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What Are The 4 Classifications of Neck Pain?

Neck pain is an extremely common affliction, with almost two-thirds of the population experiencing it at some point in their lives. While there are many possible causes, neck pain is generally categorized into one of four main types based on its underlying cause and characteristics:

Mechanical Neck Pain

Mechanical neck pain is the most prevalent classification, accounting for over half of all cases. As the name suggests, this type of pain stems from problems with the mechanical function of the structures in the neck.

Issues with any of the vertebrae, discs, nerves, muscles, or other tissues in the cervical spine can produce mechanical pain. Typical causes include poor posture, muscle strains, injuries, degenerative disc disease, arthritis, and herniated discs. Since the pain originates from physical structures, it tends to worsen with movement or physical activity.

Symptoms of mechanical neck pain include muscle tightness and spasms, stiffness, restricted range of motion, soreness, aching, and sometimes popping or clicking sounds. The pain may be localized or radiate out to the shoulders and upper back. Mechanical neck pain can arise either suddenly after an injury or trauma, or come on gradually over time due to repetitive motions and joint degeneration.

Treatments for mechanical neck pain aim to improve the alignment, flexibility, and strength of the neck. This may involve physical therapy, chiropractic adjustments, massage, acupuncture, and ergonomic corrections. Medications like NSAIDs and muscle relaxants may provide temporary relief as well. Surgery is only warranted in severe cases that do not respond to conservative treatment.

Radicular Neck Pain

Radicular neck pain refers to pain caused by irritation, inflammation, or compression of a cervical nerve root. The cervical nerves exit the spinal cord through spaces between the vertebrae and coalesce to form nerves that run down the arms.

Impingement of a nerve root produces pain that radiates out from the neck into the shoulder, arm, hand, or fingers in a pattern consistent with that particular nerve. This radiating quality helps distinguish radicular from mechanical pain. Numbness, tingling, weakness, or altered reflexes may also be present along the affected nerve.

Common sources of nerve root compression include herniated discs, bone spurs, narrowing of the spinal canal, and tumors or cysts putting pressure on the nerves. Pinched nerves often result from injuries, poor posture, or spinal degeneration. Treatments aim to take pressure off the impacted nerve through traction, injection therapy, physical therapy, or surgery for severe impingement.

Myofascial Neck Pain

Myofascial pain syndrome is a disorder of the fascia, which is the connective tissue surrounding the muscles. Trigger points develop in the fascia which are hyperirritable knots that generate pain.

In the neck, trigger points most often occur in the upper trapezius, levator scapulae, and sternocleidomastoid muscles. Myofascial neck pain tends to cause a constant dull ache with periods of more intense pain. Trigger points can limit range of motion and produce referred pain in surrounding areas like the head, shoulders, and jaw.

Myofascial neck pain frequently arises following neck strain, poor posture, or whiplash injuries. Treatments focus on inactivating trigger points using massage, dry needling, heat, stretching, and postural correction. Trigger point injections and Botox injections can provide targeted relief. Medications and stress management may also help.

Cervicogenic Neck Pain

Cervicogenic neck pain originates from a disorder of the cervical spine that is not visible on standard imaging like x-rays or MRIs. It stems from irritated nerve roots in the neck that refer pain into the head, upper back, shoulders, and arms.

Cervicogenic headaches are a prime example – they feel like migraines but emanate from damaged neck vertebrae or compressed nerves. Other symptoms may include dizziness, ringing in the ears, and vision changes. The pain spreads in patterns characteristic of the affected nerve roots.

Cervicogenic neck pain often results from whiplash, poor posture, or repetitive motions. Treatment involves physical therapy, ergonomic changes, massage, and chiropractic or osteopathic manipulation. If significant nerve dysfunction is present, injections or radiofrequency ablation of the nerve roots may provide pain relief.


Identifying one of these four classifications is key to successful management of neck pain. It allows the doctor to pinpoint the source and select optimal therapies. While many cases of acute neck pain resolve within several weeks, chronic or severe symptoms should be evaluated by a specialist who can provide targeted treatment based on a thorough assessment and classification of the type of pain. An accurate neck pain diagnosis and tailored treatment plan are crucial for long-term relief.