Neck pain is a common issue that can result from various problems in the neck, including muscles, nerves, bones (vertebrae), joints, and discs. When the pain restricts neck movement, it’s often referred to as a stiff neck.
While injuries or specific health conditions can cause neck pain, daily routines at work and home can also contribute. Although neck pain is typically temporary, neglecting proper care may lead to chronic discomfort, affecting daily activities and even disrupting sleep.
According to 2012 National Health Interview Survey data from 2016, over 14 percent of Americans experience neck pain or related problems.
In this guide, we will comprehensively explore neck pain symptoms, causes, and effective treatment methods.
Table of Contents
What is Neck Pain?
Neck pain, also known as cervicalgia, refers to pain in or around the spine beneath your head, which is referred to as the cervical spine. It is a common symptom associated with various injuries and medical conditions.
Neck pain can be categorized as axial (mostly felt in the neck) or radicular (pain shooting into other areas, such as shoulders or arms). It can be either acute (lasting days to six weeks) or chronic (lasting over three months).
If left untreated, neck pain can disrupt daily activities. Fortunately, most cases of neck pain are not severe and can be improved with conservative treatments, including pain medication, exercise, and stress management.
Neck Pain Symptoms
People experiencing neck pain often describe it as:
- A persistent ache.
- A stabbing or burning sensation.
- A shooting pain that extends from the neck to the shoulders or arms.
To be more specific, the symptoms of neck pain usually include:
- Pain that gets worse when keeping the head in one position for extended periods, like when driving or working on a computer.
- Headache.
- Muscle tightness and spasms.
- Reduced ability to move the head.
Common Causes of Neck Pain
There are many potential causes of neck pain, including:
Ageing
As you get older, your cervical spine can undergo wear and tear, leading to various issues causing neck pain. Conditions like osteoarthritis (where joint cartilage wears down) and spinal stenosis (narrowing spaces in your spine) can contribute to this discomfort.
Repetitive movements and stress over time can weaken spinal disks, resulting in a herniated disk or pinched nerve. When a disk ruptures, its jelly-like center leaks out, irritating nearby nerves, causing what’s known as a herniated disc. This issue, while more common in younger people, remains a frequent cause of pain in older individuals.
Aging causes spinal disks to dry out and become less flexible and spongy, increasing the likelihood of a herniated disc.
Physical Strain
If you overuse your neck muscles in repetitive or demanding activities, it can result in stiffness and pain. Poor posture, weak abdominal muscles, and carrying excess body weight can throw off your spine’s alignment, contributing to neck pain.
For instance, straining your neck to look at a computer screen for extended periods is a common cause of such discomfort. The good news is that neck pain due to muscle tension or strain typically resolves on its own within a few days.
Mental Stress
Long-term stress can make our neck and shoulder muscles tense, leading to pain. Neck pain is a frequent result of ongoing stress. The more stressed we feel, the tighter our muscles become, intensifying the pain and discomfort.
When you’re stressed, you might unconsciously tighten your neck muscles, resulting in pain and stiffness. Often, people aren’t aware they’re doing this until their neck starts hurting.
Injury
Damage to muscles, ligaments, disks, vertebral joints, and nerve roots in your spinal cord can cause neck pain. Falls or accidents, like car crashes, are common culprits. Whiplash, which is a soft tissue injury to the neck, is also known as a neck sprain or strain.
Growths
An unusual growth, like a tumor or bone spur, can apply pressure on the nerves in your neck, leading to pain.
Other Health Conditions
Neck pain can be a symptom of various health issues, such as meningitis, rheumatoid arthritis, and cancer.
Diagnosis
Diagnosing neck pain typically involves a series of steps aimed at understanding the underlying cause. The diagnostic process aims to pinpoint the cause of neck pain, ruling out serious conditions and providing a clear understanding that helps in developing an appropriate treatment plan.
1. Medical History
A healthcare provider begins by discussing your medical history. They inquire about previous neck injuries (like whiplash), activities that might strain your neck, and details about the pain itself—when it started, its location, how long it lasts, and its intensity.
2. Physical Examination
A thorough physical exam follows. The provider checks your head and neck alignment, observes your neck’s range of motion during movement, and palpates the neck and supporting muscles for tenderness or signs of strain.
3. Imaging Tests
While not always necessary, imaging tests may be conducted if the healthcare provider suspects a serious issue or if the pain persists and doesn’t improve. These tests can include:
X-rays: These reveal problems with bones or soft tissues in the neck, such as cervical alignment issues, fractures, slipped disks, or arthritis.
MRI (Magnetic Resonance Imaging): This provides detailed images showing problems with the spinal cord, nerves, bone marrow, and soft tissues. It’s effective in detecting slipped disks, infections, or masses causing neck pain, like cysts or tumors.
CT (Computed Tomography) Scan: When an MRI isn’t possible, a CT scan can reveal bone spurs and signs of bone deterioration.
4. Additional Tests (Rarely)
In some cases, additional tests might be ordered, though this is uncommon:
Electrodiagnostic Tests: These assess nerve and muscle function. They may involve nerve conduction studies or myelograms if an MRI isn’t suitable.
Lab Tests: Blood tests such as a complete blood count (CBC), urinalysis, or markers of inflammation can help identify causes beyond musculoskeletal injuries, such as infections, rheumatological conditions, or cancers.
How is Neck Pain Treated?
Mild to moderate neck pain often gets better in two or three weeks with self-care. Simple remedies like pain relievers and applying heat may be sufficient. Many causes of neck pain improve over time and can be dealt with at home. Here are some ways your healthcare provider might suggest to manage and treat your neck pain:
Physical Therapy
Physical therapy is a widely used treatment for chronic neck pain. Typically, these programs aim to alleviate pain and stiffness, making it possible to initiate a regimen of neck-strengthening and stretching exercises.
The techniques and exercises employed in physical therapy may differ from person to person, and the duration of the treatment plan can vary as well. Examples include applying ice packs, heat therapy, massage therapy, ultrasound, electrotherapy, and others.
Pain Medications
There are two main classes of over-the-counter pain medications: NSAIDs (non-steroidal anti-inflammatories) and analgesics (pain relievers). Some drugs may serve both purposes, while others may not.
Almost all of the drugs discussed here are over-the-counter NSAIDs, which can help reduce pain, fever, and inflammation. COX-2 inhibitors, another type of NSAID, may also be effective, but they are available only with a prescription.
It’s important to be aware that most drugs have potential side effects, and NSAIDs are no exception. Some NSAID side effects can be serious, posing risks to your health. The major concerns associated with these drugs include kidney problems, heart attacks, and stomach ulcers.
Learn more: Medications for Neck Pain
Transcutaneous Electrical Nerve Stimulation (TENS) Unit
A TENS unit sends a gentle electrical current through your skin near the nerves, disrupting pain signals that cause discomfort. Always consult a healthcare provider before using one.
For neck pain relief with a TENS unit, position two electrodes on the lower back of your neck, ideally on each side of the painful area. Place two more electrodes either above or beside the shoulder blades on both sides of your spine. If the neck pain extends lower, move the electrodes slightly down the back or neck.
Adjust the settings to achieve the desired pain relief. You can modify the pulse rate, width, or length until you find the level of relief that works best for you.
Steroid Injections
Cervical epidural steroid injections (ESIs) are a short-term pain relief solution for specific causes of chronic neck pain. Healthcare providers administer these injections by delivering an anti-inflammatory medication into the epidural space around your spinal nerves. Around 40% to 84% of patients receiving cervical ESIs report temporary relief from pain.
Acupunture
Acupuncture, a traditional Chinese medicine practice with a history spanning thousands of years, involves inserting needles into specific pressure points to alleviate stress, tension, and pain.
While some researchers suggest that acupuncture may activate the body’s natural pain-relieving mechanisms, others view its effects as a placebo.
To ensure safety, you should consult a certified practitioner. Choose a board-certified professional, and verify that all needles are sterilized.
Surgery
Not everyone with neck pain needs surgery. However, surgery may be necessary if a vertebra in your spine has moved out of place or is pressuring your nerves.
Severe disc herniation or degenerative conditions might require surgery to relieve nerve pressure or stabilize the spine. In some cases, replacing a damaged cervical disc with an artificial one could be an option to restore function and reduce pain.
How Can I Relieve Neck Pain at Home?
Here’re some options to help you relieve neck pain at home:
Heat Therapy
Heat therapy is a helpful way to ease pain, relax muscles, and aid healing. If you’re dealing with chronic neck pain or stiffness, it can be a simple and cost-effective solution.
How does it work? Heat therapy expands blood vessels and boosts blood flow in the targeted area, potentially improving circulation and reducing discomfort. By warming up muscles and soft tissues, it increases flexibility and eases tightness.
Here are some easy heat therapy options:
- Warm shower or bath
- Heat packs like gel packs or wraps
- Heating pads
- Warm, damp cloth or towel
The duration of heat therapy can vary. Some find relief in 10 to 20-minute sessions, while others prefer longer periods, up to 1 or 2 hours.
A word of caution: Avoid direct contact between your skin and the heat source to prevent burns or skin damage. Check your skin regularly, especially if you have conditions like diabetes that reduce skin sensitivity.
Cold Therapy
Ice application is commonly used for recent injuries, like muscle strains occurring in the last 24 to 48 hours. Cold therapy works by narrowing local blood vessels and decreasing blood flow, which can be effective in reducing swelling during the initial days after an injury.
Despite being more commonly associated with acute injuries, some individuals choose cold therapy for treating chronic pain and stiffness. When using an ice pack or other cold therapy methods, limit applications to 15 to 20 minutes and allow at least 2 hours of rest between sessions to prevent skin damage. Many people find it beneficial to alternate between cold and heat therapy for enhanced relief.
Better Posture
How you position your head matters, especially during screen time or phone use. Tilting your head down, a common habit, strains neck muscles and can cause “tech neck,” a repetitive stress injury.
To ease neck discomfort and enhance posture:
- Raise your phone or device to eye level, avoiding neck bending.
- Align your head with your body’s center.
- Roll shoulders downward, away from the ears.
These simple adjustments can alleviate strain and promote better neck health.
Reduce Stress
When stress hits, your neck, shoulders, and back muscles can tighten up. Managing stress is key to tackling and avoiding neck pain and stiffness.
Here’s how you can do it:
- Listen to music
- Try meditation techniques
- Take a mini getaway or short break
- Engage in hobbies you love
Setting boundaries in your personal and work life can also work wonders. Don’t hesitate to say “no” when you’re already overwhelmed by demands on your time.
Change Your Sleep Position
A good night’s sleep is crucial for your health, and how you sleep can impact your neck comfort.
Sleeping on your side or back (supine) is gentler on your neck compared to stomach sleeping (prone). Side sleeping, with proper alignment of your thoracic and cervical spine, is particularly key to avoiding neck pain.
A 2017 study found that lying supine with your dominant hand raised by your forehead increased neck pain. Instead, opt for side sleeping with a well-aligned pillow for better sleep quality.
Some pillows claim extra neck support, though not all are scientifically proven. Still, many people find the right pillow can enhance neck comfort. Experiment and find what works for you.
Don’t forget about your mattress – it could also impact your sleep quality. See if a change makes a difference in your neck’s comfort.
Learn more about how to sleep with neck pain.
How Can I Prevent Neck Pain?
Whether stemming from an underlying condition or poor lifestyle habits, it’s crucial to take proactive measures to prevent and alleviate neck discomfort. Here’re some practical strategies to help you out:
1. Ergonomic Workstations
Working long hours at a poorly set up computer can really be a pain in the neck – literally. Whether you’re at an office or working from home, having an ergonomic setup is super important. Here’re the steps to set to your workstations to prevent neck pain:
- Set your chair at a height where your feet can comfortably touch the ground, and your thighs are parallel to the floor.
- Pick a desk that’s the right height, so when you type, your forearms are parallel to the floor.
- Try to have the screen at eye level, so you’re looking at the top part of it. This way, you won’t have to keep looking down, and it’ll ease the stress on your neck muscles.
Don’t forget to take short breaks during the day. Stand up, stretch, and change your posture. This helps with better blood flow, reducing the chances of neck pain.
2. Tech Neck Prevention
The rise of smartphones and constant connectivity has given birth to a new concern – “tech neck.” This term refers to the strain and discomfort caused by the continuous downward gaze at screens.
To avoid the adverse effects of tech neck, you may:
- Reduce the time spent on texting or scrolling through social media.
- Hold your devices or smartphones at eye level to minimize the need to look down constantly.
- Prop your devices up on a pillow or another supportive surface instead of holding your devices on your lap.
- Set timers on your phone to remind you to take breaks from your devices.
3. Exercise Your Upper Back
As we get older, our upper back muscles might start slacking off, leading to a slouchy posture that strains our neck and upper back. Here are some simple exercises to pump up those upper back muscles:
- Scapular Squeezes: Pinch your shoulder blades together like you’re squeezing a pencil between them. Do this 10 times, and you’re on your way to a stronger upper back.
- Standing Push-Ups: Find a doorframe and do push-ups with your shoulders going past your hands. Repeat this 10 times to give your upper back a good workout.
- Theraband Rowing: Grab a theraband and find a doorknob to anchor it. Stand up, hold an end of the theraband in each hand, and pull your hands toward your waist. Do this 10 times, and you’ll feel the burn in your upper back.
4. Quit Smoking
Smoking is a double whammy for your neck. It narrows your blood vessels and reduces blood flow, plus it speeds up the drying out of your cervical discs.
When you’re ready to quit smoking, talk to your healthcare provider—they can provide you with resources, from tips to quit to smoking cessation classes if you need extra support.
5. Stay Hydrated
Water is the superhero for your spinal discs. They’re mostly water, and keeping them hydrated is key to their health. Aim for around 64 ounces of water a day, but adjust based on your location, exercise routine, and body size.
Set alarms every couple of hours to remind yourself to drink up. Chug a full glass of water when the alarm goes off. And remember, low-sugar juices and teas count too, but go easy on the caffeine and sugar—they can dehydrate you, undoing all your hydration efforts.
When to Seek Medical Attention
Call your doctor if your neck pain interferes with daily activities or if you experience:
- Pain after an accident.
- Loss of bowel or bladder control.
- Persistent pain while moving or at rest.
- Neck pain accompanied by headache, dizziness, nausea, or vomiting.
- Chills, fever, or unexplained weight loss along with neck pain.
- Numbness or tingling in arms, shoulders, or legs.
- Weakness in legs or loss of coordination in arms or legs.
- No relief from over-the-counter medications.
- No improvement after one week.
Sophia Anderson, PT, DPT is a physical therapist who offers online pain management consultations. She helps people with various types of pain, especially neck, back, and knee pain.
She graduated from the University of St. Augustine with a Doctor of Physical Therapy (DPT) degree. She has experience in orthopedic physical therapy, sports medicine, neurological rehabilitation, advanced assessment and treatment of running injuries, and advanced treatment of the pelvic complex, spine, and extremities.
If you’re experiencing any pain, let Sophia Anderson, PT, DPT help you out.