Physiotherapy for Neck Pain

Pilates and Manual Therapy for Acute and Chronic Neck Pain


At Pilates4Physio, we are manual therapists and Pilates-based rehabilitation instructors. This means we treat using joint massage or mobilizations, soft tissue massage and Pilates. The combination of skills here is unique in that we treat our patients with all these modalities. We do not transfer you to another person for part of your treatment.

Neck pain can be simple and more complex. For this reason, it is even more important for all the treatment to be provided by a physiotherapist. We do not use chiropractic-type adjustments, as most of the time it is unnecessary. More gentle joint mobilizations are just as effective.

Assessment for Neck Pain

The assessment is the most important piece of the treatment plan. The type of injury will determine what type of assessment is required. For the neck, safety is paramount so we take you through a thorough process. We ask a lot of questions about your symptoms. Some symptoms may require you to go back to your GP. We know what to look for so we can let you know if this is the case.

a lady in a cobra pose
Lady holding her neck because it hurts


Muscle and joint-related pain:

Sitting at computers, texting and screen time can overload the muscles, making them tired and achey. Sometimes they develop areas of acute tenderness on touch. The pain may radiate up or down the neck and may cause tension headaches. Certain postures may cause this type of neck pain. Head forward posture is where the head sits too far forward. The upper back is usually stiff. The neck becomes over-loaded and strained.

Locked joints in the neck:

Sometimes if the neck has become very stiff, the joints may become locked. Usually, pieces of soft tissue around the joint get trapped and then prevent movement. You might suddenly find you cannot turn your neck and the pain is quite severe. We assess this by looking at your neck movements and what type of pain this produces. This type of neck pain should resolve with gradual manual therapy and exercises.

Radiculopathy or pinched nerves:

This is where a nerve becomes pinched in the neck and causes pain down the arm. Symptoms may include numbness and tingling to the hand. There may be nerve-type pain in the arm and shoulder. Treatment is initially manual therapy to mobilize the neck and free the nerve. Then we look at what has caused the trapped nerve and treat that. Postural problems can exacerbate this injury.

Disc-related injuries:

Just like the lower back, discs can bulge, protrude and herniate in the neck. The main signs and symptoms are similar to the pinched nerve scenario in the above paragraph. There will be a more severe loss of movement and pain will be higher. Again, manual therapy to restore neck movement is the primary treatment. Then exercises to mobilize the upper back and neck should follow.


We talk about whiplash injuries in our blog. Whiplash is a sudden acceleration or deceleration injury to the neck. Usually, this occurs in a car accident. Your neck movements may be very limited with pain. The pain will vary depending on the type of whiplash. If you have an associated concussion, it is essential to be checked by your GP or a Sports Medicine Doctor. Some clinics have concussion clinics and we recommend going to them first to be assessed.

We treat most types of whiplash injuries. The combination of physiotherapy for neck pain and Pilates is ideal. Pilates allows a gradual return to a normal range of motion. The classic equipment supports the head and neck for safe exercise. The whiplash assessment is essential to tease out any signs or symptoms that require referral to your doctor.


Treatment for neck pain is initially focused on pain relief. Graduated movement is the key to reducing pain, both acute and chronic. Manual therapy, massage and education are also essential to managing pain. Once pain is under control, therapeutic exercises will mobilize the joints and strengthen the neck muscles. Over-protection for too long can create a chronic response. Restoring movement and strength is key to a full recovery.

  • Manual Therapy:
    Gentle joint mobilizations on the neck and upper back vertebrae reduce pain and stiffness. We do not do aggressive joint manipulations as most of the time they are not needed. Instead, we do a mobilization which is a lot safer and effective.
  • Massage:
    At Pilates4Physio, we use sports massage techniques to reduce pain and restore normal soft tissue mobility. This can be very effective on the muscles that tend to become tight. Reducing pain is key as the sooner you can start active exercises, the faster your overall recovery will be.
  • Pilates:
    We use Pilates rehabilitation because it’s ideal for both injuries and persistent painful conditions. The classic equipment allows the right movements in the neck, in non-painful positions. The repertoire of exercises is vast in Pilates and provides many more options compared to conventional gym equipment.
    It is important to move the whole spine for many types of neck pain. The spine is all connected. In many types of neck pain, the whole spine may become involved. Pilates takes a total body approach and gets to the root cause of the neck pain.


Will changing my pillow help with neck pain?

Possibly yes. However, many people are told that their mattress or pillow is the cause of the problem when it is not. It may play a part, but not be totally responsible. We can give you advice on good pillows and sleeping positions to reduce neck pain at night.

Is my neck pain all postural?

Sometimes, yes it can be. Sitting for long periods over many years causes stiffness in the mid and upper back. Then the neck has to compensate for the stiffness in the lower thoracic spine. The joints and muscles become overloaded. Regular movements in directions you do not usually move in will help.

Does my neck pain cause headaches?

Yes, it can. Persistent neck pain can radiate to the muscles that attach to the skull. This can also radiate to the front of the head. Even the jaw bone can become painful from some chronic neck conditions. You may also experience some dizziness with the headaches. Regular neck and upper back exercises can reduce these types of headaches.