Neck Pain
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Medical Encyclopedia
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Neck pain
Illustrations
Pain - neck; Neck stiffness
Neck pain may originate from any of the
structures in the neck. These include muscles and nerves as well as spinal
vertebrae and the cushioning discs in between. Neck pain may also come from
regions near the neck, like the shoulder, jaw, head, and upper arms.
When your neck is sore, you may have
difficulty moving it, especially to one side. Many people describe this as
having a stiff neck.
If neck pain involves nerves (for example,
significant muscle spasm pinching on a nerve or a slipped disc pressing on a
nerve), you may feel numbness, tingling, or weakness in your arm, hand, or
elsewhere.
A common cause of neck pain is muscle strain
or tension. Usually, everyday activities are to blame. Such activities include
bending over a desk for hours, having poor posture while watching TV or reading,
placing your computer monitor too high or too low, sleeping in an uncomfortable
position, or twisting and turning the neck in a jarring manner while exercising.
Traumatic accidents or falls can cause severe
neck injuries like vertebral fractures, whiplash, blood vessel injury, and even
paralysis.
Other causes include herniated disc,
fibromyalgia (pain syndrome throughout the body), and arthritis. Meningitis,
although much less common, can cause significant neck stiffness.
For minor, common causes of neck pain:
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Take acetaminophen or ibuprofen.
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Apply heat or ice to the painful area. One good method is to use ice for
the first 48 - 72 hours, then use heat after that. Heat may be applied with
hot showers, hot compresses, or a heating pad. Be careful not to fall asleep
with a heating pad on.
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Perform slow range-of-motion exercises -- up-and-down, side-to-side, and
from ear-to-ear -- to gently stretch the neck muscles.
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Have a partner gently massage the sore or painful areas.
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Try sleeping on a firm mattress without a pillow or with a special neck
pillow.
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Call your health care provider if
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One week of self care hasn't helped.
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You have a fever and headache, and your neck is so stiff that you cannot
touch your chin to your chest. THIS MAY BE MENINGITIS -- CALL 911 or get to
a hospital.
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You have numbness, tingling, or weakness in your arm or hand.
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Your neck pain was caused by a fall, blow, or injury (if you cannot move
your arm or hand, have someone call 911).
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You have swollen
glands or a lump in your neck.
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Your pain does not respond to standard doses of over-the-counter pain
medication.
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What to expect at your health care provider's
office Return
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Your doctor will perform a physical
examination and ask detailed questions about your neck pain, such as:
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Is your pain in the front, back, or side of your neck?
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Are both sides of your neck affected equally?
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When did the pain first develop?
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Is it painful all the time or does pain come and go?
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Can you touch your chin to your chest?
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What makes your neck feel worse? What makes your neck feel better?
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Do you have neck weakness or neck
stiffness?
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Do you have any accompanying symptoms like numbness, tingling, or
weakness in your arm or hand?
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Do you have swollen glands or a lump in your neck?
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The following diagnostic tests may be performed:
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Blood tests such as a complete blood count or a thyroid test
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Occasionally, an MRI of the neck
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If the pain is due to muscle spasm or a
pinched nerve, your doctor may prescribe a muscle relaxant and possibly a more
powerful pain reliever. Prescription drugs are not necessarily better than
over-the-counter medications. The doctor may prescribe a neck collar or, if
there is nerve damage, refer you to a neurologist or neurosurgeon for
consultation.
If meningitis is suspected, you will be sent
to an emergency department for further tests, antibiotics, and hospital
admission.
If a thyroid condition is considered (due,
for example, to a lump in the front of your neck), follow-up care for abnormal
blood tests will be needed.
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Use relaxation techniques and regular exercise to prevent unwanted
stress and tension to the neck muscles.
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Learn stretching exercises for your neck and upper body. Stretch every
day, especially before and after exercise. A physical therapist can help.
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If you tend to get neck pain from exercise, apply ice to your neck after
physical activity.
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Use good posture, especially if you sit at a desk all day. Keep your
back supported. Adjust your computer monitor to eye level. This prevents you
from continually looking up or down.
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If you work at a computer, stretch your neck every hour or so.
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Use a headset when on the telephone, especially if answering or using
the phone is a main part of your job.
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When reading or typing from documents at your desk, place them in a
holder at eye level.
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Evaluate your sleeping conditions. Make sure your pillow is properly and
comfortably supporting your head and neck. You may need a special neck
pillow. Make sure your mattress is firm enough.
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Use seat belts and bike helmets to prevent injuries.
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Kasch H, Bach FW, Stengaard-Pedersen K,
Jensen TS. Development in pain and neurologic complaints after whiplash: A
1-year prospective study. Neurology. 2003; 60: 743 - 749.
Devereaux MW. Neck pain. Prim Care.
2004; 31(1): 19-31.
Phero JC. Pharmacological management of head
and neck pain. Otolaryngol Clin North Am. 2003; 36(6): 1171-1185.
Updated by: Thomas A. Owens, M.D., Departments of
Internal Medicine and Pediatrics, Duke University Medical Center, Durham, NC.
Review provided by VeriMed Healthcare Network.
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