Neck pain

Topic Overview

Neck pain 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.

Most neck pain is 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.

You may feel a knot, stiffness, or severe pain in your neck. The pain 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.

The type of treatment you need will depend on whether your neck pain is caused by activities, an injury, or another medical condition.


Neck pain can be caused by:

  • An activity that harms the neck.
  • An injury.
  • Another medical condition.

Activities that cause neck pain

Most neck pain is caused by activities that involve repeated or prolonged movements of the neck. This can result in a strain (an overstretched or overused muscle), a sprain (injury to a ligament), or a spasm of the neck muscles.

These activities include:

  • Holding your head in a forward or odd position for long periods of time while working, reading, watching TV, or talking on the telephone.
  • Sleeping on a pillow that is too high or too flat or that doesn't support your neck, or sleeping on your stomach with your neck twisted or bent.
  • Spending long periods of time resting your head on your upright fist or arm.
  • Work orexercise that uses the upper body and arms, such as painting a ceiling or other overhead work.

Stress and focusing intensely on a task can also cause neck pain. Tension may develop in one or more of the muscles that connect the head, neck, and shoulders. They may feel tight and painful.

Injuries that cause neck pain

Minor injuries may occur from tripping or falling a short distance or from excessive motion of the cervical spine .

Severe neck injuries may occur from:

  • Whiplashin a car accident.
  • Falls from significant heights.
  • Direct blows to the face or to the back or top of the head.
  • Sports-related accidents.

Medical conditions that cause neck pain

Certain medical problems can cause neck pain. These include:

  • Problems related to aging, such as:
    • Narrowing of the spinal canal (cervical spinal stenosis).
    • Arthritisof the neck (cervical spondylosis).
  • Illnessessuch as:
    • Meningitis, which causes inflammation around the tissues of thebrainand spinal cord.
    • Flu, which tends to make the neck and the rest of the body ache all over.
  • Chronic conditionssuch as:
    • Fibromyalgia.
    • Rheumatoid arthritis.
    • Ankylosing spondylitis.
  • TorticollisTorticollis(wryneck).Torticollis is caused by severe muscle tightness or a shortened muscle on one side of the neck, causing the head to be tilted to one side. Torticollis is usually a symptom of another medical problem.
  • Referred pain. Referred pain occurs when a problem in one place in the body causes pain in another place. For example, a problem with your jaw (temporomandibular disorder) or yourheart(such as a heart attack) can cause neck pain.
  • Infection or a tumorin the neck area.

Some medicines can cause neck pain as a side effect.


Neck pain may:

  • Spread to the upper back, shoulders, or arms.
  • Be worse with movement.
  • Make your neck stiff or tender.
  • Cause headaches. These are common and may last for months.

Nerve-related symptoms caused by pressure on the spinal nerve rootsor spinal cord  include:

  • Numbness, tingling, or weakness in your arm or hand.
  • A burning feeling when you are touched on the skinof the arm or hand.
  • A pain that feels like a shock and extends into your arm or hand.
  • Leg numbness or weakness, and loss of the ability to control urination (bladdercontrol) or bowel movements. This can occur when there is pressure on or injury to the spinal cord.

Exams and Tests

Initial testing

Neck pain is usually evaluated with a medical history and physical exam. your doctor will check your neck's range of motion and check for pain caused by movement. He or she will look for areas of tenderness and any nerve-related changes, such as numbness, tingling, or weakness in the arm or hand.

Blood tests may be done to check for an illness or infection.

You may not need X-rays or other imaging tests.

Besides X-rays, tests may include:

  • MRIMRI, which can help identify problems such as aherniated discor a pinched nerve.
  • CT scanCT scan, which looks at the bone andspinal canal .
  • MyelogramMyelogram, which looks at the spinal canal and nerve roots.
  • Electromyogram and nerve conduction studiesElectromyogram and nerve conduction studiesor nerve blocks, which can help find a nerve problem that is causing pain, numbness, or weakness in the arm or hand.



Medication Painkillers such as paracetamol and ibuprofen may help and you should use them if you need to. It’s important that you take them regularly and at the recommended dose to help you control the pain and allow you to continue exercising. Don’t wait until your pain is severe before taking painkillers. You shouldn’t take ibuprofen or aspirin if you’re pregnant or have asthma, indigestion or an ulcer until you’ve spoken to your doctor or pharmacist. Medication can have side-effects so you should read the label carefully and check with your pharmacist if you have any queries.

Manual Therapy or chiropractic

There are well over 100 types of adjustment techniques used by chiropractors throughout the world. Typically, chiropractors will focus on and utilize 8 to 10 different approaches in their practice.

The common goal of most chiropractic techniquesis to restore or to enhance joint function, with the general goals of resolving joint inflammation and reducing pain. Some approaches use some force (spinal manipulation), while others are more gentle (spinal mobilization).

Spinal Manipulation
. The manipulation often results in an audible "pop," as chiropractors use their hands to apply a controlled sudden force to a joint while the body is positioned in a specific way.

Spinal Mobilization (Low-Force or Gentle Chiropractic Techniques)
Some conditions (such as osteoporosis), pathology, the patient's size, patient comfort, or patient preference, may require a gentler approach generally referred to as spinal mobilization. In addition, some patients and/or clinicians prefer mild spinal mobilization techniques that do not involve twisting of the body or a forceful thrust.


  • traction:In traction, the therapist will try to stretch and mobilize your spine so that you feel less pain and can move more easily. He or she can do this manually—the hands-on approach—or by using a mechanical traction device.


Physical therapy for neck pain focuses on strengthening and improving the muscles, tendons, and ligaments that support the vertebrae. The main goals of neck therapy are:

To stretch and strengthen muscles in the affected areas, accelerating the healing process by reducing neck pain and swelling, while making muscles more flexible and strong.

To teach posture and other body mechanics that can protect the neck and spine, preventing future neck pain.

To show patients how to take care of pain flare-ups if re-injury occurs.

A physical therapist will always start by asking you questions designed to help figure out the scope of the problem, everything from your lifestyle to medical history. If your neck pain was caused by major trauma or disease, your physical therapist will consult with your doctor

Sports and Corrective Exercises

Exercise Exercise is the most important way that you can:

  • ease stiffness and pain
  • build up muscle strength and stamina
  • improve your flexibility and general fitness.

 If your neck pain lasts a while, lack of movement can cause the muscles to become weak. This makes it more likely that you’ll strain them in future. It’s important that you don’t rest for too long and keep moving your neck.

Laser Therapy

Laser Therapy is a treatment that utilizes specific wavelengths of light to interact with tissue and is thought to help accelerate the healing process. It can be used on patients who suffer from a variety of acute and chronic neck  conditions in order to help eliminate pain, swelling, reduce spasms and increase functionality.

The laser is placed directly over the injured area for 30 seconds to several minutes, depending on the size of the area being treated and the dose provided by the cold laser unit.

During this time, the non-thermal photons of light that are emitted from the laser pass through the skins layers (the dermis, epidermis, and the subcutaneous tissue or tissue fat under the skin). This light has the ability to penetrate 2 to 5 centimeters below the skin

Once the light energy passes through the layers of skin and reaches the target area, it is absorbed and interacts with the light sensitive elements in the cell.

When cells absorb this light energy, it initiates a series of events in the cell that is theorized to eventually result in normalizing damaged or injured tissue, a reduction in pain, inflammation, edema and an overall reduction in healing time by increasing intracellular metabolism.


A person with chronic neck pain may benefit from receiving a cortisone injection during the initial stages of their treatment.Cortisone works by reducing inflammation around a joint, nerve, or other structure, which helps with pain and can speed up recovery. Cortisone is not specifically a pain-relieving drug. It works solely by reducing the body's inflammatory response to an injury or condition..Cortisone is often injected as a mixture with a local anesthetic. The anesthetic allows for near immediate but temporary pain relief if the injection is successfully placed, while the cortisone allows for more gradual but longer-acting pain relief as it takes effect.


A neck brace is a temporary device to help your neck heal and relieve neck pain. It's important to wear your neck brace properly to get the maximum benefit. Neck braces can range from simple, one-piece, soft wraparound collars to rigid braces with pads supported by hard plastic.

Whether your doctor recommends a soft cervical collar or a semi-rigid plastic brace depends on the severity of your neck problem and the length of time you will be wearing the brace.

A good neck brace should decrease motion but not cause discomfort, so let your doctor know if your neck brace is uncomfortable.


Studies have shown acupuncture to be effective in relieving certain types of neck pain, particularly those caused by whiplash. Some studies suggest acupuncture can treat degenerative neck disorders such as ankylosing spondylosis and cervical spondylosis; in many cases, acupuncture has worked for patients whose conditions could not be solved using conventional approaches.

Acupressure and herbal medicine are sometimes used in conjunction with acupuncture for neck pain. Applying acupressure to the neck muscles can reduce spasm and lessen pain, leading to a relaxed state and a heightened sense of well-being. Depending on the patient's condition, certain herbal products can be used to improve circulation and blood flow and ease muscle contraction.


As the therapist uses his or her hands or specialized tools to rhythmically knead, rub, and stroke (effluerage) muscles, circulation is stimulated. Blood flow delivers oxygen and nutrients and is key to helping muscles eliminate waste products, such as lactic acid, that may collect in muscles from spasms causing pain.

Following trauma, muscles may act as mini-splints to protect and limit motion, similar to a cast on a broken arm. A typical example is a person who uses a computer for a prolonged time period without taking a break to stretch the neck. The result: a stiff, aching neck and sometimes pain. Taking periodic breaks to rub (mini-massage) and stretch the neck will promote circulation to the muscles.

before getting a massage for back pain or neck pain, talk to your doctor. He or she may be able to refer you to a licensed or certified massage therapist.

home remedies

  • Reduce inflammation by applying cold, such as an ice pack or ice wrapped in a towel, for up to 20 minutes several times a day. Or alternate the cold treatment with heat. Try taking a warm shower or using a heating pad on the low setting. Heat can help relax sore muscles, but it sometimes aggravates inflammation, so use it with caution.
  • Lie down from time to time during the day to give your neck a rest from holding up your head. Avoid prolonged rest, since too much inactivity can cause increased stiffness in your neck muscles.
  • Gently move your neck to one side and hold it for 30 seconds. Stretch your neck in as many directions as your pain allows. This may help alleviate some of the pain.

 Herbal Treatment and Traditional Medicine

Menthol and camphor: Whenever we suffer from acute neck pain, we use pain relievers which have menthol and camphor as their main ingredient. Now, menthol and camphor when rubbed on the affected area, increases blood circulation and produce a warm or cooling effect which soothes the neck muscles.

-Lavender: Lavender has been used for medicinal purposes since ancient times, but these days its oil is extracted and used in aromatherapies and massage oils which provide relief from neck pain.

-Ginger: Consuming ginger juice, tea or extract can help a lot in reducing pain caused by inflammatory diseases like neck pain. One can also rub ginger oil on the neck for instant relief.

-Arnica: Arnica is one of the best remedies used to relieve pain. It is made from the extracts of fresh Arnica flowers and helps relieve neck pain relief and stiffness.

-Devil's claw:  It is mainly used to treat rheumatoid arthritis, but also soothes neck pain as it has anti-inflammatory properties too.


  • Avoid slouching or a head-forward posture. Don't sit for long periods without getting up or changing positions. Take short breaks several times an hour tostretch your neck muscles.
  • If youwork at a computer, adjust the monitor so the top of the screen is at eye level.
  • If you use the telephone a lot, use a headset or speaker phone.
  • Adjust the seat of your car to a more upright position that supports your head and lower back
  • Use properlifting techniques. Lift with your knees, not your back.
  • Use apillow that keeps your neck straight.
  • Don't sleep on your stomach with your neck twisted or bent.
  • Strengthen and protect your neck by doingneck exercises once a day.
  • Stay at a healthy body weight.