This article deals with both sudden and serious neck pain, plus less urgent and longer-term problems. The article also covers neck pain that begins elsewhere in the upper body.
The neck contains the spine running down it at the back, and the air pipe at the front. Otherwise, the neck is soft tissues including muscle, blood vessels, and nerves.
The most serious causes of neck pain are the least common. Doctors need to see these problems as soon as possible.
Contents of this article:
Common causes and treatment of neck pain
Everyday aches and pains are common causes of neck pain. If there is no underlying disease or injury to explain a sore neck, there could be a problem such as:
Neck pain is often caused by a strain or sprain.
- Strains and sprains
- Poor posture, or being in one position for too long
- Longer-term bone and spine problems
Strains and sprains to the muscles or ligaments in the neck may occur after a physical activity. This can be the case especially if it is a new activity or the person has stretched too far.
The initial treatment for a neck strain or sprain is the same as for other muscles. Basic initial steps include:
- Protecting from more injury by stopping the activity that caused it and not doing the activity until better
- Applying ice, which may help ease pain and reduce inflammation
Strains and sprains should improve and go away themselves over time. There should be no need for medical treatment beyond the self-care, and perhaps over-the-counter painkillers if needed. If initial sprain or strain aches and pains do not improve within days and go away within a week or two, people should see a doctor.
For a longer-term neck pain, when a doctor can find no cause such as an underlying disease or injury, it may benefit from:
- Reassurance that there was no serious cause
- Getting moving again
- Having better posture
- Movement and stretching whenever sat in one position
- Stretching and exercise, including physical therapy and massage
Neck pain with muscle spasm
One potential problem that can cause muscle spasm with neck pain is a twisted neck. This is managed with painkillers and self-care after ruling out other causes.
The pain of a twisted neck usually lasts for a few days. Activities such as driving may need to be avoided while the problem lasts. This is because the neck cannot be turned to see properly to the left or right.
Neck pain with numbness or weakness
Radiculopathy is a pinched nerve because of a spine problem, which doctors can diagnose and help manage.
Pain on one side of the neck, shoulder, or arm, and around a particular skin area, may be diagnosed as cervical radiculopathy. This is when the sensation in the neck tissues or skin is strange, or a neck muscle feels numb or weak.
These symptoms are often not because of radiculopathy, however. In any case, medical diagnosis and care are important with neck symptoms.
When is neck pain serious?
There are some occasions where neck pain can be caused by a serious condition.
Less common cases of neck pain that need treating straight away are those when the pain:
Heart problems can cause neck pain, as well as pain in the chest and difficulty breathing.
- Is severe
- Occurs with other symptoms
- Lasts a number of days without improving
Serious heart events, including heart attack, can cause neck pain. Immediate help is needed for neck pain if there are symptoms such as:
- Chest pain that feels like pressure or tightness
- Severe, ripping chest pain
- Difficulty breathing
Urgent heart problems can also cause arm, shoulder, and other pain starting in the chest.
Serious infection is another urgent problem with the wider body that can result in neck pain. Infection also needs immediate medical help. Serious infections such as meningitis are signaled by these sorts of symptoms:
Local infections to the neck, or somewhere close to it, can also lead to neck pain. Anyone who has recently had surgery or a wound should be alert and get any possible infection seen as soon as possible.
An injury that badly affects or hurts the neck needs to be seen straight away, even if it does not appear to be very painful. Help should be found when someone has a bad neck injury without showing great pain but is not moving or responding - they could be in more urgent need of medical care.
Examples of when a bad physical injury can happen include a sporting clash or when older people have a fall. Some people are more at risk than others, but fit and healthy people also need to be checked when the neck is involved.
First aid advice for possible neck injuries includes the following:
- Calling for medical help - this is urgently important if the person is not responding
- People who know first aid should assess and do any that is needed
- People who don't should call for someone who does
- Keeping the head and neck safe from moving, which might worsen an injury
- Keeping the head and neck in the same place as found
If the person is moving their head and is generally responsive, this is good news. It is important for anyone involved in an accident to be assessed, however. Some minor injuries may be more noticeable after the shock of the accident.
Longer-term bone and spine problems
Some people have neck pain because of long-term conditions such as arthritis. Another condition that can affect the spine at the neck is osteoporosis. Any long-term problems with neck pain should be under the care of a doctor.
What is whiplash?
Whiplash is caused by a type of impact that is common in road accidents. Any impact that causes sudden, forceful movement of the head and neck may lead to whiplash. Whiplash injuries are most likely with side-impact road crashes.
Road accidents can lead to a type of neck injury called whiplash.
Whiplash is an injury to the soft tissues of the neck such as the muscles. Typical features include neck pain that may spread to include a shoulder or arm. Headache is another symptom of whiplash.
Doctors will first rule out or treat other more serious problems before diagnosing a case of whiplash.
Some medical researchers have graded whiplash. It can range from an injury that involves only pain, stiffness or tenderness, and no visible, physical signs of trauma. It can also be more severe, causing reduced movement or nerve effects that lead to weakness or reduced sensation.
The more severe symptoms of whiplash are less common and need checking by a doctor. These include:
- Not being able to turn the neck as far as usual
- Tiredness, dizziness, numbness, or nausea
- Muscle spasm
Longer-term whiplash problems
A whiplash injury can have lasting effects. One study of whiplash, published in 2012, categorized longer-term whiplash problems as late whiplash syndrome or LWS.
In the study, LWS meant that whiplash kept people from returning to normal life, perhaps stopping them driving, doing their work, or doing leisure activities. It would be classed as LWS if the pain, restricted movement, or other neck symptoms lasted for at least 6 months.
For longer-term neck pain and other symptoms resulting from whiplash, the recommended approach is to try and get back to normal activities when possible. Avoiding or delaying getting back to normal can make pain and disability worse.
Self-care, painkillers, and other therapies can sometimes help. People with long-term whiplash should discuss these options with a healthcare professional.