Why Your Neck Still Hurts: A Smarter Approach to Diagnosing and Treating Neck Pain
- Colin O'Banion, DPT
- Sep 17
- 5 min read
Updated: Oct 3
Neck pain can be frustrating, confusing, and deeply disruptive — especially when nothing seems to work.
If you’ve tried massage, chiropractic, or even traditional physical therapy and still feel tension, stiffness, or nerve pain in your neck or arm, you’re not alone.
At Colin O’Banion Physical Therapy in Boulder, neck pain is one of the most common — and most misunderstood — issues I treat. With over two decades of clinical experience and a personal journey through chronic neck pain, I take a root-cause approach that goes far beyond symptom relief.
My Journey Through Neck Pain
(And What It Taught Me as a Physical Therapist)
If I had to pick one area of the body I truly love treating, it's the neck. I’ve always found the cervical spine to be incredibly complex and rewarding to work with — and my own history with neck pain is a big part of why.
Back at the very start of my career, I dealt with chronic neck pain for several years. I rarely have any issues now, but that experience was one of my best teachers.
I was lucky enough to receive treatment from a few different experienced, talented clinicians. The immediate relief and changes in motion I experienced after treatment were profound — it showed me what’s possible when the right techniques are applied by experienced hands. It was this experience that allowed me to learn from those clinicians and gave me the skills to treat my own neck pain and transfer those skills to treating my patients.
That shaped the way I practice today. I understand how pain can affect every part of life, and I know how powerful hands-on, precise, individualized care can be when you’re stuck.
That personal experience taught me two things:
What it feels like to live with neck pain — I know what clients are going through physically and emotionally.
What truly effective care looks like — it’s not rushed, generic, or symptom-focused. It’s specific, thoughtful, and rooted in a deep understanding of how the body really works.
Today, that perspective drives everything I do in the clinic. I’m especially passionate about helping patients who feel like they’ve “tried everything” — because I’ve been there too.
Why Standard Neck Pain Treatments Fall Short
In my experience, many people with neck pain have already seen multiple providers — from chiropractors and massage therapists to orthopedists and general PTs. They may have received some temporary relief, but the pain keeps coming back.
Often, the missing piece is a comprehensive, nuanced evaluation. Without understanding what's truly driving the pain, even well-intentioned treatment can miss the mark.
Neck pain is rarely one-size-fits-all. Whether it’s caused by disc irritation, facet joint dysfunction, muscular tension, or nerve compression, each pattern requires a different clinical approach.
Getting the right results starts with one key step: a thorough, expert-level evaluation that looks beyond just the symptoms.
I Provide a Different Standard of Care
At my clinic in Boulder, every new patient begins with a full 60-minute one-on-one session that includes:
A detailed conversation about your pain history, patterns, posture, and habits
Passive and active testing to assess the joints, muscles, nerves, and soft tissues
Movement analysis to identify what’s helping — and what’s hindering — your recovery
A review of any past imaging or diagnoses, integrated into the broader clinical picture
This process allows me to create a precise, personalized treatment plan — rooted in years of experience, not guesswork or protocols.
What’s Causing Your Neck Pain? It Depends — And That Matters
One of the most important questions in any neck pain case is:“Is this coming from a disc or nerve root — or something else entirely?”
This distinction changes everything. For example, disc-related pain or nerve compression needs a completely different approach than muscle tension or joint irritation. And treating the wrong issue the wrong way can make things worse.
In my evaluations, I’m looking at a range of possible causes, including:
Disc or nerve root involvement – Often shows up as numbness, tingling, burning, or weakness down the arm. Needs careful handling.
Facet joint inflammation – Can result from whiplash, poor sleep posture, or age-related changes. Usually more localized pain.
Muscle and fascial restrictions – Common in high-stress clients or those with postural overload. Often feels like “tightness” that won’t let go.
Cervical stenosis – Narrowing of the spinal canal, which requires a more nuanced and gentle approach.
Stress and nervous system overload may be contributing to or even causing the pain.
Every diagnosis demands a tailored treatment strategy — from the type of manual therapy I use to the specific exercises and postural changes I prescribe. I evaluate for all of these possible causes.
What Treatments Work Best for Neck Pain?
Once we’ve identified the true driver of your neck pain, treatment can be highly focused — and much more effective. I don’t rely on a “cookie-cutter” routine. Instead, I draw from a wide range of advanced tools and techniques, including:
Manual therapy — Over 20 years of experience using mobilization, soft tissue release, and HVLA (high-velocity low-amplitude) adjustments when appropriate
Dry needling — Targets deep muscle and trigger point tension to reduce pain and restore movement
Neuromuscular stimulation — I use the NeuX NXPro for real-time muscle retraining and pain reduction
Shockwave Therapy (ESWT) — A cutting-edge modality that helps with chronic tissue irritation and improves circulation
Postural education and activity coaching — So you’re not unknowingly reinforcing the problem throughout the day
Targeted exercise programming — Not a printout of generic stretches, but movements tailored to your specific diagnosis, lifestyle, and schedule
Targeted therapeutic exercises are a cornerstone of my treatment plans — tailored not just to your diagnosis, but also to your daily routine and goals. Research increasingly supports this kind of individualized strategy for managing chronic neck pain. This study emphasizes the importance of person-centered exercise therapy for long-term results.
Together, these tools help me create an integrated, individualized plan — not just to reduce your symptoms, but to help your body recover and stay out of pain for the long term.
You Don’t Need to “Just Live With It”
If you’ve been dealing with nagging neck pain — or worse, nerve symptoms into your shoulder or arm — and feel like you’ve hit a wall, don’t give up.
Humans tend to commonly hold their stress in the head, face, neck, and shoulders. My evaluation considers this as one of the, or the, primary underlying causes of chronic neck pain. If it is determined that this is your pattern, I will educate you and teach you some techniques to help manage stress (aka control your autonomic nervous system). I can also refer you to some other expert clinicians that might be able to help provide holistic care.
Pain that hasn’t responded to standard PT, chiropractic, or injections may simply need a more advanced evaluation and a more precise treatment plan.
At Colin O’Banion Physical Therapy in Boulder, I specialize in finding and fixing what others miss — using a root-cause approach built on experience, education, and a passion for solving difficult cases.
How to Connect with Me:
Colin O’Banion, Doctor of Physical Therapy
Colin is a licensed Physical Therapist and founder of Colin O’Banion Physical Therapy in Boulder, Colorado. With 20 years of experience, he specializes in solving complex and chronic pain cases through a root-cause, integrative approach. Colin combines advanced manual therapy, shockwave therapy, dry needling, and movement re-education to help clients return to the activities they love. His one-on-one practice is dedicated to clients seeking lasting solutions when traditional PT has fallen short.
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