Neck Pain That Keeps Coming Back? Why It Won’t Go Away

Why Does My Neck Pain Keep Coming Back? The Answer May Be Below Your Neck

Key Takeaways

1. Neck pain that keeps coming back is often a sign the neck is working too hard for a problem somewhere else in the body, such as an old ankle sprain, a past surgery, or an injury that never fully settled.
2. If new neck pain has lasted only a couple of weeks, massage, physiotherapy, or chiropractic care is a sensible first step. If it keeps returning after about two months of care, it’s worth looking deeper.
3. The small muscles at the base of your skull are packed with position sensors, so they react to changes anywhere in the body. That’s one reason neck pain can come with headaches, eye strain, and trouble focusing.
4. Treating only the sore spot can bring short-term relief, but the pain may return if the patterns behind it aren’t addressed.
5. At Unpain Clinic, chronic neck pain care starts with a whole-body history and may include focused and radial shockwave therapy alongside hands-on care and exercise. Results vary between individuals.

You’ve had the massage. You’ve seen the chiropractor. You’ve stretched, switched pillows, and taken the pills. For a few days your neck feels better, and then the tightness creeps back, sometimes with a headache on top. If that sounds familiar, the problem may not start in your neck at all. Neck pain that keeps coming back is often the neck paying for a problem lower down in the body.

This article is based on our podcast episode, Chronic Neck Pain Relief: The Hidden Root and How to Fix It, where Uran Berisha, founder of Unpain Clinic, explains why so many people stay stuck with neck pain and what changes when you look at the whole body.

Why does my neck pain keep coming back?

Neck pain often keeps coming back because the neck is compensating. Your head and neck sit at the very top of the body. When something lower down isn’t working well, like an ankle, a hip, or your core, the neck muscles tighten to keep your head steady and your eyes level. Treat only the neck, and that extra load is still there the next day.

Uran explains it with a tree:

“Imagine our head and neck, it’s pretty much the tip of the tree. And if the trunk of the tree is not as stable, then pretty much any wind, any challenge, any shaking, it’s going to shake the tip of the tree more than it should.” Uran Berisha, Founder, Unpain Clinic

That’s why the stiff, sore neck we see so often at Unpain Clinic isn’t always a neck problem. It’s often a whole-body problem that shows up as constant neck muscle tightness and tension.

What should I do first when my neck starts to hurt?

If your neck pain is new, has been there for only a couple of weeks, and you don’t know why, start simple. New neck tension often comes from an activity outside your normal routine. A few massage therapy sessions are a good first step. If that doesn’t help, physiotherapy or chiropractic care is a sensible next option.

Many people get relief at this stage. In physiotherapy, IMS or dry needling can release tight neck muscles. A chiropractic adjustment can help the joints of the neck move more freely. If your neck builds up tension at a desk all day, a few simple fixes for work-from-home pain may help too.

If you’ve given these a fair try, for about two months, and the pain keeps coming back, that’s a sign something else may be driving it. That’s the point to look deeper.

See a doctor promptly if any of these apply:

• Your neck pain started after a car accident, a fall, or a hard hit to the head.
• Numbness, tingling, or weakness is spreading into your arm or hand, or getting worse.
• You have a fever, a sudden severe headache that’s new for you, or a stiff neck with nausea.
• You notice trouble walking, poor balance, or changes in bladder or bowel control.
• You’ve lost weight without trying, or the pain wakes you at night and won’t ease in any position.

If arm symptoms are part of your picture, our article on a pinched nerve in the neck explains the signs to watch for. If your neck pain started with a crash, our whiplash recovery guide covers that in detail.

How can an old injury somewhere else cause neck pain?

Your body works as one connected structure. When one part gets hurt, other parts quietly take over some of its work. Over time, those changes travel up the body. The neck, which has to keep your head and eyes level, ends up holding the tension. That’s how an old ankle sprain or a past surgery can show up as neck pain years later.

Uran gives the example of walking. If your big toe doesn’t extend fully and you don’t push off properly with each step, the jolt travels up the body and, in his words, it’s “going to jam your neck.”

Ankle sprains are one of the first things we ask about. We only have two legs, so when one gets hurt, the other one gets overworked. You start walking differently, often without noticing, and the neck has to adjust to keep your head steady. It doesn’t matter how long ago it happened. If the sprain was big enough that you remember it, it counts.

Surgeries matter too. Any surgery where skin and fascia were cut, such as a C-section, appendix or gallbladder removal, breast surgery, or heart surgery, can change how the body moves. Our article on how surgery scars change your body explains why.

Uran describes this as the body keeping score. Each injury that never fully settled adds another layer of compensation. Then a bigger event, like a car accident or a bad fall, hits a body that’s already working hard. The system goes into protection mode and tightens everything up. After a while, the body can learn that tight, guarded posture as its new normal. Even when the original injury has healed, the pattern stays.

Why does neck pain come with headaches, eye strain, and brain fog?

The small muscles at the base of your skull, called the suboccipital muscles, are packed with sensors that tell your brain where your head is in space. They work closely with your eyes and your balance system. When these muscles are tight and overworked, headaches, light sensitivity, and trouble focusing often come along with the neck pain.

A study of these small muscles found some of them holding more than 200 position sensors per gram of muscle, which is a very high count [1]. That sensitivity is useful, but it also means these muscles react to almost any change in how the rest of your body moves.

Your eyes and neck learn to work as a team from infancy. A baby discovers it can see more by turning its head, and the nervous system pairs the eyes and neck muscles from then on. Your balance centre in the inner ear is part of that team too. When the neck is locked up, the whole system has to work harder.

The sternocleidomastoid, or SCM, is another common player. It runs from behind your ear to your collarbone. When your core and the front of your body aren’t doing their share, the SCM works overtime to hold your head up. It has several trigger points that can send pain into the head, which is one reason chronic neck tension so often comes with persistent tension-type headaches or recurring migraines.

Uran also points to energy. You start each day with a fixed amount. When muscles work inefficiently, they use more of it, and you’re left tired and foggy by the afternoon. Many people with chronic neck pain also describe brain fog or difficulty focusing.

Is my pillow causing my neck pain?

Usually, your pillow isn’t the root cause. A pillow can make existing neck pain better or worse, but the problem often starts with how your neck and body are working during the day. If you’ve bought several pillows and none of them fixed it, that’s a good clue the pillow isn’t the main issue.

As Uran puts it:

“You first have a dysfunctional problem and then a pillow becomes an aggravating or relieving factor.” Uran Berisha, Founder, Unpain Clinic

Sleep still matters a lot. If neck pain keeps you from sleeping well, your body doesn’t fully recharge, and the next day starts with less in the tank. If that’s you, trouble falling or staying asleep is worth addressing as part of your plan.

Should I take anti-inflammatories for neck pain?

Anti-inflammatories can ease pain when it’s high, and sometimes that’s what you need to get through a bad stretch. Always talk to your doctor or pharmacist about any medication. Research from McGill University suggests early inflammation is part of how the body heals, and that blocking it may raise the chance that pain lingers.

In that 2022 study, people whose new low back pain settled showed a strong, short-lived inflammatory response. People whose pain became long-term did not. In a large UK health database, people who took anti-inflammatories for new back pain were more likely to still have pain later [2]. The study looked at backs, not necks, so it isn’t the final word on neck pain.

Uran’s point is not to avoid medication. It’s that your body is constantly trying to heal you, and pain relief alone doesn’t change why it hurts. Our article on the truth about inflammation explains this in more detail.

Which neck pain treatments help, and what does each one do?

Different treatments do different jobs. Massage, physiotherapy, and chiropractic care often ease pain and improve movement, and clinical guidelines support exercise and hands-on care for neck pain [3]. When pain keeps returning, adding a whole-body assessment and treatments that reach deeper tissue may help address what’s keeping it going.

Massage therapy

What it does: eases muscle tension and helps the body relax. Best for: new or mild neck tension. Keep in mind: relief may fade if something else keeps loading the neck.

Physiotherapy

What it does: builds strength and control, and techniques like IMS or dry needling release tight muscles. Best for: most neck pain, especially when movement is limited. Keep in mind: if the driver is somewhere else in the body, a neck-only program may stall.

Chiropractic care

What it does: adjustments help the joints of the neck and upper back move. Best for: stiffness and joints that feel stuck. Keep in mind: tight muscles can pull the joints back into the same position.

Pain medication

What it does: reduces pain in the short term. Best for: getting through a bad flare, with your doctor’s advice. Keep in mind: it doesn’t change why your neck hurts.

Whole-body assessment with shockwave therapy

What it does: finds old injuries and compensation patterns, then uses focused and radial shockwave on the neck and the muscles that pull on it. Best for: neck pain that keeps returning after other care. Keep in mind: it takes a few sessions and time for your body to respond, and results vary between individuals.

How does Unpain Clinic treat chronic neck pain?

At Unpain Clinic, chronic neck pain treatment starts with your whole history, not just your neck. We look for old injuries and surgeries that may be feeding the problem, treat those first where needed, then work on the neck and the muscles around it. Here’s what that usually looks like.

1. A full history. We ask about every ankle sprain you remember, every surgery from birth to today, accidents, sports injuries, and what you’ve already tried.
2. A head-to-toe assessment. We look at how you stand, walk, and move, and where your body is compensating.
3. Treating old injuries first. Uran calls this peeling the onion: working from the oldest injury toward the most recent. An old ankle sprain, for example, may be treated with focused shockwave, often in a single session, to help restore stability.
4. Treating the neck and everything that pulls on it. We use true shockwave therapy (focused) together with radial shockwave therapy from the base of the skull down the neck, across the upper shoulders, the rotator cuff, the front of the neck, the chest, and the muscles under the armpit that hold the shoulder blade to the ribs. Focused shockwave can reach deep layers of muscle that hands can’t easily get to.
5. Combining care. Chiropractic adjustments, physiotherapy exercise, massage, walking, and heat all help. Uran describes shockwave as “almost that regeneration seed,” and everything else as the fertilizer that helps it grow.
6. Giving your body time, then reviewing. For neck pain that has already been treated elsewhere, a typical start is three to five sessions, then four to six weeks to let your body respond, then a review. Some people need little more after that. Others benefit from a top-up session every six weeks to three months while they continue other care.

“If we just go straight after your neck and we don’t actually correct the previous injuries, we are just treating a symptom, the latest symptom.” Uran Berisha, Founder, Unpain Clinic

What does the research say about chronic neck pain?

Neck pain is one of the most common causes of disability worldwide, and it’s expected to become more common as the population ages. Research supports exercise and hands-on care for neck pain. Early studies suggest shockwave may help muscle-related neck pain when it’s used alongside other treatments.

• In 2020, about 203 million people worldwide were living with neck pain, and that number is projected to reach about 269 million by 2050 [4].
• A review of 10 trials found shockwave therapy reduced pain from tight, knotted upper trapezius muscles better than sham treatment or ultrasound. It worked about as well as dry needling or trigger point injections, and the authors suggest using it alongside other care rather than instead of it [5].
• Clinical practice guidelines for physical therapists recommend exercise, often combined with hands-on care, for many types of neck pain [3].

Studies on shockwave for neck pain are still small. That’s why we use it as part of a plan, not as a stand-alone fix.

Frequently asked questions

Why does my neck pain keep coming back?

Neck pain often keeps coming back because the neck is compensating for a problem somewhere else in the body, such as an old ankle sprain, a past surgery, or weak core muscles. Treating only the neck can bring short-term relief, but the extra load returns. A whole-body assessment can help find what’s keeping it going.

How long should I wait before getting neck pain checked?

For new neck pain with no clear cause, it’s reasonable to try massage, physiotherapy, or chiropractic care first. If the pain keeps returning after about two months of care, it’s worth a deeper assessment. See a doctor right away if the pain follows a fall or accident, or comes with numbness, weakness, fever, or a sudden severe headache.

Can an old ankle sprain really cause neck pain?

It can contribute. When one ankle is injured, you tend to walk differently, and the rest of the body adjusts all the way up to the neck. The muscles at the base of the skull are very sensitive to these changes, so an old sprain can be part of why neck tension keeps returning.

Is my pillow causing my neck pain?

Usually not on its own. A pillow can make neck pain better or worse, but the underlying problem often starts with how your neck and body work during the day. If several pillows haven’t helped, the cause is likely somewhere else.

Can neck pain cause headaches and trouble focusing?

Yes, it often does. Tight muscles at the base of the skull and along the side of the neck have trigger points that can send pain into the head. These muscles also work closely with your eyes and balance system, so neck tension can come with eye strain, light sensitivity, and brain fog.

How many shockwave sessions does chronic neck pain usually need?

It varies from person to person. At Unpain Clinic, a typical start for neck pain that has already been treated elsewhere is three to five sessions, followed by four to six weeks for the body to respond and a review. Some people need occasional top-up sessions after that.

Do I need a referral to book an assessment for neck pain?

No referral is needed to book an assessment at Unpain Clinic. Many extended health plans cover physiotherapy, chiropractic, and massage therapy, so it’s worth checking your plan before your visit.

“My wife has had problems with a stiff and sore neck and back for over 15 years … After seeing Uran at the Unpain Clinic six times, she no longer has the pain or stiffness.” Jay H., Google review

About the author

Written by Uran Berisha, Founder of Unpain Clinic and the Medical Shockwave Institute. Medically reviewed by Uran Berisha. Last reviewed November 3, 2026. Uran has spent more than 20 years in rehabilitation, with over 13 years focused on shockwave therapy. Unpain Clinic is located in Edmonton, Alberta. unpainclinic.com

Tired of neck pain that always comes back?

If you’ve tried massage, adjustments, and exercises and your neck still won’t settle, the next step is a one-on-one assessment. At Unpain Clinic in Edmonton, we look at your whole history and the whole chain, not just the sore spot, then build you a clear plan. No referral needed. If we don’t think this approach is a good fit for you, we’ll tell you honestly.

Book your assessment!

References

1. Kulkarni V, Chandy MJ, Babu KS. Quantitative study of muscle spindles in suboccipital muscles of human foetuses. Neurology India. 2001.
2. Parisien M, Lima LV, Dagostino C, et al. Acute inflammatory response via neutrophil activation protects against the development of chronic pain. Science Translational Medicine. 2022.
3. Blanpied PR, Gross AR, Elliott JM, et al. Neck Pain: Revision 2017. Clinical practice guidelines. Journal of Orthopaedic and Sports Physical Therapy. 2017.
4. GBD 2021 Neck Pain Collaborators. Global, regional, and national burden of neck pain, 1990 to 2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. The Lancet Rheumatology. 2024.
5. Zhang Q, Fu C, Huang L, et al. Efficacy of extracorporeal shockwave therapy on pain and function in myofascial pain syndrome of the trapezius: a systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation. 2020.
6. The Unpain Podcast. Chronic Neck Pain Relief: The Hidden Root and How to Fix It (Episode 12). Unpain Clinic. https://www.unpainclinic.com/en/podcast/why-whiplash-pain-doesnt-go-away-and-how-to-cure-it