Neck pain can occur anywhere in your neck, from the bottom of your head to the top of your shoulders. It can spread to your upper back or arms. It may limit how much you can move your head and neck.
Neck pain is common, especially in people older than 50.
Most neck pain is caused by activities that strain the neck. Slouching, painting a ceiling, or sleeping with your neck twisted are some things that can cause neck pain. These kinds of activities can lead to neck strain, a sprain, or a spasm of the neck muscles.
Neck pain can also be caused by an injury. A fall from a ladder or whiplash from a car crash can cause neck pain. Some less common medical problems can also lead to neck pain, such as:
You may feel a knot, stiffness, or severe pain in your neck. The pain may spread to your shoulders, upper back, or arms. You may get a headache. You may not be able to move or turn your head and neck easily. If there is pressure on a spinal nerve root, you might have pain that shoots down your arm. You may also have numbness, tingling, or weakness in your arm.
If your neck pain is long-lasting (chronic), you may have trouble coping with daily life. Common side effects of chronic pain include fatigue, depression, and anxiety.
Your doctor will ask questions about your symptoms and do a physical examination. He or she may also ask about any injuries, illnesses, or activities that may be causing your neck pain.
During the physical examination, your doctor will check how well you can move your neck. He or she will also look for tenderness or numbness, tingling, or weakness in your arms or hands.
If your pain started after an injury, or if it doesn't improve after a few weeks, your doctor may want to do more tests. Imaging tests such as an X-ray, an MRI scan, or a CT scan can show the neck muscles and tissues. These tests may be done to check the neck bones, spinal discs, spinal nerve roots, and spinal cord.
The type of treatment you need will depend on whether your neck pain is caused by activities, an injury, or another medical condition. Most neck pain caused by activities can be treated at home.
For neck pain that occurs suddenly:
To treat chronic neck pain, your doctor may prescribe medicine to relax your neck muscles. Or you may get medicines to relieve pain and help you sleep. You might also try massage or yoga to relieve neck stress.
Surgery is rarely done to treat neck pain. But it may be done if your pain is caused by a medical problem, such as pressure on the spinal nerve roots, a tumour, or narrowing of the spinal canal.
You can avoid neck pain caused by stress or muscle strain with some new habits. Avoid spending a lot of time in positions that stress your neck. This can include sitting at a computer for a long time.
If your neck pain is worse at the end of the day, think about how you sit during the day. Sit straight in your chair with your feet flat on the floor. Take short breaks several times an hour.
If your neck pain is worse in the morning, check your pillow and the position you sleep in. Use a pillow that keeps your neck straight. Avoid sleeping on your stomach with your neck twisted or bent.
Learning about neck pain:
Living with neck pain:
Neck pain can be caused by:
Most neck pain is caused by activities that involve repeated or prolonged movements of the neck. This can result in a strain (an overstretched or overused muscle), a sprain (injury to a ligament), or a spasm of the neck muscles.
These activities include:
Stress and focusing intensely on a task can also cause neck pain. Tension may develop in one or more of the muscles that connect the head, neck, and shoulders. They may feel tight and painful.
Minor injuries may occur from tripping or falling a short distance or from excessive motion of the cervical spine.
Severe neck injuries may occur from:
Certain medical problems can cause neck pain. These include:
Some medicines can cause neck pain as a side effect.
Neck pain may:
Most neck pain gets better within several weeks with treatment that includes taking steps to relieve pain, modifying activities, and doing exercises or manual therapy. Neck pain caused by an injury such as a severe whiplash may take longer but usually improves in 6 to 12 months.
Neck pain may become long-lasting (chronic) when it occurs in combination with other health conditions, such as conditions associated with increasing age. These include narrowing of the spinal canal (cervical spinal stenosis), arthritis of the neck (cervical spondylosis), or herniated disc. In some cases, chronic neck pain can be caused by repeated and prolonged movements, such as long hours working at a computer.
Chronic neck pain can make it hard to cope with daily life. Common side effects of chronic pain include fatigue, depression, and anxiety. For more information, see the topic Chronic Pain.
Risk factors for neck pain that you cannot control include:
Risk factors that you can control include:
Call 911 or other emergency services immediately if:
Call your doctor now or seek immediate medical care if:
For more information, see the topic Neck Problems and Injuries.
Most neck pain doesn't require a visit to a doctor.
If the pain doesn't get better after 1 or 2 days and you can't do your normal daily activities, call your doctor.
If you still have mild to moderate pain after at least 2 weeks of home treatment, talk with your doctor. He or she may want to check for problems that may be causing your neck pain.
Health professionals who can evaluate and treat neck pain include:
If your neck pain is severe or long-lasting, health professionals who can treat you include:
You can also get care from:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Neck pain is usually evaluated with a medical history and physical examination. Your doctor will ask about your symptoms, injuries or illnesses, any previous treatment, and habits and activities that may be causing your neck pain. During the physical examination, your doctor will check your neck's range of motion and check for pain caused by movement. He or she will look for areas of tenderness and any nerve-related changes, such as numbness, tingling, or weakness in the arm or hand.
Blood tests may be done to check for an illness or infection.
You may not need X-rays or other imaging tests. But tests may help if your neck pain doesn't get better, especially when:
Besides X-rays, tests may include:
Most neck pain is caused by activities that involve repeated or prolonged movements of the neck. Non-surgical treatment works well on this type of pain. Most cases of neck pain caused by activities get better in 4 to 6 weeks.1
Home treatment includes applying heat or ice, taking it easy but staying as active as you can, and using over-the-counter pain relievers.
For severe pain or muscle spasm, your doctor may prescribe stronger medicines.
Manual therapy, including massage, mobilization, and manipulation, can help some neck pain. See a physiotherapist, chiropractor, or osteopathic doctor for this type of care, and to learn stretching and strengthening exercises that you can do at home.
For long-lasting neck pain, you can use the same pain-relief measures used for acute pain. For more information, see Home Treatment.
Your doctor may also prescribe antidepressants.
People who have chronic pain syndrome and its associated problems, such as depression or drug dependence, may respond to treatment more slowly. Counselling along with medical treatment may help in recovery.
Surgery is rarely required for neck pain. It may be an option when neck pain is caused by certain conditions.
Even if you need medical treatment such as prescription medicines for your neck pain, the following home treatment measures will help speed your recovery.
There is not strong evidence that either heat or ice will help. But it won't hurt to try them.
For more information, see:
An important part of home treatment is learning how to keep from hurting your neck again. For more information, see Prevention.
Medicines can relieve neck pain and reduce inflammation of the soft tissues. Pain relief will allow you to move your neck gently, so you can begin easy exercises and start the healing process.
Although pain relievers, muscle relaxants, and antidepressants are commonly used for neck pain, none are well-proven treatments.2
Non-prescription pain relievers include:
Prescription pain relievers include:
Surgery is rarely needed for neck pain. It may be an option when:
Some people can consider artificial disc replacement instead of spinal fusion. This surgery is currently just for carefully selected patients, and it is done by specially trained surgeons. Doctors have not yet done long-term studies to know how well this works over time.
Other types of treatment for neck pain may help relieve your symptoms, restore movement, and strengthen the muscles around your spine to help prevent further injury.
Other types of treatment include:
Complementary and alternative treatments are sometimes used to relieve pain and restore neck mobility. They include:
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- American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Cervical strain. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 929–933. Rosemont, IL: American Academy of Orthopaedic Surgeons.
- Binder A (2008). Neck pain, search date May 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- Graham N, et al. (2008). Mechanical traction for neck pain with or without radiculopathy (review). Cochrane Database of Systematic Reviews (3).
- Chow RT et al. (2009). Efficacy of low-level laser therapy in the management of neck pain: A systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet, 34(9705): 1897–1908.
Other Works Consulted
- Garra G, et al. (2010). Heat or cold packs for neck and back strain: A randomized controlled trial of efficacy. Academic Emergency Medicine, 17(5): 484–489.
- Peloso P, et al. (2007). Medicinal and injection therapies for mechanical neck disorders. Cochrane Database of Systematic Reviews (3).
- Sasso RC, et al. (2007). Artificial disc versus fusion: A prospective, randomized study with 2-year follow-up on 99 patients. Spine, 32(26): 2933–2940.
- Trinh KV, et al. (2006). Acupuncture for neck disorders. Cochrane Database of Systematic Reviews (3). Oxford: Update Software.
|Primary Medical Reviewer||William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
|Specialist Medical Reviewer||Robert B. Keller, MD - Orthopedics|
|Last Revised||May 15, 2013|
Last Revised: May 15, 2013
Author: Healthwise Staff
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