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Saying, “It’s a pain in the neck,” can signal overuse problems, most commonly with the structures of the cervical spine. Only in rare instances is neck pain a sign of a systemic illness. Although the pain may be severe, the good news is that most individuals with neck pain improve within 1-2 weeks, and the vast majority are over their episodes in 8-12 weeks.
Neck pain is just that – pain in the neck. Pain can be localized to the cervical spine or may travel down an arm (radiculopathy). All age groups are at risk of developing neck pain. People who sit in one location staring at computer screens for long periods of time may be at an increased risk. About 30 percent of the population has an episode of neck pain each year. Neck pain may occur slightly more frequently in women than men.
Most episodes of neck pain are caused by the wearing out of the structures (mechanical) of the neck, which is associated with aging, or with overuse of the neck or arms. About 10 percent of instances of neck pain are associated with systemic illnesses, such as polymyalgia rheumatica, ankylosing spondylitis, rheumatoid arthritis, tumors and infections.
The common mechanical disorders that cause neck pain are the following:
In most circumstances, a medical history and physical examination are the essential parts of an evaluation required to diagnose neck pain/disorders. In some instances, individuals who do not respond to starting therapy may undergo specialized radiographic tests, such as plain X-rays, magnetic resonance imaging (MRI) or computerized tomography to screen for additional problems of soft tissues, herniated discs, spinal stenosis, tumors, or nerve injuries.
Maintaining motion is an important part of therapy for neck pain. The use of neck braces should be kept to a minimum.
While regular exercise should be discontinued until the neck pain is improved, movement of the neck is encouraged. Gradual movement in all directions of motion of the neck stretches muscles that may be excessively tight. This exercise may be particularly helpful while under a stream of warm water during a shower.
Five- to 10-minute ice massages applied to a painful area within the first 48 hours of the start of pain can help relieve pain as can heat, which relaxes the muscles. Heat should be applied for pains of durations greater than 48 hours. Over-the-counter pain relievers such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, frequently are enough to control episodes of neck pain, and muscle relaxants may help those with limited motion secondary to muscle tightness.
Individuals with increased stress may have contracted neck muscles. Massage therapy has proven helpful for those with chronic muscular neck pain.
A small minority of neck pain patients, particularly those with arm pain or signs of spinal cord compression, require cervical spine surgery. A new option for neck surgery is an artificial disc. This device made of metal and plastic, is the correct choice for a very small number of individuals with neck pain only and no other abnormality in the cervical spine than a worn out disc.
The best way of living with neck pain is trying to prevent it. The best things you can do to prevent neck pain are pay attention to your body, exercise, eat right and maintain a healthy life style. In addition, do not sit at the computer for hours without getting up frequently to stretch the neck and back. Take the stress of the day out of your neck muscles and do your exercise routine. If you smoke, stop. Smoking is a predisposing factor for neck pain. If you are overweight, try to increase your activity level and eat healthier to get into shape.
Reviewed May 2015. Written by David Borenstein, MD, and reviewed by the American College of Rheumatology Communications and Marketing Committee.
This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.
© 2015 American College of Rheumatology
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