Around two thirds of people experience neck pain at one moment in their life and it is becoming increasing more common throughout the world. Common symptoms of neck pain include muscle pain, muscle spasm, headache, facet joint pain, nerve pain, referred pain and bone pain. From acute neck pain to long term chronic pain, there are many structures that could be the leading cause of this pain and the team at Niche Physio and Pilates are here to help.
We provide a targeted, hands-on approach to the treatment of neck pain followed by providing a rehabilitation program aimed at restoring optimal function. All therapists are certified clinical pilates instructors and have a strong exercise rehabilitation focus. We strongly believe that patient self-management strategies are an integral to the prevention of ongoing neck pain.
What neck pain actually feels like
Neck pain rarely stays in the neck. People come to us describing a dull ache between the shoulder blades that builds through the working day, a sharp catch when they check a blind spot, headaches that start at the base of the skull and wrap behind the eyes, or pins and needles running into an arm or hand.
Some of it is stiffness that eases once you get moving. Some of it wakes you at 3am and will not let you find a comfortable position. Both are worth assessing, and they usually have different causes.
What we treat, and what tends to cause it
The team at Niche treat neck pain from whiplash, TMJ dysfunction, degenerative disc disease, disc bulges, cervicogenic headache, osteoarthritis and facet joint irritation. In practice, most of what walks through the door falls into a handful of patterns.
Postural and workstation strain
By far the most common presentation. Long hours at a desk, a laptop set too low, or a new job with a different chair. The pain is usually a deep ache across the upper traps and between the shoulder blades, worse by the afternoon, better on weekends. It responds well to a mix of hands-on treatment and specific strength work — and to fixing the setup that caused it.
Acute wry neck
You wake up and cannot turn your head one way. It is alarming and painful, but it typically settles quickly with the right early treatment rather than rest alone.
Whiplash and trauma
Most often after a car accident, but also from sport. Symptoms can take 24–72 hours to appear and often include headache, dizziness and jaw pain alongside the neck itself. Early, graded movement generally produces better outcomes than immobilising the neck.
Cervicogenic headache
Headaches driven by the upper neck joints rather than by the head itself. Usually one-sided, often starting at the base of the skull, and frequently mistaken for migraine. If your headaches change when you move your neck, this is worth investigating.
Nerve-related pain
Pain, numbness or weakness travelling into the shoulder, arm or hand suggests a nerve is involved. This needs proper assessment rather than guesswork, and occasionally onward referral.
What happens in your first appointment
An Initial Physiotherapy Consult runs for 30 minutes. If you have a lot going on, or two separate areas to address, book a Long Consult at 60 minutes instead.
- We listen first. When it started, what makes it worse, what you have already tried, and what you actually need to get back to — whether that is sleeping through the night, lifting your toddler, or returning to the gym.
- We assess. How your neck moves, which movements reproduce your symptoms, the strength and control of the muscles around the neck and shoulder blade, and a neurological screen if there is any arm involvement.
- We explain what we find. In plain language, including what the pain most likely is and — just as importantly — what it is not.
- We treat on the day. Depending on the findings, that may include hands-on joint and soft tissue work, dry needling, and taping.
- You leave with a plan. Specific exercises, guidance on what to do and avoid in the short term, and a realistic idea of how long this should take.
How long recovery usually takes
This is the question everyone actually wants answered, and the honest answer is that it depends on the cause.
An acute wry neck often improves substantially within a week or two. Postural neck pain that has built up over months usually settles within four to six weeks, though it can improve noticeably much sooner — the longer part is building enough strength that it does not simply return. Nerve-related pain and whiplash are more variable and are best judged after an assessment.
What consistently makes the difference is doing the exercise component. Hands-on treatment gives relief and creates a window to move better; the strength work is what makes it hold.
How we treat it
We use a targeted, hands-on approach followed by a rehabilitation program aimed at restoring normal function. All of our therapists are certified clinical Pilates instructors with a strong exercise rehabilitation focus, so the transition from treating pain to rebuilding capacity happens under one roof.
Where it suits the presentation, we also use dry needling for trigger points and muscle tension, and clinical Pilates for people who want closely supervised strength work as part of their rehab.
We believe strongly that self-management is what prevents neck pain from recurring, so you will always leave knowing what to do on your own.
Fees
| Appointment | Length | Fee |
|---|---|---|
| Initial Consult | 30 min | $110 |
| Subsequent Consult | 30 min | $105 |
| Long / 2 Areas Consult | 60 min | $210 |
Private health rebates apply if you hold extras cover with physiotherapy — the amount you get back depends on your fund and level of cover. Appointments with a senior physiotherapist are $120 initial and $110 subsequent.
Common questions
Do I need a referral to see a physio for neck pain?
No. Physiotherapy is a primary contact profession in Australia, so you can book directly. You only need a referral if you are claiming through a specific scheme such as a Medicare care plan, workers compensation or a motor vehicle insurance claim.
Do I need a scan first?
Usually not. Most neck pain is diagnosed from a good history and physical examination, and scans of pain-free necks very often show changes such as disc degeneration that are a normal part of ageing. If your assessment suggests imaging would change what we do, we will tell you and arrange the referral.
Can physio help my headaches?
If the headaches are coming from the upper neck — cervicogenic headache — then yes, often substantially. A useful clue is whether neck position or movement changes them. We will assess that specifically, and if the pattern points elsewhere we will say so rather than treat indefinitely.
Will you crack my neck?
Only if it is appropriate and you are comfortable with it, and never without discussing it first. Plenty of people get excellent results with joint mobilisation, soft tissue work and exercise alone, and that is what we use most of the time.
How many sessions will I need?
For straightforward neck pain, most people need somewhere between two and six sessions, spaced further apart as things improve. We would rather get you self-managing than book you in indefinitely, and we will give you an estimate after the first assessment rather than before it.
What about private health, NDIS or workers compensation?
Physiotherapy is claimable if you hold extras cover that includes it — bring your card and we will sort out the claim with you. We also treat clients under NDIS, workers compensation, motor vehicle and DVA arrangements. If you are not sure which applies to you, call the clinic on (08) 9242 1102 before booking and we will point you to the right appointment type.