Conditions · Carrollwood · Tampa Bay
Neck Pain in Tampa
A stiff neck, a headache that starts at the base of the skull, and tingling in two fingers can all begin in the same place. They don't all get treated the same way.
We examine your neck before we treat it. We check how it moves, where it's tender, and what reproduces the pain you actually came in with. If symptoms are traveling into an arm, we test reflexes, strength, and sensation too. You see Dr. Bobby Koser, DC, chiropractic physician, at every visit, and he explains what he found before you leave.
Neck Pain Overview
Neck pain from a desk job: posture and what drives it
It shows up in the afternoon at first. Then it's there when you wake up. A lot of neck pain arrives with no injury behind it at all: nothing happened, you just spend six or eight hours a day with your head in roughly one position, and at some point the neck stops tolerating it.
What people usually notice:
- Stiff checking a blind spot
- Woke up with it locked
- Ache at the base of the skull
- Pain into the shoulder blade
- Tingling or numbness down the arm
- Headache that builds through the workday
- It has hurt since the crash
Posture is part of this, though it carries more blame than any one position deserves. There isn't one correct way to hold your head, and the issue is really hours rather than posture. In a forward-head position, chin drifting out toward the screen, the muscles along the back of the neck hold the head up instead of letting the spine stack beneath it. The further forward the head sits, the more those muscles carry. Twenty minutes of that costs little. Six hours a day, most days, is a different load. When the screen is a phone, people call the position text neck, and the phrase fits what they mean.
So the examination looks at how your daily positions load the neck: which segments have stopped moving well, which muscles are doing work they can't keep doing all day, and what your job asks of your body between 8 and 6.
Treatment usually ends up being some mix of restoring motion where it's restricted, treating the trigger points keeping those muscles loaded, and changing two or three things about how you sit and how often you get up. That last item is the least interesting one on the list. If your day is what's loading the neck, though, a plan that ignores your day is working against itself.
People ask at this point whether it is going to keep getting worse. That is not answerable from a description over the phone. It depends on which of those three things your examination turns up, and in what combination.
Waking up with a stiff neck
Some people call it a crick in your neck. You woke up unable to turn your head one way, so you hold it tilted and turn your whole body to check a blind spot. Usually a neck joint or muscle got irritated overnight and the muscles around it clamped down to guard it. The guarding is often the bigger problem. Plenty of these loosen up on their own inside a week.
The exam looks at which direction is blocked, which segments have stopped moving, and whether this is muscle guarding or something we'd want a closer look at. A stiff neck that arrives with tingling or numbness down an arm is a different picture: that can point to a pinched nerve in the neck, covered further down this page. One that keeps coming back on the same side is worth examining too.
Headaches that start in the neck
A cervicogenic headache is a headache whose source is in the neck. The description people give is fairly consistent. It starts at the base of the skull, usually on one side, and works forward toward the temple or behind the eye. It gets worse after a long stretch at a desk or a bad night's sleep, and turning the head toward that side is often limited. That pattern is one of the things the neck examination at HealthSpine in Carrollwood, Tampa looks for.
It gets read as migraine, and sometimes both are running at once, which is why it's worth examining. The exam is what separates them: whether pressure on specific segments of the upper neck brings on the headache you get, and whether the muscles at the base of the skull reproduce your pattern when they're pressed. Restricted rotation on one side is common with it.
If the neck is driving it, treatment is aimed at the neck. That means the joints that aren't moving and the trigger points in the muscles that refer into the head. More on that approach on our dry needling for headaches page. Headaches with other causes are covered on our headaches page.
Is it a pinched nerve in the neck?
Pain and tingling down the arm sometimes start in the neck. Most people call that a pinched nerve, though the phrase gets used for everything from a stiff muscle to true nerve compression, and the exam is how you tell which one you have. The strict version is what doctors call cervical radiculopathy. A nerve root gets compressed or irritated where it leaves the spine, often by a disc or a narrowed opening, and the symptoms show up further down than the problem: pain into the arm, pins and needles, numbness in specific fingers, or a grip that isn't what it was last year.
The pattern is the useful part. Each nerve root serves a fairly predictable strip of skin and set of muscles, so where the numbness sits and which movement is weak point toward the level involved. At HealthSpine in Carrollwood, Tampa, Dr. Koser tests reflexes, strength, and sensation before deciding whether arm symptoms are coming from the neck, and adds positional tests that either reproduce your symptoms or ease them. Not everything that hurts down an arm starts there. The shoulder, the elbow, and nerve irritation further down can produce something that feels similar, and sorting that out is exam work. If your symptoms are progressing or strength is dropping, that changes the plan. That may mean imaging, or a referral out. You'll hear it in the room.
If your neck pain started with a car accident
Crash-related neck pain is a different visit here, with its own paperwork and its own examination. Florida's PIP law requires that your care begin within 14 days of the accident. Neck symptoms after a collision often surface a few days later, not the day of.
Crash care is billed to your auto insurance under Florida PIP, not at our self-pay rates. PIP has its own math: it pays 80 percent of covered charges, and what is available for your care depends on your policy and on an emergency medical condition determination. Our Florida PIP page walks through the numbers with the statute linked.
Already have an attorney? Tell us and we'll send documentation to their office. Don't have one? We open your PIP paperwork and treat you the same way, and a lawyer is not a requirement to be seen here for care. Our auto accident page covers how that first visit works at HealthSpine in Carrollwood, Tampa, and our whiplash page covers what the examination looks for after a collision.
How the neck examination works
- History about your day. When it started, what it's like at 4 p.m. compared with 8 a.m., how you sleep, what you do for eight hours, and whether anything travels into your head or your arm.
- Hands and movement. Where the tenderness sits, which segments have lost motion, what reproduces your pain, and what changes it. Reflex, strength, and sensation testing when symptoms are traveling into an arm.
- A live ultrasound look. We may choose to look at the muscles and soft tissue where it hurts, and you watch the screen while we explain what's on it. This is screening and visual confirmation.
- Findings before you leave. What the examination showed, what it means, and what Dr. Koser suggests next.
New patients start with the Pain Source Exam. Neck pain is one of several complaints that page covers, and the parent page for the whole region is spine care in Tampa.
What treatment looks like
What you're offered depends on what the examination found. These are the services that may be recommended to you; your plan comes from your findings.
| Option | What it addresses |
|---|---|
| Chiropractic adjustment | Segments of the neck and upper back that aren't moving the way they should, which is often where the stiffness and the guarding are coming from. |
| Dry needling | Trigger points and myofascial pain in the muscles of the neck, upper back, and the base of the skull. |
| Ultrasound-guided dry needling | Live ultrasound while the needle goes in, so its position at the spot being treated can be seen and confirmed. You watch the screen. It is a way of performing the procedure more precisely, not a different treatment. Seeing the needle does not change what the needling does. |
| Hands-on soft tissue and joint work | Restricted motion and muscle tension where a thrust technique isn't the right choice, or where you'd rather we didn't use one. |
| Loading and range work you do at home | The part that depends on you rather than on us. Range work, and loading for the muscles that keep giving out on you by Thursday. |
Some neck pain doesn't need much of this. A neck that locked up in one night and otherwise moves fine is a different problem from one that's been building for three years with numbness in two fingers, and the plans should not look alike. Read more about dry needling in Tampa if muscle pain is a big part of your picture.
The exam checks that you are in the right office before anything gets treated. Most neck pain comes from joints, muscles, or a disc reacting to load and position, which is chiropractic work, though not every neck problem is. A smaller number of cases point somewhere else, and a few need medical care first. If your history or your examination points that way, we'll say so and help you get to the right provider. Either way, you leave with our findings the same day.
Some neck symptoms need emergency care rather than an appointment.
Call 911 or go to the emergency department for:
- Sudden severe neck pain unlike any you have had before
- Drooping on one side of the face, slurred speech, double vision, or sudden unsteadiness
- New weakness or numbness down one side of the body
Get medical care the same day for:
- A stiff neck with fever and headache, especially with discomfort in bright light
- Clumsiness in the hands, trouble with buttons, or a change in how you walk
- Numbness or weakness affecting both arms
What the Research Shows
Each treatment listed above has been studied. Here is what the research found, cited in full so you can check it yourself.
On chiropractic care. A Cochrane review found that a course of neck manipulation works about as well as gentle mobilization for neck pain, and that manipulation of the upper back can improve neck pain and function in the short term.1 That second finding matters here, because the upper back is often where a stiff neck is actually being driven from, and it is part of every neck examination in this office.
On acupuncture. A separate Cochrane review found moderate-quality evidence that acupuncture relieves neck pain better than sham treatment, measured at the end of care and at short-term follow-up.2 Longer-term benefit has not been established. Dr. Koser is certified in acupuncture by the Florida Board of Chiropractic Medicine.
On dry needling. A review of 20 clinical trials found that dry needling of trigger points relieved neck and shoulder pain in the short and medium term.3 It did not find needling beats every other treatment. Where a trigger point reproduces your pain on examination, it is a target worth treating.
On strengthening. A Cochrane review found that strengthening exercises for the neck and shoulder-blade muscles can reduce lasting neck pain and improve function.4 The same review found that stretching alone showed no benefit, which is worth reading twice if your current plan is a stretching handout.
None of this is a promise about your neck. It is the reason these treatments are offered here.
1. Gross A, Langevin P, Burnie SJ, et al. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database Syst Rev. 2015;(9):CD004249. PubMed
2. Trinh K, Graham N, Irnich D, Cameron ID, Forget M. Acupuncture for neck disorders. Cochrane Database Syst Rev. 2016;(5):CD004870. PubMed
3. Liu L, Huang QM, Liu QG, et al. Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2015;96(5):944–955. PubMed
4. Gross A, Kay TM, Paquin JP, et al. Exercises for mechanical neck disorders. Cochrane Database Syst Rev. 2015;(1):CD004250. PubMed
What it costs to start
$195Regular price $330
Self-pay only, one per patient.
Pain has a source. This visit looks for where it is coming from.
- A complete examination with Dr. Koser, which may include a live ultrasound look at the muscles and soft tissue where it hurts.
- Treatment the same visit unless the examination finds a reason it should not: a chiropractic adjustment, dry needling, cupping, laser, or electrical stimulation with infrared, chosen from what the examination finds and what is safe for you.
- Your findings explained the same day.
You’ll leave knowing what we found and what it means. First visit with us, one per patient.
Not ready to begin a membership? Start here and pay as you go. Membership rates apply only under a signed membership agreement. See membership plans.
Self-pay patients only. Not valid with insurance, PIP/auto claims, Medicare, or Medicaid. Injured in a car accident? Book the Auto Accident Injury Visit instead.
THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR PAYMENT FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT THAT IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE SERVICE, EXAMINATION, OR TREATMENT.
Every other bookable price is on our pricing page.
Common questions about neck pain
Can a chiropractor help with neck pain?
Yes: neck pain is a musculoskeletal complaint, squarely inside what a chiropractic physician examines and treats. Dr. Bobby Koser, DC, examines the neck first: range of motion, tenderness, which movements bring the pain on, and a reflex, strength and sensation screen when symptoms travel into an arm. He treats what the exam found with an adjustment, dry needling, hands-on work, or a combination, and refers out problems outside chiropractic care.
Why did I wake up with a stiff neck?
Usually a neck joint or muscle got irritated overnight and the surrounding muscles are guarding, which limits turning. An awkward sleeping position or a pillow that angles the head can set it off; often no cause is found. An occasional stiff neck is common. One that keeps returning or comes with tingling down an arm is worth an examination, and one with a fever belongs with a medical provider first.
How long does a stiff neck last?
A simple stiff neck, the kind that shows up overnight with no injury behind it, often eases over a few days to a couple of weeks, and some take longer. Nobody can promise a timeline from a description alone. An examination is worth having when a stiff neck is not easing, keeps returning, or comes with symptoms traveling into an arm, because the exam finds which joints have lost motion and which muscles are guarding, and that is what treatment would address.
Can neck problems cause headaches?
Yes, some headaches start in the neck. A cervicogenic headache is a headache whose source is in the neck, and the usual description is one-sided pain that starts at the base of the skull and works forward toward the temple or behind the eye, with neck rotation limited toward that side. The examination checks whether pressure on the upper neck segments and on the muscles at the base of the skull brings on the headache you get. Migraine and cervicogenic headache can also occur in the same person, which is a reason to examine the neck rather than assume.
What does a pinched nerve in the neck feel like?
A pinched nerve in the neck, called cervical radiculopathy, is a nerve root compressed or irritated where it leaves the spine. Symptoms usually sit in the arm: pain, pins and needles, numbness in specific fingers, or a weaker grip. Each root serves a predictable area that points to the level. Reflex, strength, sensation and positional testing sorts it out; progressing symptoms or dropping strength may call for imaging or referral.
Do I need an X-ray or an MRI for neck pain?
Not as a starting point. Age-related changes turn up on neck X-rays and MRIs in plenty of people who have no pain at all, so a report describing degenerative changes does not by itself explain your symptoms. Imaging earns its place when something in your history or your examination calls for it, such as arm symptoms that are progressing, an injury that raises a specific question, or pain that is not behaving the way a mechanical problem behaves. Dr. Koser will refer you for imaging when that is the case.
Is having your neck adjusted safe?
Your history and examination come first and decide whether a cervical adjustment is appropriate, and we treat the area you came in for. Where the neck does need work, adjusting is one option among several: lower-force and non-adjusting tools exist, and you can decline a neck adjustment and still be treated. Temporary soreness or stiffness for a day or so is the common effect. Every treatment has less common risks as well, and Dr. Koser goes over anything that applies to you and answers your questions before treatment begins.
My neck has hurt since a car accident. Which visit should I book?
Book the Auto Accident Injury Visit. Crash care bills to auto insurance under Florida PIP and must begin within 14 days of the accident. PIP pays 80 percent of covered charges after any deductible; the remaining 20 percent is yours or your health plan's. $2,500 is available unless a qualifying provider determines you had an emergency medical condition, which can raise it to the $10,000 policy limit.
How much does neck pain treatment cost in Tampa?
At HealthSpine in Carrollwood, Tampa, a chiropractic adjustment is $60, and a dry needling session is $80. Those are our time-of-service rates, available when you pay in full at the visit. Care billed to a third-party payor, including auto insurance under Florida PIP, health insurance, Medicare, or workers' compensation, is billed on our standard fee schedule without that discount. New patients start with the Pain Source Exam; its price and its terms are in the pricing section above.
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This page is general health information and is not medical advice for any individual. The studies summarized describe groups, not any one person’s outcome, and whether a finding explains your symptoms can only be determined by examination. Talk to Dr. Bobby Koser, DC, about your own situation, and seek emergency care immediately for the warning signs described on this page.
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