What is an Chronic Neck Pain?

  • Chronic Neck Pain is a very common condition that can arise from the muscles, facet joints, intervertebral discs, or nerves of the cervical spine (neck). It may result from poor posture, age-related wear and tear (cervical spondylosis), previous injury, or prolonged strain on the neck structures. Although most neck pain is not caused by a serious underlying condition, it can become persistent and significantly affect quality of life if not managed appropriately.
  • Neck pain may be localised to the neck or may be associated with headaches, shoulder pain, or nerve-related symptoms such as pain, tingling, numbness, or weakness in the arm.
  • It is important to distinguish facet joint pain from myofascial pain, particularly in patients with conditions such as fibromyalgia or myofascial pain syndrome, where muscles and trigger points are often the primary source of pain. These conditions are common but require different treatment strategies and interventional approaches. Careful assessment is therefore essential to ensure the most appropriate treatment is offered.

What are the symptoms?

    You may experience:

  • Aching, stiffness, or sharp pain in the neck
  • Pain worsened by movement, prolonged sitting, or sleeping in certain positions
  • Reduced neck mobility or feeling of tightness
  • Tension headaches (pain radiating to the back of the head)
  • Shoulder or upper back discomfort
  • In some cases, arm symptoms (tingling, numbness, or weakness) if nerves are affected

How is it diagnosed?

Diagnosis is based on:

  • A detailed clinical history and physical examination.
  • Identification of mechanical pain patterns, movement restriction, and the most likely pain generator.
  • Imaging (MRI or CT scans), where clinically indicated, to exclude serious underlying pathology. In many patients with mechanical neck pain, imaging findings do not correlate well with the severity of symptoms.
  • Assessment for facet joint pain, disc-related pain, nerve root irritation (cervical radiculopathy), and myofascial pain, as these conditions require different treatment approaches.

What treatments do we offer?

We provide a range of targeted, non-surgical, minimally invasive treatments for persistent neck pain.

1. Cervical Facet Joint Interventions

For pain arising from the small joints of the neck (facet joints), we may offer:

  • Diagnostic medial branch blocks to confirm the facet joints as the source of pain and provide short-term relief.
  • Radiofrequency denervation (RFD) to provide medium-term pain relief in carefully selected patients who respond well to diagnostic blocks.
  • These procedures are performed under ultrasound or X-ray guidance as day-case or office-based procedures.

2. Selective Nerve Root Injections

If your neck pain is accompanied by arm pain, tingling, numbness, or other nerve-related symptoms, a selective nerve root injection may be appropriate.

This procedure aims to reduce inflammation around the affected nerve root, provide pain relief, and help guide further treatment.

3. Trigger Point Injections

For pain arising from muscle tension or spasm, particularly in the upper trapezius, levator scapulae, or cervical paraspinal muscles, we may offer trigger point injections.

These are particularly helpful when myofascial pain is a significant contributor to your symptoms.

4. Stellate Ganglion Block

In selected patients with whiplash-associated disorders, sympathetic overactivity, persistent upper limb pain, complex regional pain syndrome (CRPS), or associated facial pain, a stellate ganglion block may be considered as part of a broader treatment strategy.

5. Pulsed Radiofrequency (PRF)

For selected patients with persistent nerve-related neck pain, pulsed radiofrequency (PRF) may be used to modulate pain signals and provide longer-lasting pain relief without intentionally damaging the nerve. PRF may also be used to treat myofascial trigger points in carefully selected patients with chronic myofascial neck pain.

 

Self-Management & Rehabilitation Advice

  • We offer guidance on posture correction, activity pacing, and gentle stretching exercises
  • Physiotherapy, either independently or as a referral, may help restore neck mobility and reduce recurrence
  • Guidance is provided on activity modification, stretching, pacing, and simple exercises to help reduce pain and prevent recurrence.

Medication Optimisation

  • We review your pain medications to ensure they are safe, effective, and necessary.
  • In line with local prescribing guidelines, we do not prescribe opioids or pregabalin. These medications must be managed by your own GP. We may recommend safer alternatives and Support deprescribing where needed.

What to expect from treatment

  • Most people experience gradual improvement with the right combination of physical strategies and targeted interventions
  • All procedures are minimally invasive and performed as day-case treatments
  • Our goal is to help you reduce pain, restore function, and reduce reliance on medication

What we do not offer

  • We do not provide surgical interventions or spinal operations
  • We do not prescribe opioids or pregabalin, in line with local guidelines
  • We do not offer emergency care for acute neck trauma or neurological emergencies
  • We do not offer medicolegal assessments