Doctors can treat neck pain with prescription and over-the-counter (OTC) medications, such as opioids or acetaminophen. A person can also try home remedies and alternative treatments.

The neck is the flexible part of the body that supports the weight of the head. Due to its position and structure, the neck can be vulnerable to conditions that cause pain and restrict movement.

Neck pain is one of the most common musculoskeletal disorders. Most cases of neck pain are mild and will resolve on their own within a few days. However, when a person’s neck pain lingers for more than a week, they may need medications or other treatments.

This article looks at OTC and prescription medications for neck pain. It also outlines some alternative treatments and home remedies.

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OTC medications for neck pain include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs).

Acetaminophen

Acetaminophen, also known as paracetamol or Tylenol, is usually the first-line treatment and one of the most common analgesics for people with neck pain. While its mechanism of action remains unclear, researchers believe it has a multidirectional effect across several metabolic pathways to relieve pain.

Doctors may administer acetaminophen as single drug therapy to treat mild and moderate neck pain or in combination with an opioid analgesic to treat severe neck pain.

People should take only the doctor-recommended doses of acetaminophen. They should avoid taking more than the doctor recommends or using it with alcohol to reduce their risk of liver damage.

NSAIDs

Neck pain due to infection, injury, or other conditions can affect the structures in the neck and may lead to swelling or inflammation. In these cases, doctors may recommend NSAIDs to alleviate pain and reduce inflammation.

NSAIDs act by inhibiting the action of the enzyme cyclooxygenase (COX). COX converts arachidonic acid to prostacyclins, prostaglandins, and thromboxanes — the enzymes implicated in inflammatory responses.

NSAIDs are available in oral tablet form or as topical creams, gels, and patches.

Examples of NSAIDs doctors commonly prescribe include:

Learn more about NSAIDs here.

Doctors may prescribe medications to treat neck pain. These include:

Opioids

A doctor may prescribe opioids to treat chronic neck pain when NSAIDs and other analgesics are ineffective.

Opioids bind to opioid receptors in the nerve cells of the brain, spinal cord, and other parts of the body. This results in the blockage of pain messages from the body to the brain.

However, a 2020 analysis suggests that a minority of patients benefit from using opioids long-term and that people who use them for long periods may be at a higher risk of overdose and addiction.

Learn more about opioids here.

Corticosteroids

Corticosteroids offer relief by reducing inflammation and immune responses associated with neck pain. To reduce the risk of side effects, doctors will prescribe the lowest dose to produce the desired result.

Some examples of corticosteroids include:

  • cortisone
  • prednisone
  • prednisolone
  • methylprednisolone

Corticosteroids are available in the following forms:

  • tablets
  • capsules
  • lotions, creams, ointments, or gels
  • nasal or mouth sprays
  • injections

Learn more about corticosteroids here.

Muscle relaxants

A doctor may prescribe a muscle relaxant with pain medication to treat neck pain that occurs due to stiff neck muscles or damage to spinal cord nerves.

Different muscle relaxants work in different ways. They can work on the brain, spinal cord, or directly on the muscle to reduce stiffness, pain, and any associated discomfort.

There are two classes of muscle relaxants:

Antispastics

These work on the spinal cord or muscles and can help treat spinal cord injuries and conditions that cause spasms.

Examples of antispastics include:

Antispasmodics

These bind to receptors in the cell membrane of muscles and inhibit sudden involuntary muscular contractions known as spasms.

Some common forms of antispasmodic medications are:

Learn more about muscle relaxants here.

Anticonvulsants

Although doctors recommend anticonvulsants for people with epilepsy, their nerve-calming potential may also soothe the burning sensation from nerve damage causing neck pain.

Examples include:

Antidepressants

Doctors can prescribe antidepressants to manage chronic pain even when a person does not have depression. These medications treat pain by increasing the level of neurotransmitters in the spinal cord.

The high level of neurotransmitters can reduce the transmission of pain signals to the brain and spinal cord.

Doctors may prescribe the following antidepressants to treat pain:

Selective serotonin reuptake inhibitors

Selective serotonin reuptake inhibitors (SSRIs) increase serotonin levels in the brain. They generally cause fewer side effects than other antidepressants.

Examples of SSRIs include:

Serotonin-norepinephrine reuptake inhibitors

Serotonin-norepinephrine reuptake inhibitors (SNRIs) may effectively treat people with chronic neck pain and depression. They increase the levels of serotonin and norepinephrine in the brain.

Examples of SNRIs include:

Tricyclic antidepressants

Tricyclic antidepressants (TCAs) may relieve neuropathic pain by blocking the reabsorption of the neurotransmitters serotonin and noradrenaline.

TCAs include:

  • clomipramine (Anafranil)
  • amitriptyline (Elavil)
  • desipramine (Norpramin)
  • imipramine (Tofranil)
  • nortriptyline (Pamelor)

Learn more about TCAs here.

Doctors may recommend other treatments alongside medications, such as:

  • Epidural injections: If chronic neck pain is due to injury or damage to a nerve root in the neck, a doctor may administer an epidural injection to relieve pain. The doctor will inject an epidural corticosteroid into the facet joints at the back of the spine.
  • Physical Therapy: A physical therapist will teach a person alignment and neck-strengthening exercises to improve the movement and function of their neck muscles.
  • Surgery: On rare occasions, a doctor may recommend surgery to ease neck pain by decompressing a nerve root or stabilizing a cervical spine. Surgery may be the last resort when all other forms of treatment are ineffective.

A person can practice the following self-care remedies to ease neck pain:

  • Exercise: A person can ask a doctor or physical therapist for easy at-home neck exercises to relieve tension and pain. Research from 2019 suggests that neck exercises may significantly benefit people with chronic neck pain.
  • Massage therapy: A massage therapist or another person can lightly stroke the neck muscles with moderate pressure while the person with neck pain lies prone. According to a 2020 study, massage therapy can give short-term relief to people with chronic neck pain.
  • Acupuncture: In this procedure, an acupuncturist will insert needles into the skin of the neck to produce the desired pain-relieving sensation.
  • Ice and heat therapy: A person can apply an ice pack or warm pads to the point of neck pain for 20–30 minutes. Alternating the temperature on the surface of the neck can help ease any burning or tingling sensations.
  • Transcutaneous electrical nerve stimulation (TENS): TENS is a portable, battery-operated device that generates electrical impulses. This mild electrical current may reduce the intensity of pain traveling to the brain and spinal cord.

If neck pain does not resolve within a few days, a person should contact a doctor.

The American Academy of Orthopaedic Surgeons notes that a person should speak with a doctor if they have neck pain and any of the following symptoms:

A doctor can help rule out any underlying cause and recommend the best treatment.

A 2015 report states that neck pain is the fourth leading cause of disability. The authors also note that while most episodes of neck pain will resolve with or without treatment, nearly 50% of people will continue to experience some degree of pain or frequent occurrences.

Evidence from 2020 estimates that as much as 67% of the world population will experience neck pain some time in their lives. In addition, people who sit for over 95% of their working time have a twofold higher risk of cervical spine pain than those who have never worked in this position.

When neck pain results from pressure on a nerve, that pressure can also lead to numbness, pain, or weakness in the part of the arm the nerve supplies.

While medications, physical therapy, and home remedies can effectively treat neck pain, surgery can be the most effective form of treatment when other treatment options fail.

Learn more about neck pain here.

If a person has persistent neck pain, a doctor will identify the location and cause of pain to determine the most suitable treatment.

Medications for neck pain include OTC or prescription medications. The doctor may also recommend other treatment options, including surgery in severe cases.

Before taking a medication, a person should discuss potential side effects with the doctor to avoid adverse drug interactions.

Home remedies for neck pain include exercise, massage, and heat or ice therapy.