Neck Pain

Neck pain is one of the most common reasons people seek physical therapy — yet it’s also one of the most misunderstood. Many people experience neck stiffness, tightness, headaches, ear discomfort, or pain that worsens with sitting, stress, or talking, even when imaging such as MRI or X-ray shows “nothing wrong.”

At Osteopractic Physical Therapy of the Carolinas, we help patients in Fort Mill, Charlotte, and the surrounding Carolinas resolve neck pain by identifying the true mechanical and neuromuscular causes — not just treating symptoms. Our approach emphasizes hands-on manual therapy, spinal manipulation, and targeted treatment of the muscles and joints most commonly responsible for persistent neck pain.

If you’ve been told your imaging is normal, that you just need to “strengthen your posture,” or that nothing structurally is wrong — you’re not alone, and you’re not broken.

What Does Neck Pain Usually Feel Like?

Neck pain doesn’t always present as sharp pain. Many patients experience:

• Tightness or stiffness on one side of the neck

• Pain with turning the head or looking up

• Headaches that start at the base of the skull

• Ear fullness, jaw discomfort, or throat tightness

• Pain that increases with prolonged sitting or talking

• A constant “something feels off” sensation

These symptoms are often driven by joint restrictions, muscle overactivity, and altered movement patterns, not tissue damage.

Why Is My Neck Pain There If My MRI Is Normal?

Most neck pain does not show up on imaging because it is caused by:

• Joint stiffness or poor segmental motion

• Muscle trigger points and guarding

• Nervous system sensitivity

• Poor coordination between deep neck stabilizers and global muscles

MRI and X-rays are excellent for identifying serious pathology — but they do not assess movement quality, muscle tone, or joint function.

At OPTC, we evaluate:

• Cervical joint mobility (not just posture)

• Muscle tone and trigger point referral patterns

• Movement coordination and load tolerance

• How your neck responds to stress and daily activity

Can Tight Neck Muscles Cause Ear Pain, Headaches, or Throat Symptoms?

Yes — and this is very commonly overlooked.

Muscles such as the sternocleidomastoid (SCM), upper trapezius, levator scapulae, and suboccipitals can refer symptoms to the:

• Ear

• Jaw

• Temple

• Throat

• Base of the skull

Because these symptoms don’t follow a typical “neck pain” pattern, patients are often referred to ENT or neurology first. When imaging and testing are normal, muscular and joint-based causes are frequently the missing piece.

Is Spinal Manipulation Safe for Neck Pain?

When performed by a Doctor of Physical Therapy with advanced training, spinal manipulation is a safe and effective tool for many neck pain presentations. The Doctors at OPTC have extensive post graduate training and certifications in Spinal Manipulation. Dr. Zacharko has over 20 years of clinical experience with spinal manipulation and is a Senior Instructor for the American Academy of Manipulative Therapy’s Spinal Manipulation Institute. He has traveled the country for the past 10+ years teaching Spinal Manipulation to other healthcare providers. To date he has taught over 250 courses on the topic.

At Osteopractic Physical Therapy of the Carolinas:

• Manipulation is never forced

• Patients are thoroughly screened

• Most often combined with other treatments ie dry needling, soft tissue treatment, movement retraining etc. for maximum effectiveness

• It is only used when clinically appropriate

For many patients, spinal manipulation improves:

• Joint mobility

• Muscle tone

• Pain-free range of motion

• Overall movement confidence

How Is OPTC’s Neck Pain Treatment Different?

Most traditional physical therapy focuses on:

• General stretching

• Exercise sheets

• Passive modalities

At OPTC, treatment emphasizes:

• One-on-one sessions with a Doctor of Physical Therapy

• Advanced hands-on manual therapy

• Targeted dry needling when appropriate

• Cervical and thoracic spinal manipulation

• Addressing the actual movement restriction, not just symptoms

This often allows patients to improve in fewer visits with longer-lasting results.

How Many Visits Should Neck Pain Take?

There is no universal number — but many uncomplicated neck pain cases improve within 3–6 focused visits when the primary drivers are correctly identified.

Our goal is not to keep you coming indefinitely, but to:

• Restore normal movement

• Reduce recurrence

• Give you clear guidance for long-term management

Neck Pain Physical Therapy in Fort Mill & Charlotte, NC

Osteopractic Physical Therapy of the Carolinas serves patients throughout:

• Fort Mill, SC

• Charlotte, NC

• Surrounding Carolinas communities

No referral is required, and all care is provided in a private, one-on-one setting.

FAQ

Written by Dr. Noah Zacharko, DPT
Doctor of Physical Therapy
Senior Instructor, American Academy of Manipulative Therapy’s Spinal Manipulation & Dry needling Institutes
Founder, Osteopractic Physical Therapy of the Carolinas