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Neck pain, also known as cervicalgia, refers to any pain or discomfort located in the area of your spine directly beneath your head, known as the cervical spine. Common causes of neck pain include poor posture, which can result from leaning over a computer or slouching over a workbench, as well as osteoarthritis.
The pain experienced can be classified into two types: axial neck pain, which is primarily confined to the neck area, and radicular neck pain, which radiates to other parts of the body such as the shoulders or arms. Neck pain can be acute, persisting for a few days up to six weeks, or chronic, lasting more than three months.
Untreated neck pain can disrupt daily life and diminish overall well-being. It is essential to seek medical attention if neck pain is accompanied by numbness, a decrease in arm or hand strength, or if the pain extends into a shoulder or down an arm. Although most neck pain conditions are not severe and can improve with non-invasive treatments like pain medication, exercise, and stress management techniques, professional evaluation and treatment are advisable to prevent worsening conditions.
Symptoms
Symptoms to be aware of include:
- Pain in the neck that may be a continuous dull ache, or it could be sharp and burning, sometimes even radiating from the neck down to the shoulders or arms.
- Difficulty in turning the neck or tilting the head.
- Limited ability to move the head.
- Experiencing headaches.
- Stiffness in the neck, shoulders, and upper back.
- A sensation of numbness or tingling, akin to “pins and needles,” in the shoulders or arms.
Immediate medical attention is required if severe neck pain is due to an accident, such as a motor vehicle collision, a diving mishap, or a fall.
Reach out to a healthcare professional if the neck pain:
- Is intense.
- Continues for several days without improvement.
- Radiates down the arms or legs.
- Is accompanied by headaches, numbness, weakness, or a tingling sensation.
Causes
Due to its role in supporting the weight of the head, the neck is susceptible to injuries and conditions that may lead to pain and limited motion. Causes of neck pain include:
- Worn joints: Similar to other joints in the body, neck joints can wear down with age, leading to the formation of bone spurs. These spurs can impact joint motion and result in pain.
- Muscle strains: Overuse, such as spending extended periods hunched over a computer or smartphone, can trigger muscle strains. Even seemingly minor activities, like reading in bed, may strain neck muscles.
- Nerve compression: Herniated disks or bone spurs in the neck vertebrae may exert pressure on nerves branching out from the spinal cord.
- Diseases: Certain conditions, such as rheumatoid arthritis, meningitis, or cancer, can contribute to neck pain.
- Injuries: Whiplash injuries often occur in rear-end auto collisions, causing the head to jerk backward and then forward, straining the soft tissues of the neck.
Risk factors
Neck pain is prevalent, impacting 10% to 20% of adults. It is more frequently observed in women and individuals assigned female at birth. The likelihood of developing neck pain tends to rise with age.
Diagnosis
Your healthcare provider will conduct a thorough medical history and perform a physical examination. This examination will include checking for tenderness, numbness, and muscle weakness, as well as assessing the range of motion of your head in forward, backward, and side-to-side movements.
Imaging tests are also valuable in identifying the cause of neck pain. Examples of these tests include:
- X-rays: X-rays can reveal areas in the neck where nerves or the spinal cord might be pinched by bone spurs or other structural changes.
- Computed tomography (CT) scan: CT scans combine X-ray images captured from various perspectives to create comprehensive cross-sectional images of the internal structures of the neck.
- Magnetic resonance imaging(MRI): Utilizes radio waves and a strong magnetic field to create detailed images of both bones and soft tissues, including the disks, the spinal cord, and the nerves emanating from the spinal cord.
It is important to note that X-ray or Magnetic Resonance Imaging can show structural issues in the neck even in the absence of symptoms. Therefore, imaging studies should be used in conjunction with a careful history and physical examination to pinpoint the cause of pain.
Other diagnostic tests include:
- Electromyography (EMG): EMG is a test that can help determine if neck pain is related to a pinched nerve. This involves inserting fine needles through the skin into a muscle to measure the speed of nerve conduction and assess nerve function.
- Blood tests: Blood tests can sometimes detect signs of inflammation or infections that may be causing or contributing to neck pain.
Treatment
Typically, mild to moderate neck pain, the most common types, typically improves with self-care within two or three weeks. Pain relievers and the application of heat may be sufficient for relief.
Medications
Pain relievers may consist of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen or naproxen sodium, as well as acetaminophen. It’s crucial to take these medications only as directed, as overuse can lead to serious side effects.
If over-the-counter pain relievers prove ineffective, your doctor might recommend prescription NSAIDs or muscle relaxers as an alternative.
Therapy
- Physical therapy: A physical therapist can instruct on proper posture, alignment, and neck-strengthening exercises. Physical therapy may also incorporate the use of heat, ice, and other measures to alleviate pain.
- Transcutaneous Electrical Nerve stimulation (TENS): Electrodes placed on the skin near painful areas deliver small electrical impulses that may offer pain relief. However, there is limited evidence supporting the effectiveness of TENS for neck pain.
- Soft neck collar: Using a soft collar that supports the neck may help alleviate pain by reducing pressure on the neck. However, prolonged use for more than three hours at a time or beyond 1 to 2 weeks might have adverse effects rather than benefits.
Surgical and other procedures
- Steroid injections: A doctor may administer steroid medications near the nerve roots, into the spinal joints, or into the muscles in the neck. Numbing medications, like lidocaine, can also be injected to alleviate neck pain.
- Surgery: While rarely necessary for neck pain, surgery might be considered as an option to address nerve root or spinal cord compression.
