Online physiotherapy for neck pain
If your neck pain fits, a video consultation lets your physiotherapist watch how your neck and shoulders move, ask about your daily set-up and give you exercises to do at home. It is not the right route if you have arm weakness or numbness, balance changes, dizziness or visual symptoms, or neck pain after an injury. Those need 999, A&E or 111.
If you’re in the Glasgow area, you can book a home visit instead of a video call.
How online physiotherapy works for neck pain
Neck pain often shows up in how you hold and turn your head, and a camera is well placed to see that. We ask you to sit side-on and then face-on to the screen so that we can watch you turn, tilt and look up and down, and see how your shoulders and upper back share the work.
Your own space is part of the assessment. We ask you to show us how you sit at your desk, where your screen is, how you hold your phone and what your pillow set-up looks like. Changes to those are easy to try straight away, and you can tell us in the same call whether they made a difference.
The NHS advises trying neck flexibility exercises and says not to wear a neck collar. In our plans, that means gentle, regular movement is where we start, and we show you each exercise on camera so that we can correct it as you do it.
Some neck problems need a different route. The NHS says to see a GP if neck pain does not go away after a few weeks, or if you have pins and needles or a cold arm. We cannot touch your neck by video or order tests, so if what you describe needs a hands-on check or investigation, we will say so and help you decide where to go.
NHS England describes remote physiotherapy as suitable for people who do not need an in-person physical examination. We use that as our starting question for every neck appointment.
What the video assessment checks
- How far you can turn your head each way, tilt it to each side and look up and down, and whether the movement is smooth or catches.
- A chin tuck and rotation check done on camera, so that we can see how your head and neck move together.
- How you sit and stand, including how your head sits over your shoulders and how your shoulders move when you raise your arms.
- Whether pain stays in the neck, spreads to the shoulder or arm, or comes with pins and needles, and whether that is changing.
- How your work set-up, phone use, sleeping position and stress levels fit with when the pain is worst.
- The red flag questions below, including balance, dizziness, vision and any recent injury, which we ask at the start of every appointment.
What treatment usually involves
A first plan for neck pain is usually short. We give you two or three gentle movements to repeat through the day, a change or two to your desk or sleeping set-up, and a plan for gradually adding strengthening for the neck, shoulders and upper back as the pain settles.
For neck pain, the number of appointments varies from person to person. It depends on your condition; your physiotherapist will give you an estimate after your assessment. The first is a 60-minute video assessment at £40, and follow-ups are 30 minutes at £30, and we review the estimate as we go.
Because we cannot do hands-on treatment over video, nothing in your plan depends on us touching your neck. Everything we give you is something you do yourself, which means you keep it going between sessions and after you finish.
If your arm symptoms are the main issue, or they are not following the pattern we expect from the start, we will tell you honestly and discuss whether a GP review is the better next step.
How long recovery usually takes
According to the NHS, most neck pain only lasts a few weeks. If it has not gone after a few weeks, or it is getting worse, see a GP rather than waiting, and let us know if you are already working with us.
When you need to be seen in person instead
A video appointment is not the right route for the situations below, and a home visit is not a substitute for urgent care.
- Call 999 if you have chest pain that spreads to your neck, jaw or arms, or chest pain that feels tight or squeezing. Do not drive yourself.
- Call 999 if you have sudden weakness or numbness in an arm or down one side of your body, a drooping face or trouble speaking (possible stroke). Do not drive yourself. Call 999 as well for blurred vision, loss of sight or sudden dizziness, which can also be stroke signs.
- Call 999 or go to A&E, or call 111 if you are not sure, if you notice changes in your balance or co-ordination.
- Call 999 or go to A&E, or call 111 if you are not sure, if your neck pain started after an accident or injury.
- Call 999 or go to A&E, or call 111 if you are not sure, if you have dizziness or visual symptoms when you move your neck.
- If you have neck pain or stiffness with a high temperature, a very painful headache, confusion, a rash that does not fade when pressed, or you are worried it could be meningitis, call 999 or go to A&E. Do not drive yourself.
- NICE Clinical Knowledge Summaries, written for GPs, list some neck pain features as red flags that need medical referral: nerve symptoms such as pins and needles, weakness or numbness, feeling generally unwell or feverish, weight loss you cannot explain, pain that does not let up and disturbs your sleep, and a past history of cancer, neck surgery or a raised risk of osteoporosis. If you feel feverish or unwell with neck pain or stiffness, use the meningitis line above. For the others, ask your GP for an urgent appointment instead of booking with us. Sudden weakness or numbness, and neck pain after an accident or injury, follow the 999 and A&E lines above.
- Ask your GP for an urgent appointment if you have pins and needles or an arm that feels cold. The NHS lists these for a GP visit, and NICE CKS guidance for clinicians treats nerve symptoms as a red flag, so do not wait. See a GP if your neck pain has not gone after a few weeks.
- If you are not sure whether your symptoms are urgent, call 111 or speak to a GP rather than waiting for a video appointment.
Exercises and self-checks
Common questions
Can neck pain be assessed over video?
We can ask about your symptoms, watch your neck and shoulders move and check your set-up, then give you exercises. Over video, we cannot examine you by hand, and certain symptoms need in-person care. We screen for them at the start and will tell you if a video appointment is not right.
Should I wear a neck collar?
The NHS advises against wearing a neck collar for neck pain. We will talk you through gentle movement and what to avoid for now, based on what we see on camera.
How long will my neck pain last?
The NHS says most neck pain only lasts a few weeks. We cannot give you an exact timeline, but we review how it is going at each appointment and will suggest seeing a GP if it is not settling.
What if I get pins and needles in my arm?
Tell us at booking and at the start of the session. The NHS says to see a GP for pins and needles or a cold arm, and NICE CKS guidance for clinicians treats nerve symptoms as a red flag, so ask your GP for an urgent appointment. Call 999 if you have sudden weakness or numbness in an arm or down one side of your body, a drooping face or trouble speaking (possible stroke). Do not drive yourself. Dizziness or blurred vision also needs a 999 call. Neck pain after an injury, or with balance changes, needs A&E or a 111 call. None of these are suited to a video appointment.
Further reading
This information is general and not a substitute for an assessment. Don't start a new exercise programme without advice from a physiotherapist or doctor who knows your condition. If an exercise causes pain that doesn't settle, stop and seek advice.
Sources
Book an online assessment
A 60-minute video assessment with an HCPC-registered physiotherapist is £40.
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