An Overview of Neck Pain

Learn about what causes neck pain and your treatment options.

Neck pain is pain in the neck that may radiate into the upper back or head. It’s sometimes accompanied by neurological symptoms, such as numbness, tingling, weakness or loss of motion, and may involve pain that radiates into the shoulder(s) or arm(s). Neck pain is a common problem.

Symptoms of neck pain without neurological symptoms

The exact cause of neck pain without neurological symptoms is often unknown. This type of pain is most commonly related to cervical strain and degenerative changes.

Cervical strain (neck strain, neck spasm) refers to stress on the neck muscles and ligaments that can lead to muscle spasms and neck pain. Cervical strain may last up to six weeks. It may be caused by various factors, such as:

Holding your neck in the same position for a prolonged time, such as while working at a computer or desk
Sleeping in an awkward position or on a too-soft mattress
Having poor posture
Overusing your neck and shoulder muscles
Heavy lifting
Carrying a heavy backpack
Being under stress
Injury (such as whiplash)
Taking certain medications

Degenerative changes are caused by normal aging or disease, and may include:

Cervical spondylosis (also referred to as osteoarthritis of the spine or degenerative disc disease)
Cervical discogenic pain (pain associated with degenerative changes in the discs)
Cervical facet syndrome (pain associated with degenerative changes in the facet joints)
Neck pain without neurological symptoms may also be caused by problems such as:
Myofascial pain (painful areas in muscles)
Fracture
Malignant (cancerous) tumor
Infection
Inflammatory arthritis, such as ankylosing spondylitis (an autoimmune disease of the spine that can fuse the vertebrae together making the neck stiff) or rheumatoid arthritis (an autoimmune disease in which certain joints are inflamed)
Congenital (present at birth) deformity
Referred pain from other parts of the body, such as the stomach, heart, lungs, shoulder or thoracic back

Symptoms of neck pain with neurological symptoms

Neurological symptoms may be due to radiculopathy (compression, irritation or injury of nerve roots in the cervical spine) or myelopathy (compression of the part of the spinal cord that runs through the cervical spine). Both of these conditions are often caused by degenerative changes. A herniated cervical disc may also cause these conditions.

Degenerative changes are caused by normal aging or disease, and may include conditions such as:

Cervical spondylosis (also referred to as osteoarthritis of the spine or degenerative disc disease)
Cervical spondylotic myelopathy (narrowing of the spinal canal by degenerative changes)
Spinal stenosis (a narrowing of the spinal canal that can put pressure on the spinal nerves)
Nerve root impingement
A herniated cervical disc (ruptured or slipped disc)

Less common causes of neurological symptoms may include:

Malignant tumor
Infection, such as an abscess (collection of pus)
Trauma

Radiculopathy may also be caused by irritation of the spinal nerves (not compression) caused by problems such as:

Herpes zoster (a viral infection that affects the nerves)
Lyme disease (a tick-borne illness)
Diabetes

Conservative treatment. Most people who have neck pain get better with conservative treatment and never need surgery. It’s recommended that you fully try conservative treatment before thinking about surgery for neck pain or radiculopathy.

Activity modification
Heat or cold applications
Exercise or physical therapy
Massage
Relaxation and pain medication

The length of time to try conservative treatment varies depending on the cause of your neck pain.

Surgery. There’s rarely a need to make a quick decision to have surgery for neck pain. If a serious cause is detected, such as a tumor, infection, injury or significant nerve or spinal cord compression, surgery may be recommended first. Otherwise, surgery usually isn’t necessary because most people with neck pain alone improve during the first four to six weeks with conservative treatment measures.

Surgery may be considered if other treatments have failed and the pain is persistent and interferes significantly with sleeping, working and daily activities. And the cause may be corrected by surgery. This decision should be considered carefully due to the risks of surgery and the possibility that it may not improve your symptoms.

By Optum Contributing Writer

Sources

Isaac Z. Treatment of neck pain. UpToDate. Accessed September 9, 2017.
Isaac Z, Dec KL. Patient information: Neck Pain. UpToDate. Accessed October 3, 2017.
Centers for Disease Control and Prevention. Nonopioid treatments for chronic pain. Accessed October 3, 2017.

Last Updated: October 19, 2017