“It’s a pain in the neck” can signal mechanical problems with the structures of most commonly 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 one to two weeks, and the vast majority are over their episode in 8 to 12 weeks.
Fast Facts
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Neck pain affects 10% of the population each year.
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Whiplash from motor vehicle accidents is a common cause of neck pain.
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The diagnosis of neck pain is determined by a medical history and physical examination, and rarely requires expensive or uncomfortable tests.
What
neck pain is
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| Acute strain may occur after sleeping in an awkward position. |
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Neck pain is just that – pain in the neck. Pain can be localized to the cervical spine or may radiate down an arm (radiculopathy).
What causes neck pain
Most episodes of neck pain are caused by mechanical disorders associated with gradual changes associated with aging, or with overuse of the neck or arms. About 10% of instances of neck pain are associated with systemic illnesses, such as polymyalgia rheumatica.
Muscle strains usually related to sustained physical activity such as sitting at computer terminals for prolonged periods of time. Acute strain may occur after sleeping in an awkward position.
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Osteoarthritis resulting from the narrowing of the intervertebral discs located between the vertebrae of the spine. The adjacent vertebrae grow spurs in response to the increasing pressure placed on them. The bony growths can cause localized pain in the neck or arm related to nerve compression.
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Herniated intervertebral discs, which cause arm pain more frequently than neck pain. The pinching of a nerve in the neck causes severe arm pain (brachialgia). Disc herniations can cause a loss of function of the nerve including loss of reflex, sensation or muscle strength.
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Spinal stenosis which is a narrowing of the spinal canal that causes compression of the spinal cord (cervical myelopathy). The narrowing is caused by disc bulging, bony spurs and thickening of spinal ligaments. The squeezing of the spinal cord may not cause neck pain in all cases but is associated with leg numbness, weakness and incontinence.
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Whiplash, an acceleration-deceleration injury to the soft tissues of the neck, most commonly caused by rear-impact motor vehicle accidents. The pain and stiffness associated with these accidents generally develop 24 to 48 hours after the injury.
Systemic disorders that can lead to neck pain include ankylosing spondylitis, rheumatoid arthritis, polymyalgia rheumatica, tumors and infections.
Who gets neck pain
About 10% of the population has an episode of neck pain each year. Neck pain may occur slightly more frequently in women than in men.
How neck pain is diagnosed
In most circumstances, a medical history and physical examination are the essential components of an evaluation required for diagnosis of neck disorders. On occasion, individuals who do not respond to initial therapy may undergo specialized radiographic tests, such as plain x-rays, magnetic resonance imaging (MRI) or computerized tomography to screen for additional involvement of soft tissues, ruptured discs, spinal stenosis, tumors or nerve injuries.
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| Massage therapy has proven helpful for those with chronic muscular neck pain. |
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How neck pain is treated
Maintaining motion is an important component of therapy of 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 planes of motion of the neck stretch muscles that may be excessively contracted.
Applying ice massages for 5 to 10 minutes at a time to a painful area within the first 48 hours of pain onset can help relieve pain as can heat, which relaxes the muscles. Heat should be applied for pains lasting greater than 48 hours. Over-the-counter pain relievers such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDS) including aspirin are frequently adequate 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.
Living with neck pain
The best way of living with neck pain is trying to prevent it. 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, get into shape. Bottom line, pay attention to your body and exercise, eat right, and maintain a healthy life style.
Points to Remember
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Neck pain is a common problem and is rarely associated with a systemic illness.
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The vast majority of individuals improve by taking over-the-counter medications and remaining active.
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Most individuals are better in one to two weeks; over 90 percent are healed in eight weeks.
To find a rheumatologist
For a listing of rheumatologists in your area, click
here.
Learn more about rheumatologists and rheumatology
health professionals.
For more information
The American College of Rheumatology has compiled this list to give you
a starting point for your own additional research. The ACR does not endorse
or maintain these Web sites, and is not responsible for any information
or claims provided on them. It is always best to talk with your rheumatologist
for more information and before making any decisions about your care.
Arthritis Foundation
www.arthritis.org
National Institutes of Health
www.nih.gov
Created July 2006
Written by David Borenstein, MD, and reviewed by the American College of Rheumatology Patient Education Task Force.
