Understanding Your Recurring Neck Pain: A Movement-Based Approach
You've tried stretching it, resting it, maybe even had hands-on treatment before. It eases off for a while, then it's back. If that sounds familiar, you're not imagining things. Recurring neck pain usually has more going on underneath than we think.
I'm Auste Mickunaite, a movement-based osteopath in Crystal Palace. This page explains what I typically see, how I work, and whether this might be the right fit for you.
Who this is for
Spend long hours at a desk or screen.
Notice their neck stiffening, aching, or feeling heavy by the end of the day.
Get tension headaches that seem to originate from the neck or base of the skull, often triggered or worsened by posture, screen time, or tension.
Find that their neck pain keeps returning even when hands-on treatment brings temporary relief.
Want to understand what's driving it and take an active part in their recovery. If that's you, read on.
A different approach
Hours at a screen, head slightly forward, shoulders creeping up, it's a pattern most desk workers know well. But the reason neck pain keeps coming back is usually not the position itself.
Several things tend to drive recurring neck pain in desk workers:
How you breathe
Most people under sustained screen time gradually shift into upper chest breathing without realising it. The muscles around the neck and shoulders start doing too much, they were never designed to control your breathing all day. Over time, they become fatigued and painful. Breathing is often the last thing people expect to be part of a neck pain assessment, and frequently one of the most important.
How your mid-back moves
A stiff thoracic spine means your neck compensates for every movement that should be shared more evenly. It ends up doing more than its share, day after day.
How your body manages load
Your neck relies on a coordinated system of support from below: deep core muscles, the pelvic floor, and the diaphragm all play a role in managing intra-abdominal pressure and overall load. When that system isn't working well, the neck often picks up the slack. This connection surprises most people, but it's one of the most consistent things I see clinically.
The deep neck muscles
There is a group of small muscles whose job is to provide quiet, consistent support to the neck position and small movements. Think of it as your 'neck core'. Under load, such as desk work, screen time, or sustained posture, these muscles tend to go quiet. Restoring your 'neck core' function is often a key part of recovery.
The jaw
Jaw clenching, teeth grinding, and jaw tension are more connected to neck pain and headaches than most people realise. The muscles of the jaw and the suboccipital muscles at the base of the skull are closely linked. If you wake up with a stiff neck or headaches, or notice jaw tension during the day, this is worth exploring.
None of this means something is broken or damaged. It means your body has found ways to cope, and those coping strategies have a cost. The aim is to understand the pattern, and give your body better options.
How I assess neck pain
Rather than going straight to where it hurts, I look at the whole pattern. A first appointment typically covers:
Breathing pattern. I observe how you breathe at rest, what's moving, what isn't, whether your ribcage is doing its job. This tells me a lot about background load on the neck and shoulders.
Cervical movement. How your neck moves in all directions, the quality of that movement, and which deep neck muscles are doing their share.
Mid-back and shoulder blade mobility. Whether your thoracic spine has the range it needs, and whether your shoulder blades are moving in a coordinated way or substituting for something.
Core control. A simple movement test that shows how well your deep stabilising system is working, not your six-pack, but the deeper muscles that manage pressure through the trunk.
Jaw screen. A brief check for jaw clenching, clicking, or tension patterns that often contribute to headaches and suboccipital pain.
This gives me a clearer picture of what's maintaining your pain, not just where it is, but why it keeps coming back. If your pain is specifically in your shoulder and neck and keeps returning, here's how I assess that.
What treatment looks like
Sessions combine hands-on work with movement re-education. The two work better together than either does alone.
I start with soft tissue work, myofascial release, and joint mobilisation. This reduces protective tension and improves how your tissues move, and it creates a short window where your nervous system is more receptive to learning new movement patterns. That's when the movement work happens.
Movement re-education might involve relearning how to breathe using your full ribcage, restoring mid-back mobility, or reactivating the deep neck muscles that have gone quiet. The goal is not to give you a list of exercises to get through. It's to help you understand why your body has been doing what it's been doing, and give it better options.
Many people with desk-related neck pain notice change within 2 to 4 sessions, though this varies depending on how long the pattern has been there and what else is going on.
When should you see a doctor for neck pain?
Most neck pain is mechanical and responds well to movement-based treatment. But some symptoms need prompt medical attention. Please seek urgent care if you experience:
Severe neck pain following a fall, accident, or trauma
Numbness, tingling, or weakness in your arms or hands
Neck pain with dizziness, difficulty swallowing, or double vision
Pain that is constant, worsening, and not affected by position or movement
Sudden severe headache unlike any you've had before
Facial drooping, arm weakness, or slurred speech: call 999 immediately
Sudden vision changes, confusion, or difficulty walking alongside neck pain
If you're unsure, your GP is a good first contact.
About Auste
I bring a combined 20+ years of movement-based experience and osteopathic practice, dance, Pilates instruction, functional movement, and clinical osteopathy since 2021. I work with desk workers who've had scattered treatment over the years but never a structured, educationally-grounded approach. My practice is based in Crystal Palace, South London.
Read more about my background.
FAQs
How many sessions will I need?
1
Most people with desk-related neck pain notice a difference within 2 to 4 sessions. How quickly things shift depends on how long the pain has been there and what's driving it.
In many cases, initial symptoms may ease fairly quickly, but more lasting change usually involves some work on your part between sessions. I'll guide and support you through that process for as long as it's useful.
The aim is for you to leave each session understanding what you're doing and why. It's not about keeping you coming back to the clinic, but it does require your commitment to following through with the programme.
I'll give you a clearer picture after the first appointment.
I also get headaches. Can you help with those?
2
Tension-type headaches that originate from the neck and upper back are very common, and they often improve as the neck pain does. I'll assess whether your headaches look like they're being driven by mechanical patterns in the neck, upper back, or jaw.
However, headaches have many possible causes, some of which need medical investigation before seeing an osteopath. Please see your GP first if you experience:
A sudden, severe headache that comes on within seconds and feels unlike anything you've had before
Headaches that are progressively worsening over days or weeks
Headaches accompanied by fever, stiff neck, sensitivity to light, or a rash
Headaches with visual disturbance, slurred speech, weakness, or confusion
Headaches following a head injury
New headaches in someone over 50 with no previous history
Headaches that wake you from sleep consistently
If none of these apply and your headaches feel linked to neck tension, posture, or stress, there's a good chance they're mechanical and worth exploring together.
High-velocity low-amplitude manipulation, the technique that produces the cracking sound, is not something I use with my clients.
The evidence shows it can provide temporary symptom relief in some people, but it does not realign the spine or correct joint position, despite what is often claimed. It also carries a small but real risk, particularly in the neck, where the vital blood vessels are close to the joints being manipulated.
The goal is for you to leave each session with a better understanding of what's going on and how to influence it. A technique that produces a short-term effect without building that understanding doesn't really move things forward for you.
What I use instead is soft tissue work, myofascial release, and mobilisation with movement, combined with movement re-education.
3
Will you crack my neck?
How is this different from a regular osteopath?
4
Most osteopathic treatment focuses on hands-on work to ease symptoms. I combine that with movement re-education, helping you understand what's maintaining your pain and building your capacity to manage it yourself. The goal is fewer return visits, not more, as long as you're willing to take an active part in the process.
In practice, this means sessions bring together soft tissue work and myofascial release, neuromuscular techniques, and movement re-education. Neuromuscular techniques work on the connection between your nervous system and muscles, influencing how your brain organises muscle tone and movement patterns, rather than just addressing the tissue itself. Together, these approaches give you more than hands-on treatment alone can offer.
This is consistent with current clinical evidence, which shows combining manual therapy with movement and exercise works better for neck pain than either approach alone, not because one or the other works, but because together they address different parts of the problem. Read more about my background.
I've had neck pain for years. Is it too late?
5
No. Long-standing pain does tend to take longer to shift, but that doesn't mean it's fixed or permanent.
A lot depends on what's driving it. If your symptoms are being maintained by posture, movement habits, or how you manage load day to day, those patterns can change, especially once you understand what's behind them.
Some things are more structural: changes in the joints or discs, or previous injury, for example. Hands-on treatment is unlikely to change the structure itself, but movement re-education can improve how your neck, back, and shoulders work together. Better overall function often means symptoms become easier to manage, even if the underlying structure stays the same.
The first appointment will give us a clearer picture of which category you're in.
Why are you looking at my breathing when I have neck pain?
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Because the muscles you use to breathe and the muscles that support your neck share the same neighbourhood.
When breathing shifts into the upper chest, which happens gradually under sustained screen time and stress, the muscles around the neck and shoulders start picking up work they weren't designed to do all day. Over time, that overload shows up as tension and pain. Assessing your breathing pattern tells me how much of a role this is playing in what you're experiencing.
Why does my neck pain keep coming back even after hands-on treatment, that felt so good at the time?
7
Because treatment that only addresses where it hurts rarely addresses why it keeps happening.
Neck pain in desk workers is usually maintained by a pattern. That pattern includes how you breathe, how your mid-back moves, and how your body manages load, and load means everything: how long you sit, how much you move, how well you've slept, your phone habits, stress, and worry. It also includes the smaller habits you might not notice: breathing through your mouth, clenching your jaw, or breathing into your chest all day.
If that pattern doesn't change, the tension tends to return.
What I'm looking for is the underlying driver, not just the location of the pain. The more things we can identify together, the more levers you have to pull on, and the more combined benefit you can achieve.
What does movement re-education actually mean?
8
It means helping your nervous system find better movement options, not just stretching tight muscles or strengthening weak ones. Your brain organises movement based on what it perceives as safe and available. When pain or poor habits have narrowed those options, movement re-education helps to restore them.
In practice it might look like relearning how to breathe using your full ribcage, restoring mid-back mobility, or reactivating the deep neck and core muscles that have gone quiet.
The movements themselves are simple. What makes the difference is the coaching, making sure you understand exactly what you're doing and why, so that when you do it between sessions, you're doing it with intention rather than just going through the motions.
The goal is lasting change, not short-term relief.
Is this approach right for me?
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Neck pain varies enormously, in how it feels, where it goes, and how intense it is. In most cases, coming in for an assessment is a good starting point, and I'll tell you honestly what I think will help.
If your pain is more manageable, even with stiffness, tension, or some movement restriction, hands-on treatment can be a very helpful starting point, and a good foundation before we build into movement work.
For very acute neck pain, particularly where there's significant nerve irritation and even lying down is uncomfortable, there may be limited hands-on work we can do in the early stages to avoid further irritation. In that situation, the most honest first step might be a conversation with your GP about whether reducing pain and nerve sensitivity through medication first would make subsequent treatment more effective. I'd rather tell you that than push through when your body isn't ready.
There are some situations where it's safer to see a medical professional first:
You've had a fall, hit your head, lost consciousness, or been in a road traffic accident
You have any of the symptoms listed in the urgent help section, numbness or weakness in your arms, sudden severe headache, facial drooping, or pain following trauma
If none of those apply, come in. If I'm concerned about anything during the assessment, I'll ask you to see your GP before we continue.
When in doubt, get in touch and we can talk it through before you book.
Ready to Book?
Book your initial assessment and leave with a clear picture of what's driving your pain, and what to do about it
Not sure what to expect? Read about your first appointment.