Causes

A common cause of neck pain is muscle strain or tension. Most often, everyday activities are to blame. Such activities include:

  • Bending over a desk for a long time (often an hour or more)
  • Having poor posture while watching TV or reading
  • Having your computer monitor positioned too high or too low
  • Sleeping in an uncomfortable position
  • Twisting and turning your neck in a jarring manner while exercising
  • Lifting things too quickly or with poor posture

Accidents or falls can cause severe neck injuries, such as vertebral fractures, whiplash, blood vessel injury, and even paralysis.

Other causes include:

Considerations

When your neck is sore, you may have difficulty moving it, such as 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.

Definition

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.

References

Hudgins TH, Origenes AK, Pleuhs B, Alleva JT. Cervical sprain or strain. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 6.

Kosty J, Nasser R, Vasquez RA, Wong CC, Cheng JS. Neck pain. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier;2021:chap 48.

Ronthal M. Arm and neck pain. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 32.

What to Expect at Your Office Visit

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.

When to Contact a Medical Professional

Seek medical help right away if you have:

  • A fever and headache, and your neck is so stiff that you cannot touch your chin to your chest. This may indicate meningitis. Call 911 or the local emergency number or get to a hospital.
  • Symptoms of a heart attack, such as shortness of breath, sweating, nausea, vomiting, or arm or jaw pain.

Contact your provider if:

  • Symptoms do not go away in 1 week with self-care
  • You have numbness, tingling, or weakness in your arm or hand
  • Your neck pain was caused by a fall, blow, or injury -- if you cannot move your arm or hand, have someone call 911 or the local emergency number
  • You have swollen glands or a lump in your neck
  • Your pain does not go away with regular doses of over-the-counter pain medicine
  • You have difficulty swallowing or breathing along with the neck pain
  • The pain gets worse when you lie down or wakes you up at night
  • Your pain is so severe that you cannot get comfortable
  • You lose control over urination or bowel movements
  • You have trouble walking and balancing

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