Conditions · Neck pain

Neck Pain Treatment in Midtown NYC

For neck pain from long days at a desk that keeps coming back — even if you haven’t exercised in years.

Hiro Nakano, DC, DACBSP · Team USA volunteer medical staff · In Midtown since 2010

Does this sound like you?

  • Your neck and shoulders tighten up every afternoon at your desk, and stretching only helps for an hour or two.
  • It flares up whenever work gets busy, and you’ve stopped exercising — or never really started.
  • An X-ray showed a “straight neck” or “degeneration,” and you’re not sure what that means for you.
  • You get headaches, or tingling down your arm, along with the neck pain.
  • Massage, adjustments, or physical therapy helped for a while — and then it came back.

People usually come in with stiff-neck and strain problems, pain spreading into the shoulder blade, a pinched nerve or disc herniation in the neck, arthritis or “degenerative” changes on imaging, or headaches that come from the neck.

If this sounds familiar, you don’t need to be fit to start. You just need a clear explanation and a plan that fits your life.

Why it keeps coming back

Neck pain is rarely about one bad posture or one tight muscle. More often, it’s a mismatch between what your neck is asked to do — hours at a screen, deadlines, short nights, stress — and what it can handle right now. Rest and stretching ease it for a few days. Then the load comes back, but your neck’s capacity hasn’t changed.

Two things people often blame turn out to matter less than they think:

What the research shows: a “straight neck” is common in people with no neck pain, and studies haven’t found a consistent link between the shape of the curve and whether — or how much — the neck hurts.[1] Pillow studies are mixed, too: no single material, shape, or custom-made pillow has been shown to work for everyone.[2]

So I don’t treat the X-ray, and I won’t sell you a pillow. I look for what’s actually overloading your neck, and what your body needs to handle it.

What makes my approach different

Hands trained for four generations

My great-grandfather opened our family’s hands-on clinic in Japan in 1926. I trained and treated patients there before moving to the U.S. Hands-on care — joint mobilization and soft-tissue work chosen from that day’s exam — is the core of what I do, and often what changes pain and stiffness fastest.

Olympic-level sports medicine

I’m a Diplomate of the American Chiropractic Board of Sports Physicians, and I traveled with the U.S. team as a volunteer member of the medical staff at the 2019 Pan American Games and the 2021 Tokyo Olympic Games. I bring the same process I use with Olympic athletes to a desk-job neck: find the cause, treat it, rebuild capacity, and check how you respond. Most of the people I see aren’t athletes — and they don’t need to be.

One doctor, the whole picture

I see every patient myself. I examine your neck, shoulders, upper back, breathing, and how you move — and I can order X-rays or MRI directly when they’re needed. Hands-on care, exercise, and changes to how you sit, work, and sleep come from one plan, not separate providers.

Why not just adjustments — or just exercises?

Some clinics offer a long series of adjustments — two or three times a week for months. Others hand you a sheet of exercises and little else. Both can help. But neither tends to be enough on its own.

What the research shows: in a trial of 191 people with chronic neck pain, 20 sessions of spinal manipulation alone did worse than programs that included strengthening exercise — and the difference was still there two years later.[3] Combining hands-on care with exercise also relieves pain faster than exercise alone.[4]

That’s where hands-on care earns its place. When pain and stiffness ease quickly, it’s much easier to start moving — and to keep going. How I treat, and how firmly, depends on your age, the condition of your spine, any nerve symptoms, and what you’re comfortable with. Not everyone gets the same adjustment, and not everyone needs a strong one.

Not sure if this fits your situation?

Send me a text and tell me what’s going on. Most questions are easier to answer once we talk.

What working with me looks like

The first visit

About 90 minutes. I take a full history, examine you, rule out anything that needs other medical care, and explain what I find in plain language. You leave with hands-on treatment, exercises you can start right away, and a written summary of the plan.

While it hurts

Many people notice a change in the first visit or two. Most come once a week at first, then every two weeks as things improve. With a clear plan and exercises at home, you usually don’t need visits twice a week for weeks on end.

From pain relief to staying active

We start with what your neck can handle now — neck and shoulder-blade strength and endurance — then build toward whole-body strength and aerobic exercise. I adjust the plan based on how you feel the next day, not just during the session.

What the research shows: people who stay physically active are less likely to develop long-lasting neck pain, and adding aerobic exercise to neck exercises improved work ability more than neck exercises alone.[5] People who do muscle-strengthening exercise also have about a 10–17% lower risk of death from any cause, and lower rates of heart disease, cancer, and diabetes.[6]

After the pain is gone

For many people, neck pain ends up being the reason they finally start exercising — and keep it up. Some tell me it’s the first time in years they’ve had a regular routine. Many keep coming in every two weeks or once a month: I treat what needs attention, check how the exercises are going, and update the plan. Some finish once they feel good, and that’s fine. Others have kept this up for years, getting stronger along the way.

★★★★★

“My neck was killing me for almost a year. I had three sessions with him, and what I found very helpful was the homework he gave me, exercises that brought stability in my neck.”

Shelly M. · Google review · Individual results vary.

Common questions

You treat Olympic athletes. Is this really for someone like me?

Yes — most of the people I see aren’t athletes. Elite athletes push their bodies to the limit, so their care has to account for every detail. For most people, the path is simpler: a clear diagnosis, hands-on care, and a few well-chosen changes. Sometimes something as simple as walking more makes a real difference. What carries over from my work with athletes is the process — careful assessment, treating the cause, and building back step by step. And honestly, helping someone who hasn’t exercised in years start to enjoy it is some of the most rewarding work I do.

How many visits will I need?

Many people notice a change in the first visit or two. Most come once a week at first, then every two weeks as things improve; occasionally I’ll see someone twice in the first week. I’ll give you my best estimate at the first visit.

I don’t exercise. Can I still do this?

Yes. Many of the people I see for neck pain haven’t exercised in a long time. We start with what your neck can handle now and build gradually. You don’t need a gym, and you don’t need to be fit to start.

My neck pain comes with headaches. Can you help?

Often, yes. Some headaches come from the neck — this is called cervicogenic headache, and it’s a recognized diagnosis.[7] In a 2024 trial, adding hands-on treatment to exercise reduced headache days more than exercise alone.[8] But not every headache with neck pain comes from the neck; migraine has to be considered too. If your headaches look like they need a medical workup, I’ll tell you.

My hand goes numb or tingles. Is it my neck?

It can be — or it can come from thoracic outlet syndrome, or a nerve at the elbow or wrist.[9] I test sensation, strength, and reflexes, and check how symptoms change with neck and arm positions to find where the nerve is being irritated. If imaging is needed, I can order it directly.

When should neck pain be checked right away?

See a doctor soon if your hands are getting weaker or clumsier, or if your walking or balance is changing. A sudden, severe headache or neck pain with slurred speech, facial drooping, or weakness in an arm or leg is an emergency — call 911.

Related reading

Pain Is a Result, Not a Cause · Posture and Pain · Foundations: From Pain to Function · The Recovery & Movement Map

Ready to get back to what matters?

You don’t need to be fit or confident to start. Tell me what’s bothering you and what you want to be able to do again.

References

  1. Helliwell PS, Evans PF, Wright V. The straight cervical spine: does it indicate muscle spasm? J Bone Joint Surg Br. 1994;76(1):103-106. PubMed
    Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain. Eur Spine J. 2007;16(5):669-678. PubMed
  2. Chun-Yiu JP, Man-Ha ST, Chak-Lun AF. The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: a systematic review and meta-analysis. Clin Biomech. 2021;85:105353. PubMed
  3. Bronfort G, Evans R, Nelson B, et al. A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Spine. 2001;26(7):788-797. PubMed
    Evans R, Bronfort G, Nelson B, Goldsmith CH. Two-year follow-up of a randomized clinical trial of spinal manipulation and two types of exercise for patients with chronic neck pain. Spine. 2002;27(21):2383-2389. PubMed
  4. Miller J, Gross A, D’Sylva J, et al. Manual therapy and exercise for neck pain: a systematic review. Man Ther. 2010;15(4):334-354. PubMed
  5. Palmlöf L, Holm LW, Alfredsson L, et al. The impact of work related physical activity and leisure physical activity on the risk and prognosis of neck pain: a population based cohort study on workers. BMC Musculoskelet Disord. 2016;17:219. PubMed
    Daher A, Dar G, Carel R. Effectiveness of combined aerobic exercise and neck-specific exercise compared to neck-specific exercise alone on work ability in neck pain patients: a secondary analysis of data from a randomized controlled trial. Int Arch Occup Environ Health. 2021;94(7):1739-1750. DOI
  6. Momma H, Kawakami R, Honda T, Sawada SS. Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies. Br J Sports Med. 2022;56(13):755-763. PubMed
  7. Headache Classification Committee of the International Headache Society. ICHD-3: 11.2.1 Cervicogenic headache. Cephalalgia. 2018;38(1):1-211. ICHD-3
  8. Satpute K, Bedekar N, Hall T. Mulligan manual therapy added to exercise improves headache frequency, intensity and disability more than exercise alone in people with cervicogenic headache: a randomised trial. J Physiother. 2024;70(3):224-233. PubMed
  9. American Academy of Orthopaedic Surgeons. Cervical Radiculopathy (Pinched Nerve); Thoracic Outlet Syndrome. OrthoInfo · OrthoInfo