Neck Pain and the Injured Worker: Causes, Diagnoses, and Treatment

Injuries involving the neck are among the costliest workers’ comp claims. What are the causes, and what role does physical medicine play in recovery?

This blog is part 1 of a two-part series titled “Neck Injuries in Workers’ Comp: Managing Pain and Controlling Cost.”

As many businesses have shifted to working from home throughout the pandemic, the effect of long hours spent at a poorly designed workspace has been felt by many Americans. But poor ergonomics is just one of the many causes of neck pain among today’s workforce. In fact, injuries involving the neck are the third most costly lost-time workers’ compensation claim, behind injuries involving the head/central nervous system and multiple body parts, averaging $61,510 per claim, according to the National Council on Compensation Insurance (NCCI).

Why are neck injuries such an important focus for workers’ compensation? In this blog, we take a closer look at the nature of neck injury, methods of treatments, and the important role played by physical therapists and chiropractors in recovery.

What Causes Neck Pain?

While a claim may carry a diagnostic code for neck injury, there are often other body parts involved. Because the neck supports the weight of the head, it is particularly vulnerable to injury. Unsurprisingly, hours hunched over a computer, smartphone or book can lead to muscle strain and neck pain. However, even something as seemingly unrelated as grinding your teeth can cause neck pain and restrict motion. Additionally, if a herniated disk or bone spur is present on the vertebrae of your neck, it can put pressure on the nerves branching out from the spinal cord, leading to nerve compression and amplifying neck pain. Neck injury is also a common effect of whiplash injury in accidents such as rear-end auto collisions, which can cause the head to be jerked back and forth, straining the soft tissues of the neck. All of these triggers have the potential to have a more significant impact as we age, as neck joints wear down over time.

Diagnosing and Treating Neck Pain

In order to diagnose neck injury, a physical exam is used to assess neck function – that is, a patient’s ability to move their head forward, backward, and side-to-side – as well as symptoms such as tenderness, numbness, and muscle weakness. In some cases, imaging tests such as CT scans, x-rays or MRIs may be ordered to investigate the root cause of injury.

Once a diagnosis is made, neck injury treatment is often put in the hands of a physical therapist (PT). Among the many benefits of a more conservative approach to neck pain treatment is the reduced likelihood of opioid prescription. One study found that initially consulting with a non-pharmacological provider such as a PT can decrease opioid exposure in the year following diagnosis. PTs and chiropractors help injured workers manage neck pain and regain neck function by normalizing alignment, teaching exercises to correct muscle flexibility and strengthen deficits, and educating them on proper posture and self-care. Early on, heat, ice, and electrical stimulation may be applied along with traction, using weights and pulleys to stretch the neck – an approach often used to address nerve root irritation. In certain instances, treatment may go beyond conservative care measures to include injections of corticosteroids or numbing medications such as lidocaine to relieve neck pain; however, surgery is rarely needed.


As a common and costly problem among injured workers, neck injury has been a longtime focus for MedRisk. How has treatment in this area changed over the years, and where is it headed? In the remaining blog in this series, we will learn more about the nuances of neck pain treatment from MedRisk’s International Scientific Advisory Board member Dr. Donald Murphy, DC, FRCC, and explore the unique ways a managed physical medicine program can support recovery from neck injury.

We’re restoring movement, empowering recovery, and driving progress in workers’ compensation.

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