Abnormalities or injury in ligaments, bones and muscles of the neck can cause neck pain. Occasional neck pain is often experienced by most people. This may be due to poor posture or overuse. Usually the neck pain subsides itself in a few days. If it persists or progresses after a few days, the patient should seek medical attention. 

The anatomy of the neck

The movement of the neck is inimitable. A person can rotate the neck in various directions such as 120° inclined to either shoulder, 180° sideways rotation and 90° backward and forward motion. The movement of the neck depends on its compositions. The neck comprises seven vertebrae, 32 muscles and tendons and ligaments attached to them. Each vertebrae is protected by an intervertebral disc and connected by facet joints.

What causes the neck pain?

Multiple causes can lead to neck pain. Some of the causes and risk factors include:

  • Poor posture
  • Sleeping in a bad position
  • Sitting and working on a chair without any change in position
  • Injury
  • Whiplash: Sudden jerking of the neck
  • Jerking of the neck in between exercise
  • Muscle tension and strain
  • Osteoporosis: Small fractures due to weak bone which usually happen in arms or hands and knees but sometimes occurs in the neck.
  • Fibromyalgia: Muscle pain in the entire body, mainly in the neck and shoulder area.
  • Spondylosis: Decrement of joints and cartilage present in the neck.
  • Slipped disk: Protrusion of disk causing extra pressure on spinal cord and nerve roots. It happens due to injury or trauma.
  • Spinal stenosis: Narrowing of the spinal column leads to pressure on the spinal cord and nerve roots. It is due to chronic inflammation.

Types of neck pain

There can be multiple types of neck pains including the following:

Neuropathic neck pain

When pain originates from the nerves of the cervical spine. It can be due to slipped disc when the disc puts extra pressure on the closest nerve or due to nerve compression.

Mechanical neck pain

In this type, the pain arises from the spine and muscles, ligaments, bones or cartilages attached to it. It can be due to poor posture, stress, neck strain etc.

Central neuropathic pain

Due to spinal cord injury, stroke, multiple sclerosis, or CNS injury.

Diagnosis of neck pain

For an accurate diagnosis, the doctor will conduct a neurological exam. The doctor tests muscle strength, pain distribution, motor and sensory challenges, reflexes etc. 

If indicated, an electromyography (EMG) is performed to test nerve signalling. In EMG, the signals to and the brain and nerves are checked. If signals are taking time, it means there is nerve damage.  

A X-ray can be performed to confirm the osteoarthritis, osteophyte formation, narrowing of disc shape and fracture. 

An MRI and CT scan is conducted to look at evaluating structural problems of the spine which may be contributing to the pain.

Neck pain treatment options

Therapies that are commonly tried are: 

Physical therapy

It helps the patient to maintain the correct posture. A therapist teaches about neck strengthening exercises and alignment.  

Transcutaneous electrical nerve stimulation (TENS)

Tiny electrical impulses generated from electrodes are delivered on the area to subside the pain.

Short-term immobilisation

Supporting a neck collar to aid the neck and decrease neck pain. This removes extra pressure from the neck.

Massage

This decreases the pain, muscle tension or inflammation in the neck.

Yoga and Pilates

This boosts the core strength, helps to maintain posture and balance. It also helps in decreasing stress, which can also be a cause of severe neck pain.

Self-management

  • Use ice cubes on the area for a few days. Replace it with a heating pad, hot compress.
  • Use over the pain counter medicines such as acetaminophen or ibuprofen.
  • Avoid strenuous exercise.
  • Routinely conduct neck exercises and stretching of neck side to side and up and down.
  • Maintain a good posture.
  • Evaluate the ergonomics of the work space
  • Minimising time on hand held devices.

Injections

A doctor can administer corticosteroid injections close to nerve roots. These are injected in the muscles of the neck or small facets in the bones of the cervical spine. Lidocaine can be administered to numb the pain.

Surgical options 

Surgery is rarely an option for neck pain. If the pain is due to spinal cord compression or emerging from the nerve root, in such cases, the doctor may seek surgery.

Surgery is done for neck pain in conditions of spondylolisthesis of the the spine, in infections and spine tumours which may be primary or metastatic tumours.

Preventing neck pain

  • Posture: Maintaining a good posture while sitting and standing prevents neck pain.
  • Take breaks in between work and travelling.
  • Adjust the computer monitor to be at the eye level while working and knees should be lower than hips.
  • Stretching of the neck throughout the day is helpful.
  • Smoking can increase the risk of neck pain.
  • Do not tuck the phone between ear and shoulder.
  • While sleeping, maintain a uniform position.

Recovering from neck pain

Most people take four to six weeks to recover from neck pain completely. However, the recovery may depend on and vary by individuals.

Frequently asked questions

Can neck pain cause headaches?

Yes, neck pain often leads to headaches. 

When to go to a specialist  for neck pain?

In the following cases, consider going to a hospital:

  • If neck pain increases even after self-care
  • If it continues for many weeks and lack of response to conservative treatment
  • If it starts travelling to the arms or legs
  • If there weakness of muscles or inability to use the limbs due to weakness or numbness
  • If the patient experiences headaches or tingling or numbness with neck pain

Which doctor to consult for neck pain and headache?

The best doctor to consult is a spine specialist neurosurgeon or orthopaedic surgeon.

What can cause back neck pain?

Muscle ache, muscle spasm, shooting pains, numbness in the leg, stiffness in the back and neck are the various causes of back and neck pain. 

What types of neck pain should I be worried about?

  • Worsening pain on conservative treatment
  • Developing nerve pain
  • Onset of numbness, weakness or difficulty using limbs
  • Neck pain with other symptoms of infection
  • Neck pain which gets worse on the background of a known malignancy

Is wearing a neck brace a good idea for neck pain?

A neck brace is a temporary device to assist the neck in relieving neck pain and heal faster. It’s important to wear the neck brace properly and as advised by the doctor to get the utmost benefit. A good neck brace may sometimes limit the neck movements but never causes any kind of discomfort to the patient. It is important to inform the doctor if the patient feels any irritation or discomfort from neck brace.