Most people will experience neck pain at some point in their lives. Neck pain can be acute, meaning it lasts a few hours to a few weeks, or it can be chronic. Neck pain that lasts several weeks or longer is considered chronic neck pain.
Most causes of neck pain aren't serious. Poor posture at work, such as leaning into your computer, and during hobbies, such as hunching over your workbench, are common causes of neck pain.
But sometimes neck pain can signify something more serious. If your neck pain is so severe that you can't touch your chin to your chest despite a few days of self-care, seek immediate medical attention.
Neck pain takes many forms. Signs and symptoms of neck pain may include:
- Pain in your neck that may feel sharp or dull
- Stiffness in your neck
- Difficulty going about your daily tasks because of pain or stiffness in your neck
- Shoulder pain in addition to neck pain, in some cases
- Back pain in addition to neck pain, in some cases
Neck pain can result from several causes, including:
- Muscle strains. Overuse, such as too much time spent hunched over a steering wheel, often triggers muscle strains. Neck muscles, particularly those in the back of your neck, become fatigued and eventually strained. When you overuse your neck muscles repeatedly, chronic pain can develop. Even such minor things as reading in bed or gritting your teeth can strain neck muscles.
- Worn joints. Like the other joints in your body, your neck joints experience wear and tear with age, which can cause osteoarthritis in your neck. Neck (cervical) osteoarthritis can cause pain and stiffness in your neck.
- Disk disorders. As you age, the cushioning disks between your vertebrae become dry and stiff, narrowing the spaces in your spinal column where the nerves emerge. The disks in your neck also can herniate. This means the inner gelatinous cartilage material of a disk protrudes through the disk's tougher cartilage covering. Neck pain may occur or nearby nerves can be irritated. Other tissues and bony growths (spurs) also can press on your nerves as they exit your spinal cord, causing pain.
- Injuries. Rear-end collisions often result in whiplash injuries, which occur when the head is jerked forward and back, stretching the soft tissues of the neck beyond their limits.
When to seek medical advice
Neck pain doesn't always require medical care. Rarely, it can be a sign of an emergency.
When to try home care
Neck pain caused by muscle irritations is usually easy to self-diagnose, and it usually gets better on its own within a few of days. This type of neck pain typically develops after excessive activity, a period of overuse or prolonged postures that put excessive strain on your neck muscles. If your neck pain doesn't let up within a week or two, see your doctor.
When to seek immediate medical care
See your doctor if the following signs and symptoms occur in conjunction with neck pain:
- Severe pain from an injury. After head or neck trauma, such as whiplash or a blow to your head, see your doctor immediately. Severe pain over a bone might indicate a fracture or an injury to a ligament.
- Shooting pain. Pain radiating to your shoulder, through your shoulder blades or down your arm, with or without numbness or tingling in your fingers, may indicate nerve irritation. Neck pain from nerve irritation can last from weeks to six months or longer. More sophisticated tests and treatments are available for this type of continued nerve irritation, so see your doctor.
- Loss of strength. Weakness in an arm or a leg, walking with a stiff leg, or shuffling your feet indicates a possible neurological problem and needs immediate evaluation.
- Change in bladder or bowel habits. Any significant change, especially a sudden onset of incontinence, could indicate a neurological problem.
Tests and diagnosis
Your doctor often will be able to diagnose the cause of your neck pain and recommend treatment just by asking questions about the type, location and onset of your pain.
In less clear-cut cases, your doctor may use imaging techniques or other tests such as:
- Magnetic resonance imaging (MRI)
- Computerized tomography (CT) scans
- Electromyography (EMG)
Treatments and drugs
Most neck pain responds well to home care. If neck pain persists, your doctor may recommend other treatments.
Self-care for neck pain
Self-care measures you can try at home to relieve neck pain include:
- Over-the-counter pain relievers. Try over-the-counter pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) and acetaminophen (Tylenol, others).
- Alternate heat and cold. Reduce inflammation by applying cold, such as an ice pack or ice wrapped in a towel, for up to 20 minutes several times a day. Alternate the cold treatment with heat. Try taking a warm shower or using a heating pad on the low setting. Heat can help relax sore muscles, but it sometimes aggravates inflammation, so use it with caution.
- Rest. Lie down from time to time during the day to give your neck a rest from holding up your head. Avoid prolonged rest, since too much inactivity can cause increased stiffness in your neck muscles.
- Gentle stretching. Gently move your neck to one side and hold it for 30 seconds. Stretch your neck in as many directions as your pain allows. This may help alleviate some of the pain.
- Over-the-counter pain creams. Creams and gels made to relieve muscle and joint pain may provide some temporary relief from neck pain. Look for products with ingredients such as menthol and camphor.
Treatment for persistent neck pain:
For pain that doesn't get better with simple home-care measures, your doctor may recommend one or more treatments, such as:
- Neck exercises and stretching. Your doctor may recommend that you work with a physical therapist to learn neck exercises and stretches. A physical therapist can guide you through these exercises and stretches, so that you can do them on your own at home. Exercises may improve pain by restoring muscle function and increasing the strength and endurance of your neck muscles.
- Transcutaneous electrical nerve stimulation (TENS). Electrodes placed on your skin near the painful areas deliver tiny electrical impulses that may relieve pain.
- Injections of medication. Injections of medications into your neck may help relieve pain. Your doctor may inject corticosteroid medications near the nerve roots, near the small neck joints or into the muscles in your neck to help with pain. Numbing medications, such as lidocaine, also can be injected to numb your neck pain.
- Pain medications. Your doctor may prescribe stronger pain medicine than what you can get over-the-counter. Opioid analgesics are sometimes used briefly to treat acute neck pain. Muscle relaxants, tramadol (Ultram) or tricyclic antidepressant medications used for pain also may be prescribed.
- Traction. Traction uses weights and pulleys to gently stretch your neck and keep it immobilized. This therapy, under supervision of a medical professional and physical therapist, may provide relatively fast relief of some neck pain, especially pain related to nerve root irritation. Relief may last for hours or even days.
- Short-term immobilization. A soft collar that supports your neck may help relieve pain by taking pressure off the structures in your neck.
- Surgery. Surgery is rarely needed for neck pain. However, it may be an option for relieving nerve root or spinal cord compression.
Most neck pain is associated with poor posture on top of age-related wear and tear. To help prevent neck pain, keep your head centered over your spine, so gravity works with your neck instead of against it. Some simple changes in your daily routine may help. Consider trying to:
- Take frequent breaks if you drive long distances or work long hours at your computer. Keep your head back, over your spine, to reduce neck strain. Try to avoid clenching your teeth.
- Adjust your desk, chair and computer so the monitor is at eye level. Knees should be slightly lower than hips. Use your chair's armrests.
- Avoid tucking the phone between your ear and shoulder when you talk. If you use the phone a lot, get a headset.
- Stretch frequently if you work at a desk. Shrug your shoulders up and down. Pull your shoulder blades together and then relax. Pull your shoulders down while leaning your head to each side to stretch your neck muscles.
- Balance your base. Stretching the front chest wall muscles and strengthening the muscles around the shoulder blade and back of the shoulder can promote a balanced base of support for the neck.
- Avoid sleeping on your stomach. This position puts stress on your neck. Choose a pillow that supports the natural curve of your neck.
Talk to your doctor if you're interested in trying complementary and alternative neck pain treatments. Your doctor can discuss the benefits and risks of various alternative neck pain treatments.
Alternative neck pain treatments include:
- Acupuncture. Acupuncture involves the insertion of thin needles into various points on your body. Studies have found that acupuncture may be helpful for many types of pain. But studies in neck pain have been mixed. For results, you may need to undergo several acupuncture sessions. Acupuncture is generally considered safe when performed by a certified practitioner using sterile needles. But don't undergo acupuncture treatment if you're taking blood thinners.
- Massage. During a massage, a trained practitioner manipulates the muscles in your neck. Little scientific evidence exists to support massage in people with neck pain, though it may provide relief when combined with your doctor's recommended treatments. Massage is generally safe for most people with minor neck strains, as long as it's performed by a trained massage therapist. If you have chronic neck pain or neck pain that's caused by injury or arthritis, ask your doctor if massage would be safe for you.
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Information from the National Institutes of Health, November 2008