Pain - neck; Neck stiffness; Cervicalgia; Whiplash; Stiff neck
Neck pain is discomfort in any of the structures in the neck. These include the muscles, nerves, bones (vertebrae), joints, and the discs between the bones.
Your neck is sore. It hurts to move your head. Are you sleeping wrong, is it stress, or a result of climbing that ladder to clean your gutters? Let's get to the bottom of those real “pains in your neck.” When your neck is sore, you may have trouble moving it, especially to one side. Many people describe this as having a stiff neck. If neck pain involves nerves, such as a muscle spasm pinching on a nerve or a slipped disk pressing on a nerve, you may feel numbness, tingling, or weakness in your arm, hand, or elsewhere. A common cause of neck pain is muscle strain or tension. Usually, everyday activities are to blame. Such activities include bending over a desk for hours hunching in place, having poor posture while watching TV or reading, placing your computer monitor too high or too low, sleeping in an uncomfortable position, or twisting and turning your neck in a jarring manner while exercising. Usually, you can treat minor neck pain at home. Simple posture improvements are a great place to start, sitting straight with shoulders held back, driving with arms on armrests, and avoiding carrying shoulder bags. Take breaks when sitting in front of video displays or holding a telephone. For pain, you might try over-the-counter pain relievers such as Advil or Tylenol. And low level laser therapy can be very effective. Physical therapy can be great for treating or preventing the recurrence of neck pain. Slow range of motion exercises, moving your head up and down, side to side from ear to ear, can gently stretch your neck muscles. Applying heat beforehand may help. Good sleep position is especially important with the head aligned with the body. You can try sleeping with a special neck pillow for that. You may want to see a doctor if your symptoms linger for longer than a week of self care, or if you have numbness, tingling, or weakness in your arm or hand, or if your pain was caused by a fall, blow, or injury. If the pain is due to a muscle spasm or a pinched nerve, your doctor may prescribe a muscle relaxant or a tricyclic antidepressant, and possibly a more powerful pain reliever than you were taking at home. You may be referred to a neurologist if he suspects any nerve damage in your neck. You can help prevent neck pain or keep it from coming back in many ways. Use relaxation techniques and regular exercise to prevent unwanted stress and tension to your neck muscles. Learn stretching exercises for your neck and upper body, stretch every day, before and especially after exercise. Use good posture, especially if you sit at a desk all day, keep your back supported, adjust your computer monitor to eye level, so you don't have to continually look up or down. Talk to your doctor if pain persists, you do not want to go through life with a real pain in the neck.
When your neck is sore, you may have difficulty moving it, especially turning to one side. Many people describe this as having a stiff neck.
If neck pain involves compression of your nerves, you may feel numbness, tingling, or weakness in your arm or hand.
A common cause of neck pain is muscle strain or tension. Most often, everyday activities are to blame. Such activities include:
Accidents or falls can cause severe neck injuries, such as vertebral fractures, whiplash, blood vessel injury, and even paralysis.
Other causes include:
Treatment and self-care for your neck pain depend on the cause of the pain. You will need to learn:
For minor, common causes of neck pain:
Seek medical help right away if you have:
Call your provider if:
Your provider will perform a physical exam and ask about your neck pain, including how often it occurs and how much it hurts.
Your provider will probably not order any tests during the first visit. Tests are only done if you have symptoms or a medical history that suggests a tumor, infection, fracture, or serious nerve disorder. In that case, the following tests may be done:
If the pain is due to muscle spasm or a pinched nerve, your provider may prescribe a muscle relaxant or a more powerful pain reliever. Over-the-counter medicines often work as well as prescription drugs. At times, your provider may give you steroids to reduce swelling. If there is nerve damage, your provider may refer you to a neurologist, neurosurgeon, or orthopedic surgeon for consultation.
Barnsley L. Neck pain. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2015:chap 71.
Cheng JS, McGirt JW, Devin C. Neck pain. In: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 45.
Cohen SP. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc. 2015;90(2):284-299. PMID: 25659245
Najera LV, Alleva JT, Mohr N, Origenes AK, Hudgins TH. Cervical sprain or strain. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 6.
Last reviewed on: 3/10/2016
Reviewed by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.