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Neck Pain

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Introduction to Neck Pain

Neck pain is a common condition noticed by many individuals in their everyday. The pain is at times very disturbing that it may be difficult for the individual to perform day-to-day activities. The pain may be felt anywhere in the neck, from the lower portion of the head to the upper part of the shoulders. The neck usually feels stiff and the movement of the neck is usually restricted.1, 2


Causes of Neck Pain

Neck pain may be caused due to three major reasons:

    1. strain to the neck,

    2. trauma/injury to the neck or

    3. due to some underlying bone and joint disorders.

At times pain from other structures around the neck region may radiate till the neck, giving rise to pain in the neck.

One may strain the muscles of the neck due to abnormal positioning of the head and neck, while watching television, working on a computer or reading books, bending over the desk while working, sleeping in an awkward position and sudden twisting of the neck while performing exercises.
The spinal cord runs through the neck and can get injured due to trauma. Any injury to the spinal cord and its associated structures in the neck region can cause pain in the neck. Such injuries may occur as a result of fall from a high point, motor accidents (the injury associated with sudden to and fro jerking of the head is referred to as whiplash injury), direct blow to the neck, sports injuries or other similar incidents.

Underlying disorders that commonly result in neck pain include long-term bone conditions such as

Any infections of the spine or the related structures such as meningitis can also give rise to the pain. The increasing age is associated with various changes in the bones; among these changes, narrowing of the canal in the spinal cord through which various nerves pass is one of the reasons that cause neck pain in the elderly. In certain rare instances, a tumour in the neck region may be the cause of the pain.1


Risk Factors for Neck Pain

Awkward positioning of the neck during various day-to-day activities is one of the common risk factors that result in neck pain, while increasing age is also considered as a risk factor. Increasing age is generally associated with various disorders of the bones and the joints.

Physical work that puts significant pressure on the neck and the back is also an important risk factor. 

Some of the other risk factor include the following1,2

  • Recent injury to the neck region
  • Lack of proper exercise and
  • A history of headaches


Signs and Symptoms of Neck Pain

Neck pain due to the common straining of the neck is usually characterised by pain in the neck region from the bottom of the head to the upper parts of the shoulders or arms. There may be associated stiffness experienced in the muscles that restricts the movement of the neck. Any attempt to move the neck may be associated with increase in the pain. This kind of pain may persist for a few fours to days based on the amount of strain to the muscles of the neck. A similar variety of symptoms with varying severity may be observed in cases underlying bone and joint disorders.

In case of injuries related to the spinal cord or its associated structures, numbness, tingling sensation and weakness of the arms may also be noticed alongwith the pain in the neck. Other similar symptoms include burning sensation and shock like pain that may extend to the arm.1

Diagnosis of Neck Pain

Neck pain is a symptom that is associated with a history of strain, trauma or certain underlying illnesses. The doctor aims at identifying the cause of neck pain in order to arrive at a treatment plan. History of strain on the neck or recent incidents that would have caused stiffness of the neck muscles is generally elicited along with the history of trauma to the neck.

Medical history that involves enquiry about the underlying illnesses is also recorded. The doctor may perform certain physical examination procedures to verify the stiffness and assess the severity of the condition. Laboratory tests that include routine blood tests along with specific tests to assess the fluid normally present around the spinal cord (if meningitis is suspected) may be advised to rule out or confirm the presence of other pathologies.

Imaging studies such as radiographs, CT and MRI scanning may be advised to rule out fractures or other associated abnormalities in the bones and tissues around the neck region.1,3

Treatment of Neck Pain

In case of minor injuries or strains home care is considered sufficient enough to decrease the pain and other associated symptoms. Application of an ice pack during the first 24–48 h following such incident is useful in the prevention of swelling. Frequent application of ice packs is recommended. After 48 h application of heat packs may be helpful in reliving the symptoms. Gentle massage in the area of stiffness (not to be performed if it is painful) usually improves blood circulation and relaxes the stiff muscles. Over-the-counter medications such as ibuprofen, aceclofenac or diclofenac sodium or certain pain relieving creams are useful in relieving the pain.
A doctor should always be consulted in case of:
  • Severe trauma
  • Fall from a significant height
  • Major injury during sports
  • Weakness, numbness or tingling sensation felt in the arms or legs along with neck pain
  • Severe restriction of the neck movements
  • Neck pain persisting for a long period of time
The treatment of the neck pain is generally based on the underlying cause of the pain. The doctors may prescribe medications that belong to the group of muscle relaxants, narcotic pain relievers or antidepressants. The type of medication, its dosage and duration is dependent on the underlying cause of the neck pain.

The presence of a tumour or pressure on the nerves due to narrowing of the bones may require surgical correction.1–3


Alternative Therapies of Neck Pain

Other alterative therapies that help in relieving the pain include massage, physiotherapy, yoga and acupuncture. However, these therapies are an adjuvant to the medical therapy and a doctor must always be consulted before hand.5,6


Prevention of Neck Pain

Neck pain can be prevented by avoiding awkward positioning of the neck at home and at work place. Simple steps such as sitting straight, adjusting the computer monitor to a comfortable height, using a comfortable pillow, while sitting or sleeping and not cradling the phone on the shoulders while speaking, go a long way in better health of the neck muscles. Staying fit with proper exercises is helpful in toning the muscles to prevent stiffness.2


Complications of Neck Pain

In the absence of any underlying conditions, there are no complications associated with neck pain other than temporary restriction of movements.


Living with Neck Pain

Neck pain may either persist for a few days to weeks, while at times it may persist for months or years. Depression in the latter case is frequently noticed. Proper care and promptly following the therapeutic protocols helps in reducing the severity of the pain and helps one to lead a stress-free life.  

Written by: Healthplus24 team
Date last updated: September 29, 2012