Neck pain may signal a more serious underlying issue if it is severe, lasts longer than a week, or occurs with other symptoms.

The neck consists of a combination of support structures that include vertebrae, cervical discs, ligaments, and muscles. The muscles and ligaments both help provide support and move the head around.

Inflammation, injury, or issues with any of these structures can cause a person to experience neck pain. Though most causes are benign, such as sleeping in an uncomfortable position, some instances of neck pain can indicate a serious underlying issue.

This article reviews how to identify serious neck pain, when to seek medical help, possible causes, and potential treatments and management options.

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Neck pain typically starts in the neck and can radiate down one or both arms. Several diseases and disorders can affect the tissues in the neck, which include muscles, nerves, bones, joints, and ligaments.

Pain can be subjective, but a person may consider neck pain serious if:

  • over-the-counter (OTC) medications do not help improve it
  • there is no improvement after 1 week
  • the pain occurs after a blow to the head or injury
  • a person experiences numbness, tingling, or weakness in the arms or hands
  • it comes on with severe stiffness
  • the pain shoots down one arm
  • a fever or a headache accompanies the neck pain
  • the pain comes on with weakness in the legs or loss of coordination in the legs or arms

Severe neck pain could indicate an underlying condition or injury.

A person should contact emergency services or a doctor following an injury to the neck or head. Some possible causes include:

  • whiplash from a car accident
  • impact during a contact sport
  • fall from a ladder or other height
  • any blunt force trauma

A person should also consider contacting a doctor if they have additional symptoms, the pain lasts longer than 1 week, or it does not resolve with OTC medications.

A doctor may refer someone to a neurosurgeon if they experience lingering or persistent pain, tingling or numbness in their limbs, or other symptoms along with their neck pain.

Several underlying conditions, as well as blunt force trauma, can result in severe neck pain. Some common causes include:

  • Cervical stenosis: This often occurs due to degeneration that causes the spinal canal to narrow and compress the spinal cord.
  • Cervical myofascial pain: This refers to pain in the muscles and connective tissue, often brought on by overuse or trauma to the neck.
  • Heart attack: Pain from a heart attack can manifest in the jaw, neck, or other areas of the upper body.
  • Angina: Pain in the heart muscle due to lack of oxygen can spread to the neck in some cases.
  • Meningitis: Inflammation and swelling of the spinal cord can occur in the neck region, causing stiffness and pain in this area.
  • Arthritis: Different types of arthritis, including rheumatoid arthritis and osteoarthritis, can occur in the neck, causing stiffness and pain.
  • Fibromyalgia: This can cause pain to occur all over the body, including the neck.
  • Slipped disc: This is when a spinal disc weakens and encroaches on the spinal cord or nerve roots. In some cases, this can cause pain in the neck.

Learn more about the causes of neck pain.

Treatment for neck pain can vary based on the exact underlying cause. It can range from conservative to more aggressive treatments based on a person’s needs.

Nonsurgical treatment options can often help alleviate a person’s pain and swelling. Some common examples include:

  • prescription medications to help reduce pain and swelling
  • wearing a cervical collar
  • stopping or reducing activities
  • use of injections, such as corticosteroids
  • physical therapy
  • neuromodulation involving spinal cord stimulators

Conservative treatments may last for about 6–8 weeks. A person should seek medical attention immediately if they experience any numbness or weakness in their legs or arms during this time.

In some cases, a person may need surgical intervention to help with neck pain. Surgery may be a suitable option for a person if:

  • have decreased function due to pain
  • conservative therapy is not helping
  • are in good health
  • difficulty with walking or balance
  • experiences progressive neurological symptoms involving the arms or legs

Surgical options can include spinal fusions and artificial disc replacement, among others.

If another underlying condition affects the neck, a person will likely need additional medications and therapies to address the underlying cause.

Neck pain can occur due to a variety of benign reasons, as well as more serious causes, such as illness or injury. Severe neck pain typically requires medical treatment.

A person should consult a doctor if the pain lasts longer than 1 week, OTC medications do not help, or they experience other symptoms, such as weakness or tingling in their limbs.

Treatments can vary due to the underlying condition affecting the neck. They may be conservative, consisting of medications and braces, or more aggressive, such as surgery. A person will also need to treat any underlying condition in addition to their pain. Additional treatment may require support from specialists or other professionals.