What is neck pain?

You can have neck pain anywhere from the bottom of your head to the top of your shoulders. It can spread to the upper back or arms. Injuries, painting a ceiling, sleeping with your neck twisted, staying in one position for too long, and many other activities can cause neck pain.

Most neck pain gets better with home care. Your doctor may recommend medicine to relieve pain or relax your muscles. He or she may suggest exercise and physical therapy to increase flexibility and relieve stress. You may need to wear a special (cervical) collar to support your neck for a day or two.

Most neck pain gets better within several weeks with treatment that includes taking steps to relieve pain, modifying activities, and doing exercises or manual therapy. Neck pain caused by an injury such as a severe whiplash may take longer but usually improves in 6 to 12 months.

Neck pain may become long-lasting (chronic) when it occurs in combination with other health conditions, such as conditions associated with increasing age. These include narrowing of the spinal canal (cervical spinal stenosis), arthritis of the neck (cervical spondylosis), or herniated disc. In some cases, chronic neck pain can be caused by repeated and prolonged movements, such as long hours working at a computer.

Chronic neck pain can make it hard to cope with daily life. Common side effects of chronic pain include fatigue, depression, and anxiety.

You may feel a knot, stiffness, or severe pain in your neck. The pain may be worse when you move. It may spread to your shoulders, upper back, or arms. You may get a headache. You may not be able to move or turn your head and neck easily.

If there is pressure on a spinal nerve root, you might have pain that shoots down your arm. You may also have numbness, tingling, or weakness in your arm. You may also have a burning feeling when you are touched on the skin of the arm or hand. There might also be pain that feels like a shock and extends into your arm or hand.

If your neck pain is long-lasting (chronic), you may have trouble coping with daily life. Common side effects of chronic pain include fatigue, depression, and anxiety.

The type of treatment you need depends on the cause of your neck pain. Most neck pain caused by activities can be treated at home.

For neck pain that occurs suddenly:

• Use a heating pad on a low or medium setting for 15 to 20 minutes every 2 to 3 hours. Or you can try an ice pack for 10 to 15 minutes every 2 to 3 hours.
• Avoid more neck injury by changing some habits, such as how you sit or sleep.
• Work with a physical therapist, chiropractor, or osteopathic doctor for exercises or manual therapy. Massage or yoga may help.

Ask your doctor if you can take an anti-inflammatory medicine for pain.

For chronic neck pain, your doctor may prescribe medicine to relax your neck muscles, relieve pain, or help you sleep.

Surgery is rarely done to treat neck pain.

Manual therapy (or bodywork) is sometimes used for neck pain. Manual therapy includes massage, mobilization, and manipulation of the muscles, bones, and joints.

Before you try manual therapy for neck pain, think about the following:

• First, try home treatment, like heat, ice, pain relievers, and mild exercise or stretching. These things may help your neck pain the best.
• If you have severe pain or your symptoms are getting worse, or if you're getting new symptoms, consider talking to your doctor. Manipulation may not be the right treatment for you.
• Good manual therapy will include information on self-care and strength exercises.
• If you choose to see a health care provider who does manual therapy, find one who is willing to work with your other health care providers.

Do your research. Not all manual therapy is the same. And there isn't a good way to tell what will be helpful and what won't. If you decide to try it, talk to a couple of different manual therapy providers before you choose and get treated by one.

You can avoid neck pain caused by stress or muscle strain with some new habits.

Here are some things to try:

• Avoid spending a lot of time in positions that stress your neck. This can include sitting at a computer for a long time.
• If your neck pain is worse at the end of the day, think about how you sit during the day. Sit straight in your chair with your feet flat on the floor. Take short breaks several times an hour.
• If your neck pain is worse in the morning, check your pillow and the position you sleep in. Use a pillow that keeps your neck straight. Don't sleep on your stomach with your neck twisted or bent.
• If stress is adding to your neck pain, practice relaxation exercises. Consider getting a massage.
• Strengthen and protect your neck by doing neck exercises once a day.
• Stay at a healthy body weight.

Your doctor will ask questions about your symptoms and do a physical exam. He or she may also ask about any previous treatment you've had, as well as any injuries, illnesses, or activities that may be causing your neck pain.

During the physical exam, your doctor will check how well you can move your neck. He or she will also look for tenderness or numbness, tingling, or weakness in your arms or hands.

If your pain started after an injury, or if it doesn't improve after a few weeks, your doctor may want to do more tests. Imaging tests, such as an X-ray, an MRI scan, or a CT scan, can show the neck muscles and tissues. These tests may be done to check the neck bones, spinal discs, spinal nerve roots, and spinal cord. You may have blood tests to check for an illness or infection.

Medicines can relieve neck pain and reduce inflammation of the soft tissues. Pain relief will allow you to move your neck gently, so you can begin easy exercises and start to heal.

Nonprescription pain relievers include:

• Creams or gels that are rubbed into the neck.
• Acetaminophen (such as Tylenol). It reduces pain.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (such as Advil) and naproxen (such as Aleve). They can help relieve pain and reduce inflammation.

Prescription pain relievers include:

• Muscle relaxants. They are used to treat severe neck pain and spasms when neck pain begins.
• Opioid pain relievers. They are used to treat severe short-term neck pain.
• Antidepressants. They are used to treat long-lasting pain.
• Corticosteroid injections. These may be tried if you also have symptoms of a pinched or irritated nerve root.
• Anticonvulsants. They may help reduce long-term neck pain. One type may work better for you than another.

Health care professionals who often diagnose the cause of neck pain include:

• Primary care providers. This includes:
  • Family medicine physicians.
  • Internists.
  • Osteopathic doctors.
  • Chiropractors.
  • Physical therapists.
  • Nurse practitioners.
  • Physician assistants.
• Emergency doctors.

If your neck pain is severe or long-lasting, health professionals who can treat you include:

• Orthopedists.
• Rheumatologists.
• Neurologists.
• Neurosurgeons.
• Physiatrists.

You can also get care from:

• Acupuncturists.
• Certified massage therapists.

Surgery is rarely needed for neck pain. It may be an option when:

• A neck injury causes a fracture or abnormal motion. Surgery may be done to stabilize the spine and prevent a broken bone from causing instability and possible paralysis.
• Pressure on the nerve roots or spinal cord causes numbness or weakness in the arm, hand, or leg; severe ongoing pain; or loss of bladder or bowel control. Pressure may be caused by problems like narrowing of the spinal canal, arthritis of the neck, or a herniated disc in the neck.

Surgeries include:

• Discectomy. The surgeon removes herniated disc material that's pressing on a nerve root or the spinal cord.
• Spinal decompression. Pressure is reduced on the spinal cord or nerve roots by removing part of a bone or disc.
• Cervical spinal fusion. Selected bones in the neck are joined (fused) together.
• Artificial disc replacement. This may be done instead of spinal fusion.

Risk factors for neck pain that you cannot control include:

• Age. People who are middle-aged or older are more likely to have breakdown (degeneration) of discs or joints, as well as bone spurs in the vertebrae of the neck (cervical spondylosis).
• Recent injury or history of injury. A common injury to the neck is whiplash caused by a car accident.
• Conditions that affect the bones and soft tissues of the neck and back, such as rheumatoid arthritis, a narrowing of the spinal canal (cervical spinal stenosis), or a severely curved spine (scoliosis).
• A history of headaches.

Risk factors that you can control include:

• Awkward positions that put stress on the neck, or poor posture at home or at work.
• Stress or depression, or boredom at or unhappiness with work.
• Heavy physical work.
• Smoking or drug use.
• Poor physical condition and lack of exercise.

Complementary medicine treatments are sometimes used to relieve neck pain and restore neck mobility. They include:

• Acupuncture. This is done by inserting very thin needles into the skin. It's used to relieve pain.
• Massage. It helps with relaxation. It also helps reduce pain and increase flexibility.
• Yoga or qi gong. These are programs of exercises. They help improve flexibility and breathing, decrease stress, and maintain health.

Find out about the safety of any complementary product or practice you want to try. Most mind and body practices—such as acupuncture, massage, and yoga—are safe when used under the care of a well-trained professional. Choose an instructor or practitioner as carefully as you would choose a doctor.

Talk with your doctor about any complementary health practice that you would like to try or are already using. Your doctor can help you manage your health better if he or she knows about all of your health practices.

Neck pain can be caused by activities that strain the neck. Slouching, painting a ceiling, or sleeping with your neck twisted are some things that can cause neck pain. These kinds of activities can lead to neck strain, a sprain, or a spasm of the neck muscles.

Neck pain can also be caused by an injury. A fall from a ladder or whiplash from a car accident can cause neck pain. Some less common medical problems can also lead to neck pain, such as:

• An infection in the neck.
• Narrowing of the spinal canal in the neck (cervical spinal stenosis).
• Rheumatoid arthritis.

Sometimes neck pain may not have a clear cause.

Neck pain is pain that can occur anywhere in your neck, from the bottom of your head to the top of your shoulders. It can spread to your upper back or arms. It may limit how much you can move your head and neck.

Neck pain is common, especially in people older than 50.