Neck Pain

What is neck pain (cervicalgia)?

Neck pain, sometimes called cervicalgia, is pain in or around your spine beneath your head. Your neck is also known as your cervical spine. Neck pain is a common symptom of many different injuries and medical conditions.

You might have axial neck pain (felt mostly in your neck) or radicular neck pain (pain that shoots into other areas, such as your shoulders or arms). It can be acute (lasting from days to six weeks) or chronic (lasting longer than three months).

Neck pain can interfere with your daily activities and reduce your quality of life if it’s not treated.

Fortunately, most causes of neck pain aren’t serious and improve with conservative treatments, like pain medicine, exercise and stress management.

What does neck pain feel like?

Some people describe the pain as:

• A persistent ache.
• A stabbing or burning pain.
• A shooting pain that travels from their neck to their shoulders or arms.

Other symptoms

Neck pain may involve other symptoms, including:

• Headache.
• Stiffness in your neck, shoulders and upper back.
• Being unable to turn your neck or tilt your head.
• Numbness or tingling (pins and needles) feeling in your shoulders or arms.

Who is affected by neck pain?

Neck pain is common, affecting 10% to 20% of adults. It’s more common in women and people assigned female at birth. Your chance of developing it increases with age.

What are the possible causes of neck pain?

Neck pain has many potential causes, including:

• Aging: As you age, natural wear and tear can cause parts of your cervical spine to deteriorate, or degenerate, causing pain. Degenerative conditions such as osteoarthritis (the wearing down of joint cartilage) and spinal stenosis (narrowing of the spaces in your spine) can lead to neck pain. Over time, stress and repeated movements can cause the disks in your spine to weaken, causing a herniated disk or pinched nerve.
• Physical strain: Overusing your neck muscles during repetitive or strenuous activities can lead to stiffness and pain. Poor posture, weak abdominal muscles and heavier body weight can affect your spine’s alignment and contribute to neck pain. For example, straining your neck to view a computer screen for long periods is a common cause of neck pain.
• Mental stress: Tightening your neck muscles because you’re stressed can lead to neck pain and stiffness. Many people who tighten these muscles when they’re stressed or agitated don’t realize they do it until their neck starts hurting.
• Injury: Trauma and other injuries can damage muscles, ligaments, disks, vertebral joints and nerve roots in your spinal cord and lead to neck pain. Whiplash during automobile accidents is a common injury that causes neck pain.
• Growths: Masses, including tumors, cysts and bone spurs, can put pressure on the nerves in your neck, causing pain.
• Other health conditions: Neck pain is a symptom of many health conditions, including meningitis, rheumatoid arthritis and cancer.

How is neck pain diagnosed?

Usually, a medical history and a physical exam are enough for a healthcare provider to diagnose the cause of neck pain. A healthcare provider will first eliminate serious causes of neck pain, like pressure on your spinal cord, myelopathy, an infection or cancer.

• Medical history: Your provider will ask about previous neck injuries that may have caused whiplash or a herniated disk. They may ask about work or other activities that could strain your neck. They’ll ask about your pain, including when it started, where it’s located, how long it lasts and how intense it is.
• Physical exam: Your provider will check your head and neck alignment and observe your range of motion when you move your neck. They’ll feel your neck and supporting muscles to check for tenderness and signs of strain.
• Imaging tests usually aren’t necessary to identify what’s causing neck pain. Still, a provider may take images of the inside of your neck if they suspect a serious injury or if you’re experiencing severe pain that doesn’t improve.
• X-rays: X-rays can show problems with your bones or soft tissues that may be causing neck pain. An X-ray can show issues with cervical alignment, fractures and slipped disks, and they can detect arthritis.
• Magnetic resonance imaging (MRI): An MRI can show problems with your spinal cord, nerves, bone marrow and soft tissue. It can show if a disk has slipped out of place, signs of infection and masses that may be causing neck pain, like a cyst or tumor.
• Computed tomography (CT) scan: A CT scan may be used if an MRI isn’t available. It can show bone spurs and signs of bone deterioration.

In rare instances, your provider may order additional tests, including:

• Electrodiagnostic tests: These tests check the function of nerves and your muscle response. Tests include nerve conduction studies and, rarely, a myelogram if an MRI is contraindicated.
• Lab tests: These tests can help your provider identify causes of neck pain other than musculoskeletal injuries, like infections, rheumatological conditions or cancers. Tests include a complete blood count (CBC), urinalysis and markers of inflammation, among others.

How is neck pain managed or treated?

Treatment aims to relieve your pain and improve movement in your neck. Most causes of neck pain eventually improve and can be managed at home. Your provider will suggest treatments to manage your symptoms, including:

• Pain medications and muscle relaxers: Medicines, including nonsteroidal anti-inflammatory drugs (NSAIDs) to ease neck pain and inflammation, and muscle relaxants to help your neck muscles heal, are common first-line treatments for neck pain.
• Physical therapy: You may work with a physical therapist or a fitness trainer to learn exercises and movements that strengthen the muscles and tendons in your neck and improve flexibility.
• Transcutaneous electrical nerve stimulation (TENS) unit: A TENS unit applies a low-level electrical current to your skin near your nerves to disrupt the pain signal causing discomfort. Always check with a healthcare provider before using a TENS unit.
• Steroid injections: A shot near the nerve roots can reduce inflammation and relieve pain.
• Alternative therapies: Your provider may recommend acupuncture to relieve pain, or massage to help loosen tightened muscles contributing to your discomfort. You may see an osteopath or chiropractor to align your spine.
• Surgery: Most causes of neck pain don’t require surgery. Still, you may need surgery if one or more of the vertebrae in your spine has shifted out of place or is putting pressure on your nerves.

If your pain is severe, you may need to work with a spine or pain specialist.

What can I do to relieve neck pain at home?

In addition to taking pain relief medications, you can take steps at home to relieve neck pain, including:

• Hot therapy: Take a hot shower or place a hot towel or heating pad (on the lowest setting) on the site of your pain for 15 minutes every few hours. The heat loosens your muscles and promotes blood flow.
• Cold therapy: Place a cold pack or a bag of frozen vegetables (wrapped in a thin towel to protect your skin) for 15 minutes every few hours. The cold narrows your blood vessels, reducing inflammation and swelling. Use cold instead of heat immediately after an injury.
• Exercise: Follow your healthcare provider’s guidance on neck exercises you can try to relieve neck pain and improve your range of motion. Don’t attempt exercises if you have a serious neck injury or a pinched nerve.
• Stress reduction techniques: Mindfulness, meditation, breathing exercises and yoga can help relieve tension in your body that may contribute to neck pain.
• Quit smoking: Smoking damages bone structure, accelerates degenerative disk disease and slows healing.

How long does neck pain (cervicalgia) take to heal?

Healing time depends on what’s causing your neck pain. Neck pain caused by common issues like strains and stress usually improves within a week or two. It may take a few months before the pain disappears entirely.

How can I prevent neck pain?

You can take steps to prevent neck pain related to strains and tense muscles.

• Practice good posture. Position electronic devices, like computers and phones, so you don’t have to slouch or strain your neck when using them. Keep your shoulders aligned and your back straight when seated so you’re not straining your neck. Adjust the seats in your car to maintain good posture while traveling.
• Adjust your sleep position.Maintain good posture when you’re asleep. If you sleep on your back or side, use a pillow to support your head so your head and neck are aligned with the rest of your body. If you sleep on your back, place a pillow underneath your knees to take additional pressure off your low back. Avoid sleeping on your stomach with your head turned.
• Stay active.You can use many of the same exercises used to relieve neck pain to prevent it. If you work a job that involves sitting for long periods, take occasional breaks to move around and stretch your entire body, including your neck muscles.
• Don’t carry heavy weight on your shoulders.Avoid carrying heavy objects like book bags or suitcases over your shoulder. Instead, consider using luggage or bags with wheels.
• Exercise your upper back extensor muscles. It’s normal to lose strength in your upper back as you age. As a result, your shoulders rock forward, and your head tips forward in a position in front of your spine. This positioning puts additional strain on your neck and upper back.

Exercises that can help strengthen your upper back extensor muscles include:

• Scapular squeezes: Pinch your shoulder blades together 10 times.
• Standing push-ups: Do push-ups in a doorframe, allowing your shoulders to go past your hands 10 times.
• Theraband rowing: Wrap the middle of a theraband around a doorknob so it’s stable. While standing, grab an end with each hand. Pull your hands toward your waist 10 times.

When should I call the doctor if I have neck pain?

Contact a healthcare provider if you have neck pain that interferes with work or other daily activities. In rare cases, neck pain can be a sign of a medical emergency.

Seek urgent medical care if your neck pain:

• Develops after an accident.
• Involves a loss of bowel or bladder control.
• Persists whether you’re moving or staying still.
• Involves a headache, dizziness, nausea or vomiting.
• Occurs with chills, fever or unexplained weight loss.
• Occurs with numbness or tingling in your arms, shoulders or legs.
• Occurs with weakness in your legs or loss of coordination in your arms or legs.
• Doesn’t get better with over-the-counter medications.
• Doesn’t improve after one week.

A note from Cleveland Clinic

It’s easy to overlook the important work your neck does — until you experience neck pain or have trouble moving your head. The average human head weighs about 10 pounds. Your neck is responsible for supporting this weight and keeping your head aligned with the rest of your body. Over time, this work can take a toll on your body, especially if you’re constantly straining your neck. Take preventive steps to avoid neck pain, like practicing good posture and taking frequent breaks to move and stretch. If you’re experiencing neck pain, see a healthcare provider. They can recommend medications and therapies that can provide relief.