Neck Pain

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What is neck pain?

Neck pain is any type of pain or discomfort throughout the neck region, which consists of the cervical spine, muscles, ligaments, tendons, nerves, and blood vessels. Most people will experience neck pain at some point in their lives, and it is usually not a cause for concern.

Neck pain causes include minor problems, such as sleeping in an awkward position, and more serious problems, such as arthritis or degenerative disc disease. Any of the structures in the neck can become irritated or inflamed in response to a variety of different conditions.

Depending on the underlying cause, neck pain may last briefly, or it may be chronic, defined as lasting more than three months. Your neck pain may feel like a dull ache, or it may be sharp and jolting in a specific area. Although most cases of neck pain resolve themselves in a few days to a few weeks with basic self-care measures, neck pain can also persist and lead to more serious problems, such as nerve damage.

Neck pain usually originates in the neck itself, but it can also be due to problems in other parts of the body, such as the head, shoulders and chest, and radiate to the neck. Therefore, your neck pain may be accompanied by other symptoms.

Neck pain occurring with other symptoms, such as pain or numbness down your arm, difficulty breathing, or a stiff neck, may be a sign of a serious medical condition and should be evaluated as soon as possible or in an emergency medical facility. In addition, if your pain follows an injury or accident or is extreme, persistent, or causes you concern, contact a medical professional.

What other symptoms might occur with neck pain?

Neck pain may occur with other symptoms depending on the underlying disease, disorder or condition. For instance, if your neck pain is due to arthritis, you may experience pain in other parts of your body. Neck pain due to a pinched nerve can lead to pain, tingling, and numbness down one or both arms. Neck pain due to poor posture and stress may occur along with fatigue and sleep problems. The range of symptoms that may occur with neck pain include:

  • Altered posture

  • Dizziness

  • Fatigue

  • Fever

  • Headache

  • Shoulder pain

  • Sleep disturbances

  • Swelling

  • Pain and tingling down your shoulder and arm

Serious symptoms that might indicate a life-threatening condition

In some cases, neck pain may occur with other symptoms that might indicate a serious or life-threatening condition, such as meningitis or heart attack, which should be immediately evaluated in an emergency setting. Symptoms that may indicate a serious or life-threatening condition include:

What causes neck pain?

The neck consists of the cervical spine and spinal cord, nerves, intervertebral discs, muscles, ligaments, and tendons. Any of these structures can become irritated or inflamed in response to a variety of mild to serious conditions, such as poor posture, trauma, cervical spondylosis, and arthritis. Common causes of neck pain are overuse, poor posture, and whiplash, which is often incurred in a car accident or other trauma. Neck pain can also be caused by rheumatoid arthritis or fibromyalgia. A problem or injury in another part of the body, such as the chest, shoulders and head, can also radiate to the neck. This is “referred” neck pain.

Structural causes of neck pain

Neck pain can be due to injury, inflammation, or infection of the bones and tissues including:

  • Herniated disc

  • Osteoarthritis

  • Osteomyelitis (infection or inflammation of the spinal bones)

  • Osteoporosis (metabolic bone disease that causes fragile bones)

  • Paget’s disease of the bone

  • Rheumatoid arthritis

  • Spinal cord trauma

  • Spinal degeneration (degenerative disc disease, also called spondylosis)

  • Spinal stenosis (a narrowing of the spinal canal that presses on the spinal cord or nerves)

  • Spondylitis (infection or inflammation of the spinal joints)

  • Sprains and strains due to overuse or injury, such as a muscle spasm

  • Whiplash

Other possible causes of neck pain

Neck pain can also be due to systemic problems or problems affecting other body systems including:

Life-threatening causes of neck pain

In some cases, neck pain may be a symptom of a serious or life-threatening condition that should be evaluated as soon as possible or in an emergency setting. For example, some types of neck pain can indicate a serious bacterial infection (meningitis) of the membranes surrounding the brain and spinal cord. Life-threatening causes of neck pain include:

What are the risk factors for neck pain?

Although anyone can experience neck pain, there are certain risk factors that make it more likely to develop. In general, neck and back pain most often begin around age 30. The normal aging process leads to wear and tear of the bones and discs between each vertebra.

Risk factors include:

  • Family history of neck pain or degenerative disc disease

  • Increasing age

  • Obesity

  • Occupational activities that expose the individual to possible injury (slips, falls)

  • Poor posture, including poor body alignment at your work desk

  • Riding in a motor vehicle without seatbelts

  • Sedentary lifestyle

  • Smoking

  • Sports activities that involve physical and jarring contact

  • Stress and anxiety 

When should you see a doctor for neck pain?

Sudden neck pain can occur with a heart attack. Call 911 or go to your nearest emergency room for neck pain when:

  • The pain radiates from your chest or you also have chest, back, shoulder, arm or jaw pain.

  • You have other symptoms of a heart attack, such as anxiety, cold sweats, dizziness, lightheadedness, nausea or vomiting, shortness of breath, or weakness.

You should also seek emergency medical care for neck pain when:

  • You also have a fever, rash, severe headache, sensitivity to light, and a stiff neck that does not allow you to touch your chin to your chest.

  • You have had a traumatic accident, injury or fall, including a blow to the head.

See a doctor promptly when neck pain:

  • Accompanies difficulty walking or maintaining your balance

  • Is severe, limits head movement, or interferes with activities or sleep

  • Persists for more than a week despite home treatment like warm or cold packs

  • Occurs with numbness, tingling or weakness in the arm or hand, or new changes in bowel or bladder control

How is the cause of neck pain diagnosed?

To diagnose the cause of your neck pain, your doctor will take a medical history, perform a physical exam, and maybe order tests. The exam will focus on finding tender or painful areas, checking muscle strength, and testing your range of motion from side to side and up and down.

Questions your doctor may ask about your pain and medical history include:

  • In what part of the neck do you feel pain?

  • When and how did your neck pain start?

  • On a scale of 1 to 10, with 10 being the worst pain ever, how would you rate your neck pain?

  • Is your neck pain continuous or does it come and go?

  • Are there any activities that aggravate or trigger your neck pain?

  • What, if anything, makes the pain better?

  • Are you experiencing any other symptoms, such as numbness or tingling in your arms or hands?

  • Have you had this kind of neck pain before? How was it treated?

  • Have you injured your neck or had a blow to the head?

  • What other medical conditions do you have?

Based on your answers and the exam results, you doctor may order testing including:

  • Blood tests to check a complete blood count and look for markers of infection 

  • Imaging exams, such as X-rays, CT (computed tomography) scans, MRIs (magnetic resonance imaging), and discograms and myelograms, which are specialized X-rays with a dye to look at vertebral discs and the spine

  • Nerve conduction studies, to evaluate how well your nerves send signals and how your muscles respond to them

  • Selective nerve root blocks, which involve injecting anesthetic around specific nerves leaving the spinal cord to see if they are the source of the pain

It is not always possible to diagnose an underlying cause or condition. If the problem persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.

How do you treat neck pain?

Neck pain treatment depends on the cause and severity of the pain. Treatment goals are to provide neck pain relief and to correct any underlying problem. For minor neck pain, doctors typically use conservative treatments first. These include:

  • Immobilization with a soft collar to support the neck and relieve pressure on it. This is a short-term approach, as use for more than a couple of weeks can be harmful. 

  • Medications to relieve pain and swelling, including NSAIDs (nonsteroidal anti-inflammatory drugs), muscle relaxants, and antidepressants for certain kinds of nerve pain

  • Physical therapy to help strengthen neck muscles and improve flexibility and function. Physical therapists also use several methods to relieve pain, including massage and TENS (transcutaneous electrical nerve stimulation). 

  • Rest, ice and elevation to relieve pain and reduce swelling due to minor injuries

  • Traction to gently stretch the neck

  • Trigger point injections and epidural steroid injections for temporary pain relief

If neck pain persists after 6 to 8 weeks of these treatments, doctors may recommend surgery. Surgery may be an option earlier if there is a specific cause that will respond well to it. Surgical options depend on the cause of pain and may include decompression surgery, disc replacement, and spinal fusion. Best clinical outcomes correlate with diagnostic accuracy. Take the necessary time to allow your healthcare team to precisely pinpoint your problem with confidence.

Home remedies for neck pain

Minor neck pain often responds to home care strategies including:

  • Resting your neck is the first self-care step to take. Take a break from sports or activities that strain your neck.

  • Practicing good posture, with your head aligned over your spine and hips, not extended forward

  • Applying ice or heat to your neck. Ice is generally better at reducing inflammation. But some people like the comfort of heat. You can alternate them if this is the case. Use each one for no more than 20 minutes at a time.

  • Practicing relaxation techniques, such as meditation, to reduce stress and tension

  • Stretching your neck gently after warming it up with heat therapy and using neck pain relief exercises as recommended by your doctor or physical therapist

  • Taking over-the-counter pain relievers. NSAIDs (nonsteroidal anti-inflammatory drugs) will treat both pain and inflammation. But some people should not take these drugs. Acetaminophen (Tylenol) is an alternative for pain relief, but it is not an anti-inflammatory. 

  • Using an over-the-counter TENS unit with advice from your doctor or physical therapist

Alternative treatments for neck pain

Pain is one of the top reasons people seek out alternative medicine. Here are some popular options for neck pain:

  • Acupuncture has been successful in treating many types of pain. Studies looking at its ability to relieve neck pain have mixed results. It seems to work best in addition to traditional medical care for neck pain.

  • Chiropractic manipulation can provide pain relief with an adjustment of the spine.

  • Massage therapy may be helpful for some people with neck pain when combined with traditional treatments. The effect is generally short-lived and requires frequent treatments. Make sure your massage therapists know about any underlying cause of your neck pain.

What are the potential complications of neck pain?

Complications depend on the underlying disease, disorder or condition. For example, neck pain resulting from a degenerative condition, such as spondylosis, can lead to inactivity and its associated complications. Fortunately, most cases of neck pain can be alleviated or minimized by physical therapy, basic self-care measures, and following the treatment plan outlined by your doctor.

However, in some cases neck pain may become a chronic condition and affect your daily life. Research into the diagnosis and treatment of neck pain is ongoing, so ask your healthcare professional for the latest information on causes and treatment plans.

Over time, neck pain can lead to complications including:

  • Absenteeism from work or school

  • Permanent nerve damage (due to a pinched nerve) including paralysis

  • Physical disability

  • Physiological and psychological response to chronic pain

  • Poor quality of life
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 May 12
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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