigh and outside of the calf. Sciatica is a symptom of irritation of this nerve.

Scatica and its causes


When the nerve is irritated, symptoms can develop anywhere along the length of it. For some people this means pain from the back to the foot, and for others it can be a lot more focal. A sharp, shooting pain in a defined line is a typical symptom of sciatica. This is rarely constant but might be somewhat unpredictable. Pins and needles in the same area, or numbness or weakness are also common.

If the cause is a disc bulge, movements that stress the disc can aggravate symptoms. Examples of this are heavy lifting, twisting, and straining on the toilet. It is important to note that symptoms are not indicators of damage. Nor does intensity of symptoms predict how long an episode will last. Sometimes people with the most debilitating pain are the quickest to recover.

Causes of sciatica

The basic cause of sciatica is irritation of the nerve in the back or upper leg. There are a number of ways this can happen, and sometimes there are multiple causes. Two of the most common are:

  • Nerve compression in the back due to a bulging disc (diagram C)
  • Nerve compression in the buttock due to a tight gluteal muscle (piriformis syndrome)

When is Sciatica not Sciatica?

Not all pains in the back of the leg are down to the sciatic nerve.


The sciatic nerve runs through the same area as the hamstrings, so pain can be mistaken for sciatica when it’s not a nerve at all. A simple pulled muscle can imitate the symptoms without any sciatic involvement.

Referred pain

Sometimes the brain misinterprets pain signals and detects pain where it shouldn’t be. You may have heard of people having heart attacks but experiencing jaw pain: this is the same mechanism. Nerves cover a broad area, so when a nerve brings a pain signal to the brain, the brain has to work out where exactly the pain is coming from. Heart pain isn’t a usual sensation, so the brain thinks the pain must be coming from somewhere else in that nerve’s area. One nerve that supplies the heart also supplies the jaw, so the brain makes an educated guess.

The same can happen in the back and leg. Irritated joints in the lower back and pelvis can cause pain in the back of the thigh. This doesn’t necessarily mean that anything is wrong with your leg! Your osteopath can work out what’s happening and what needs to be done.

Plantar fasciitis

Pain and pins and needles in the foot can be symptoms of sciatica, but when they’re isolated to the sole of the foot alone they could be something else. Plantar fasciitis is inflammation of the soft tissues on the sole, unrelated to the sciatic nerve.

Book an appointment today to get on top of your sciatica

Lower Back Pain

Roughly 80% of us experience low back pain at least once in our lives, but the vast majority of cases are not serious. Even cases that lead to time off work are not necessarily indicative that something is damaged.

Osteopaths can help with lower back pain formally categorised as “non-specific”. This is an umbrella term that includes pain caused by:

  • Tight or strained muscles
  • “Slipped” discs
  • Irritated joints in the spine or pelvis
  • Ligament sprains in the back

“Non-specific” does not mean that we don’t know what is causing your pain or that we can’t do anything about it. It just means that more serious causes such as fractures or disease can be ruled out.

Do I need a scan?

These non-serious causes rarely correspond to findings on MRI or X-Ray. Making an appointment with your osteopath before getting a scan could mean being symptom free before your hospital appointment date.

In fact, evidence shows that MRIs show problems with discs in people without symptoms, so scans are far from the gold standard for diagnosing back pain. This is one reason that imaging is no longer recommended as a GP’s first strategy for straight-forward back pain. You also don’t need a doctor’s referral to see an osteopath, you can make an appointment yourself.

Due to comprehensive training, osteopaths are able to distinguish between non-specific lower back pain and more serious causes. If your back pain does require medical attention, we can support you in getting to the right practitioner.

How can I prevent lower back pain?

Some lifestyle factors have been shown to predispose an individual to developing lower back pain. These include:

  • Being overweight
  • Lack of activity
  • Overexerting during physical activity, including at work

So staying active without pushing too hard, and staying at a healthy weight will help to prevent future episodes.

Problems with the lower back are often linked to dysfunction elsewhere, such as stiffness in the upper back. Upper back restriction is something we commonly see in clinic, often exacerbated by long periods of sitting still such as when stuck at a desk. When the upper back is restricted, the body compensates by putting more movement through the other areas of the back. This can cause the muscle tension and strains mentioned above.

During an appointment, your osteopath will look at the whole body. This means we can identify these areas of restriction before they cause symptoms. Exercises and advice to keep these stiff areas at bay are also great ways to prevent episodes of pain.

What can an Osteopath do for back pain?

Osteopaths use a range of techniques for pain relief and rehabilitation. Hands-on techniques such as massaging and stretching muscles, or moving and clicking joints can be useful. Avin is also qualified in Medical Acupuncture, which has been proven to improve low back pain.

Because osteopaths look at the whole individual, we are in a position to find any factors that might have fed into the symptoms you have today.

Back pain can be debilitating and scary, so an important part of your treatment plan is rehabilitation. Exercises help keep your back happy between treatments, but they also serve the purpose of letting your body know that it is safe to move. The sooner we can get you comfortable again, the sooner you can get back to normal.

If you suffer from these symptoms, you can make an appointment at any of our 6 clinics.