Neck pain can occur suddenly, or it can develop over time. It can be mild or serious. Some causes of neck pain need urgent attention. Sometimes, neck pain can begin in another part of the body.
The neck contains the spine, which runs down it at the back, and the air pipe at the front. Otherwise, it consists of soft tissues, including muscle, blood vessels, and nerves.
Many common forms of neck pain are not serious, but some need urgent medical attention.
Causes of neck pain include trauma, such as a road traffic accident, and medical reasons, such as osteoporosis.
This article will look at some causes of neck pain and how to treat them.
Many common causes of neck pain are not serious.
They may result from:
- strains and sprains
- poor posture, or being in one position for too long
- longer-term bone and spine problems
People with severe or long-term neck pain should see a doctor.
Strains and sprains to the muscles or ligaments in the neck may occur after physical activity.
Strains and sprains are different, but the symptoms and treatment are similar.
A sprain: The ligament becomes stretched or tears. The ligaments connect the bones at a joint. When a ligament tears, there may be a popping or tearing sensation.
A strain: The muscle or tendon become stretched or torn. Tendons connect the muscle to the bone.
Click here to find out more about sprains and strains.
A sprain or strain can happen when something causes the neck to extend further than it normally does, for example, during exercise or in a road traffic accident.
It can happen if a person
- has been trying a new activity
- has done more of the activity than usual
- has stretched their neck too far
- has made a sudden movement
- has not warmed up before exercising
It can lead to:
- pain in the back of the neck that gets worse when the person moves
- muscle spasms in the shoulder blade
- numbness or tingling in the hand, arm, or both
- a headache in the back of the head
- pain that gets worse after 24 hours, rather than at once
The following may ease discomfort and help the injury to heal:
- resting from any exercise that caused the injury
- wearing a soft collar to support the head and neck
- applying ice to help ease pain and reduce inflammation for 2–3 days after an injury
- using heat pads to relieve ongoing pain
- taking medication to relieve pain and relax muscles
This type of injury often disappears in time.
If initial sprain or strain aches and pains do not improve within days or do not resolve within 1–2 weeks, the person should see a doctor.
In cervical radiculopathy, a nerve becomes pinched, compressed, or irritated at the point where it leaves the spine.
There may be:
- pain on one side of the neck that radiates down one shoulder and arm
- and numbness and tingling in the arm and hand
- muscle weakness
It can result:
- when bones degenerate with age or due to a medical condition
- when an accident when lifting or bending, for example, causes damage to a disk
The discomfort usually goes away within days or weeks.
Treatment will probably involve:
- pain relief medication
- physical therapy
- oral or injected steroids to relieve pain
A cervical collar may help, but people should only use it for a short time, as the muscles that support the neck can become weak through lack of use.
If it persists, a doctor may recommend surgery.
As people get older, the following may happen:
- the cartilage and bone wear away
- bone spurs develop as the body tries to compensate for the loss of bone
- ligaments can become less flexible
- disks between the vertebrae erode
This can lead to:
- a stiff neck
- pain in the neck and shoulders
- tingling, numbness, and restricted movement in the arms
- pain relief medication
- using a neck brace to support the head and neck
- massage and physical therapy
If these treatments do not work, a doctor may suggest surgery, but this is rare.
Serious heart events, including a heart attack, can involve neck pain.
A person with neck pain needs immediate help if they also have:
- chest pain that feels like pressure or tightness
- severe, ripping chest pain
- difficulty breathing
- pain down the left arm, shoulder, or both
- feeling dizzy
Sometimes an infection can lead to neck pain.
When viruses or bacteria attack the body, the immune system responds to fight the attack. One result of this is swollen lymph nodes or “glands,” as people commonly call them. Swollen lymph nodes in the neck area can cause pain.
Anyone who has recently had surgery or a wound should be alert and seek treatment for any possible infection as soon as possible.
A tumor in the area of the neck or head can also cause neck pain.
If a person has had an accident — such as a fall or a collision in sport — they may have a back or neck injury.
The person may have severe pain in the neck, or they may be unresponsive and not show any signs of pain.
There may also be:
- tingling or numbness
- bowel or bladder incontinence
- loss of control over part of the body
- difficulty breathing
The person needs immediate medical attention.
First aid advice for possible neck injuries includes:
- Calling for medical help, especially if the person is not responding.
- Avoiding moving the person, and especially the head and neck, as far as possible.
A qualified first aider may immobilize the neck by holding the head still or by applying a brace.
If the person is moving their head and is generally responsive, they may still need a medical assessment. Some injuries may appear minor, but they can quickly become serious.
Sometimes, a genetic factor or injury can result in a wry — or twisted — neck, known as torticollis. The person’s head will tilt to one side.
A child may be born with congenital torticollis, but it can also result from irritation to the ligaments of the neck.
This could be due to:
- an infection
- an injury or herniated disk
- a sharp movement
- scarring or muscle shrinkage due to a burn or other injury
- sleeping a bad position
- a neck muscle spasm
- wearing a neck brace
- heat, ultrasound, or physical therapy
In severe cases that do not respond to other treatment, the person may need surgery.
Whiplash can result from a road accident. It is an injury to the soft tissues of the neck such as the muscles.
Any impact that causes sudden, forceful movement of the head and neck may lead to whiplash.
- neck pain that may spread to include a shoulder or arm
- a headache
- not being able to turn the neck as far as usual
- tiredness, dizziness, numbness, or nausea
- muscle spasm
Doctors will first rule out or treat other more serious problems before diagnosing a case of whiplash.
Between 20 and 40 percent of people who experience whiplash will develop long-term symptoms, but treatment, including physical therapy, can help to prevent these.
Sometimes a person has long-term neck pain, but medical examination finds no specific cause.
Reasons for this could be:
- inappropriate posture, due, for example, to a computer screen being too high
- actions or occupations that require a person to hold their head in a particular position, such as painting ceilings, for a long time
A person may benefit from:
- getting reassurance that there is no serious cause
- keeping moving
- changing their posture, including, perhaps, reviewing how they sit when driving or working
- movement and stretching regularly when sitting in one position for a long time
- stretching and exercise, including physical therapy and massage
Neck pain is a common problem. Although it can cause discomfort, it is often not serious.
However, sometimes it can:
- start after an injury
- occur with other symptoms, such as chest pain or a fever
- persist or get worse
- continue even with home or over-the-counter remedies
In these cases, or if the pain is severe, the person should see a doctor.