Neck Pain: Common Causes, Self-Care and Warning Signs

What it involves

MedlinePlus defines neck pain as discomfort in any of the structures in the neck: the muscles, nerves, bones (vertebrae), joints, and the discs between the bones. A sore neck can be hard to move, which many people describe as a stiff neck. If a nerve is compressed, you may also feel numbness, tingling, or weakness in your arm or hand.

Who this is for

• Adults with neck pain or stiffness that has lasted more than a week
• Patients with numbness, tingling, or weakness in an arm or hand
• Patients with neck pain after a fall, a blow, or a car accident
• Patients whose pain keeps returning and who want to look at posture and work setup

What to expect

• Questions about where you feel the pain, how often it occurs, and how much it hurts
• A physical exam that checks movement, strength, and sensation in the neck and arms
• Usually no tests at the first visit, unless your history points to a fracture, infection, or serious nerve problem
• A plan for pain relief, activity, and when to follow up or be referred to a specialist

Everyday causes of neck strain

MedlinePlus says a common cause of neck pain is muscle strain or tension, and most often everyday activities are to blame: Repetitive computer and mouse use can also strain the forearm and elbow, and the elbow pain guide explains tennis elbow, which MedlinePlus says may follow repetitive typing.

• Bending over a desk for a long time, often an hour or more
• Poor posture while watching TV or reading
• A computer monitor positioned too high or too low
• Sleeping in an uncomfortable position
• Lifting things too quickly or with poor posture

Causes beyond strain

MedlinePlus also lists medical conditions such as fibromyalgia, cervical arthritis or spondylosis, a ruptured disk, spinal stenosis, sprains, torticollis, and infection of the spine. It notes that small fractures to the spine from osteoporosis can cause neck pain, and the osteoporosis and bone density guide explains who is at risk. Accidents and falls can cause serious neck injuries, including vertebral fractures and whiplash. Pain that spreads from the neck into the shoulder and arm is common, and the shoulder pain evaluation explains how a provider tells a shoulder problem apart from pain referred from the neck.

Self-care for ordinary neck pain

For minor, common causes, MedlinePlus suggests over-the-counter pain relievers such as ibuprofen or acetaminophen, ice for the first 48 to 72 hours and heat after that, stopping normal physical activity for the first few days, and slow range-of-motion exercises. It suggests a firm mattress and a pillow that supports the neck, and says a soft collar used for a long time can weaken neck muscles. Do not fall asleep with a heating pad or ice bag in place. Ask your provider about any medicine you are unsure of. Tingling or numbness in the hand can come from the neck or from a pinched nerve at the wrist, and the carpal tunnel and wrist pain guide explains the wrist-side cause and its symptoms.

Call 911 or get to a hospital

MedlinePlus says to seek medical help right away if you have a fever and headache and your neck is so stiff that you cannot touch your chin to your chest, which may indicate meningitis. Symptoms of a heart attack, such as shortness of breath, sweating, nausea, vomiting, or arm or jaw pain, also call for 911. The chest pain guide covers those signs. These are not situations for a routine appointment or a wait-and-see approach.

When to contact the office

MedlinePlus says to contact your provider if symptoms do not go away in one week of self-care, if you have numbness, tingling, or weakness in an arm or hand, or if the pain followed a fall, blow, or injury. Other reasons are swollen glands or a lump in the neck, pain that does not respond to over-the-counter medicine, trouble swallowing or breathing, pain that wakes you at night, loss of bladder or bowel control, and trouble walking or balancing. Headaches that start in the neck are covered in the headache and migraine page.

What happens at the visit

MedlinePlus says your provider will perform a physical exam and ask about your pain, and will probably not order tests at the first visit. Tests are done only if your symptoms or history suggest a tumor, infection, fracture, or serious nerve disorder, and may include x-rays, a CT scan, blood tests, or an MRI. Muscle relaxants or stronger pain relievers may be used for spasm or a pinched nerve, and a specialist referral if nerves are damaged. The low back pain evaluation describes a similar approach.

Sources

• MedlinePlus — Neck pain
• MedlinePlus — Neck Injuries and Disorders