What is neck pain?

Neck pain is a common condition that can be caused by many different things. It will affect most people at some point in their lives.

Most neck pain clears up by itself in a few days. It is very rarely a sign of something more serious.

What symptoms relate to neck pain?

Neck pain often spreads from the neck towards the shoulders or upper back. It can often cause headaches. The pain may be worse when you hold your head in one position for a long time, such as at a computer.

Neck pain might also come with muscle tightness or spasms. You also may not be able to move your head very well.

If you have a neck injury, you might also have:

• dizziness
• nausea (feeling sick)
• pins and needles or numbness
• weakness
• changes to your vision or hearing
• problems concentrating
• difficulty swallowing (dysphagia)

See your doctor if you have any of these symptoms.

What causes neck pain?

Common causes of neck pain include:

• poor posture (the way your body is positioned when standing or sitting)
• sleeping in an awkward position
• tension in your muscles
• injury such as a muscle strain or whiplash
• prolonged use of a desktop or laptop computer
• a slipped spinal disc (herniated disc)
• wear and tear in the bones of the neck, which is a normal part of ageing
• wear and tear of the spinal discs (cervical spondylosis). This is also a normal part of ageing

Rarer causes of neck pain include:

• damage to the vertebrae, spinal cord or nerves in the neck
• a compressed nerve (cervical radiculopathy)
• an infection
• osteoporosis related bone damage or fractures
• cancer
• meningitis
• arthritis

When should I see my doctor?

You should see a doctor if:

• the pain is severe
• the pain is getting worse
• the pain doesn’t ease up in a week or so
• you have a fever, sweats, or chills
• you have numbness, tingling or pins and needles in your arms or legs
• you have weakness in your arms or legs
• you start having difficulties with your bladder or bowel

How is neck pain diagnosed?

Your doctor will examine you and discuss what makes the pain worse or better. If they think there may be a more serious cause of your neck pain, they may order tests such as:

• blood tests
• x-ray
• CT scan
• MRI

However, usually these tests aren’t recommended because they won’t change how your neck pain is treated.

How is neck pain treated?

The best ways to treat most neck pain are to:

• keep moving your neck as much as possible
• stay active
• adapt any activities that might be causing your pain

Heat packs or ice packs may also be used to relieve neck stiffness and pain.

You can ask your doctor or pharmacist what over-the-counter painkillers they recommend. They may suggest an anti-inflammatory analgesic cream or gel.

Manipulating or massaging your neck can give short-term relief. Some physical therapies such as physiotherapy, chiropractic, osteopathy or acupuncture may be helpful.

It might be helpful to rest your neck at first, but don’t rest it for too long. If you don’t move, the muscles will get stiffer. This means the pain will take longer to go away. It’s better to gently stretch the neck muscles. Your doctor or physiotherapist can show you how to do this gently and safely.

If your neck pain doesn’t go away, your doctor will investigate the cause. Serious, long-term neck pain is sometimes treated with steroid injections or, very rarely, surgery.

There are ways you can manage your neck pain:

• Make sure you have a comfortable, supportive pillow. Try sleeping with one firm support pillow rather than softer pillows to avoid stretching your neck muscles.
• Ensure your working environment is adjusted to your needs. You may need a footstool to ensure your hips and knees are level. Ask for a telephone headset if you spend a lot of time on the phone. This will stop you bending your neck to one side constantly. You may also need to adjust the height of your computer screen to avoid stretching your neck. Hold reading materials at eye level to avoid hunching over.
• Work on your posture — exercises such as those found in yoga or Pilates all work to improve your posture.
• Neck supports (braces and collars) are not generally recommended, unless your healthcare professional has advised you to wear one.
• Avoid tasks such as lifting, pulling, punching, and repetitive bending and twisting for a few days. These activities can make your neck pain worse. Try not to overdo it.
• If you cannot fully move your neck left and right, you should not drive until you have regained full neck movement. If you can safely drive, adjust your headrest so that your head and neck are properly supported.

Can neck pain be prevented?

The best way to prevent neck pain is to keep your spine flexible and your muscles strong. You can do this with regular exercise — 30 minutes on most days. Make sure you take plenty of breaks throughout the day to stretch.

It’s important to develop good posture, especially when you’re sitting, at work or driving. Try not to slouch or to poke your chin out. A supportive pillow is also important to prevent neck pain.

Complications of neck pain

Sometimes pain doesn’t go away. Chronic or persistent pain can continue even after the original problem has healed. If this happens, you may need help to address emotional, social and environmental factors that may be contributing to your pain. Speak to your doctor if you experience chronic or persistent pain.

Resources and support

These websites provide more detailed information about the causes and management of neck pain.

• painHEALTH
• Musculoskeletal Australia
• Chronic Pain Australia