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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
Neck pain is common, especially in people older than
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 accident 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
If your neck pain is long-lasting (chronic), you may have
trouble coping with daily life. Common side effects of chronic pain include
Your doctor will ask
questions about your symptoms and do a physical exam. He or she may also ask
about any injuries, illnesses, or activities that may be causing your neck
During the physical exam, 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
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
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
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
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 tumor, 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
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.
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:
Nerve-related symptoms caused by pressure on the
spinal nerve roots or
spinal cord include:
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
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:
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 care professionals who often diagnose the cause of neck
If your neck pain is severe or long-lasting, health
professionals who can treat you include:
You can also get care
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 exam. 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 exam, 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
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. Nonsurgical 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 physical therapist, chiropractor, or osteopathic doctor for this type of care and to learn stretching and strengthening exercises that you can do at home.
Your doctor may recommend that you
cervical collar to support your neck. Cervical collars
may reduce neck pain, but they should only be used for a day or two.
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,
depression or drug dependence, may respond to
treatment more slowly. Counseling along with medical treatment may help in
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
Prescription pain relievers include:
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
Other types of treatment include:
Complementary and alternative treatments are sometimes used to relieve
pain and restore neck mobility. They include:
The North American Spine Society (NASS) promotes education, research, and advocacy for spine care. This group's patient education website (www.KnowYourBack.org) has information on the cause, treatment, and prevention of neck and back problems. It has references and brochures to help patients make health decisions. NASS members are spine care professionals such as orthopedic surgeons, neurosurgeons, neurologists, physiatrists, physical therapists, and researchers.
The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
website contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise.
The American Academy of Physical Medicine and
Rehabilitation (AAPMR) is the medical society for the specialty of physical
medicine and rehabilitation. The website includes a directory of member
PM&R physicians (physiatrists) that can be searched by last name, location,
or telephone number.
The American Physical Therapy Association is a national
organization representing nearly 70,000 physical therapists, physical therapist
assistants, and students. Its goal is to foster advancements in physical
therapist education, practice, and research. The APTA also provides information
and education to the public about physical therapy and how it is used to treat
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.
July 30, 2012
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Robert B. Keller, MD - Orthopedics
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