Causes of neck pain

Discogenic Causes

Cervical Disc Herniation

Most common locations — C5-C6 and C6-C7 (90% of all cervical herniations). Presents with neck pain radiating to the arm, finger numbness, hand weakness. C5-C6 herniation: numbness of thumb and index finger, biceps weakness. C6-C7 herniation: numbness of middle finger, triceps weakness.

→ Herniated Disc Treatment using a regenerative method

Cervical Disc Protrusion

Disc bulging without rupture of the fibrous ring. Dull neck pain worsening with prolonged head flexion (computer work). Whether regenerative treatment is an option in this condition is assessed by the clinic doctor.

Cervical Osteochondrosis

Disc dehydration and height reduction, osteophytes, uncovertebral arthrosis. Develops from age 30-35. Crepitus with head rotation, morning stiffness, periodic pain with loading.

→ Osteochondrosis Treatment

Spondylogenic Causes

Cervical Spinal Stenosis

Narrowing of the spinal canal in the cervical spine. More dangerous than lumbar — spinal cord compression (myelopathy). Symptoms: clumsiness in hands (difficulty buttoning shirt), gait disturbance, Lhermitte's sign (electric shock down the spine with head flexion).

→ Spinal Stenosis Treatment

Cervical Spondyloarthrosis (Facet Joint Syndrome)

Arthrosis of the facet joints in the cervical spine. Pain with head extension and rotation, localized paravertebrally. Does not radiate to the arm (unlike herniation). X-ray shows facet joint narrowing, osteophytes.

→ Facet Joint Syndrome Treatment

Muscular and Other Causes

Myofascial Pain Syndrome

Chronic tension of trapezius muscle, levator scapulae, scalene muscles. #1 cause in office workers. Dull pain, trigger points, restricted head rotation. "Text neck" — syndrome from constant forward head tilt to smartphone.

Cervicogenic Headache

Headache originating from the cervical spine (C1-C3). Pain starts in occiput, spreads to temple, forehead, eye area — always unilateral. Worsens with head rotation and flexion. Often misdiagnosed and treated as migraine.

Vertebral Artery Syndrome

Compression or spasm of vertebral artery due to instability or osteophytes. Dizziness with head rotation, tinnitus, visual disturbance, drop attacks. Requires Doppler ultrasound of neck vessels.

Whiplash Injury

Following car accidents (sudden neck flexion-extension). Pain, stiffness, headache, sometimes cognitive impairment. Without adequate treatment, becomes chronic in 30% of cases.

Red Flags — When to See a Doctor Urgently

Myelopathy

Clumsiness in hands, impaired fine motor skills, gait changes, urinary dysfunction — signs of spinal cord compression. Requires emergency MRI.

Progressive Weakness

Increasing weakness in arm, inability to make a fist, lift wrist — progressive nerve root compression.

Pain After Injury

Neck pain after a fall, blow, or car accident — fracture or vertebral dislocation must be ruled out. Cervical CT scan is mandatory.

How it is treated: the cause comes first

Treatment depends on the cause of the pain, so it starts with an examination and, if needed, imaging — X-ray, ultrasound or MRI. The same pain can be caused by osteoarthritis or by a tendon, nerve or disc problem.

Most patients are helped by conservative treatment: exercise therapy, load management, short courses of painkillers and sometimes injections. Regenerative methods (PRP, cell preparations) are discussed once the diagnosis is known and there is at least limited evidence for it; no method guarantees a result.

We send a description of your case and your images to several partner clinics. The clinic doctors give a preliminary opinion, suggest a plan and quote a price, and we help you compare the options.

Who it is not suitable for and possible risks

Contraindications

  • Active infection — at the injection site or systemic, with fever.
  • Active cancer or ongoing chemotherapy.
  • Blood clotting disorders or a low platelet count. Anticoagulants are discussed with the physician.
  • Pregnancy and breastfeeding — the procedure is usually postponed.
  • A corticosteroid injection into the same area in recent weeks.
  • Urgent surgery, not injections, is needed if there is progressive leg weakness, numbness in the groin area or bladder dysfunction.

Possible risks

  • Pain and swelling at the injection site for 1–3 days.
  • Bruising where blood or fat tissue is taken.
  • Rarely, infection. The procedure is therefore performed under sterile conditions with ultrasound or X-ray guidance.
  • The effect may be absent or smaller than expected.
  • Injections into the intervertebral disc carry a rare risk of disc inflammation (discitis).

If any of these apply to you, mention it in your request. The coordinator will check with the clinic physician whether treatment is possible. Contact a coordinator.

Scientific evidence

Studies of regenerative methods show mixed results. Clinic physicians rely on research including the following:

  1. Brinjikji W et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol, 2015.
  2. Sheth U et al. Efficacy of autologous platelet-rich plasma use for orthopaedic indications: a meta-analysis. J Bone Joint Surg Am, 2012.

Next steps: Treatment methods · Treatment cost · How treatment in Germany is organised

Questions about neck pain

Why does neck pain radiate to the arm?

Neck pain radiating to the arm is a sign of cervical radiculopathy. C5-C6, C6-C7 disc herniation or protrusion compresses the nerve root. Accompanied by finger numbness and arm weakness. Cervical MRI is necessary.

Is neck cracking dangerous?

Episodic cracking without pain is normal. Constant cracking with pain and limited motion is a sign of facet joint osteoarthritis or instability. Functional X-ray is recommended.

Can cervical herniation be treated without surgery?

Yes. Regenerative treatment treats cervical herniations through a 0.5 mm puncture under navigation control.

What is cervicogenic headache?

Headache originating from the cervical spine (C1-C3). Starts in the occiput, spreads to temple, forehead, eye. Unilateral. Worsens with head turns. Often misdiagnosed as migraine.

What tests are needed for neck pain?

Cervical MRI — primary. Functional X-ray — for instability. Neck vessel Doppler ultrasound — for dizziness. EMG — for numbness and weakness in arms.