Overview
Neck Pain (also known as Cervicalgia) is any pain originating or manifesting in the region of the body below the head and above the start of the chest and back. Pain can emanate from the muscles, tendons, ligaments, intervertebral disc, inflamed nerves, and/or skeletal structures of the spine.
Causes
The causes of acute (short-term) pain and chronic (long-term) pain tend to be different. The most common causes of neck pain are muscle strain or soft tissue sprain (ligaments, tendons) or trauma caused by a sudden force (whiplash). These can be caused by mundane behaviors such as poor posture or poor workstation ergonomics. Psychosocial factors such as emotional stress and anxiety can also lead to a manifestation of neck pain.
There are many other factors that may be associated with neck pain including:
- Osteoarthritis – wearing down of cartilage in the cervical facet joint
- Degenerative disc disease – discs gradually lose hydration and the ability to cushion the spine’s vertebrae over time. This is a normal part of aging and not a “disease.” Over time everybody will exhibit some changes in their discs and a degenerating disc does not always cause symptoms to develop
- Herniated disc – when an intervertebral disc’s protective outer layer partially or completely tears, some of the jelly-like inner layer (nucleus pulposus) may leak and cause inflammation and pain
- Spondylolisthesis – occurs when one vertebra slips over the one below it. It can be due to a tiny fracture in the vertebra, ligament laxity, or possibly from advanced disc degeneration
- Nerve compression associated with herniated discs or bone spurs
- Diseases such as rheumatoid arthritis
- Fibromyalgia
- Myofascial pain syndrome
Symptoms
The signs and symptoms of neck pain include:
- Pain that’s often worsened by holding your head in one position for long period
- Neck stiffness
- Muscle tightness and spasms
- Decreased ability to move turn your neck or move your head
- Headache
- Radicular pain – pain that radiates along a nerve from the neck into the shoulder and arm
- Cervical radiculopathy – neurological deficits (such as problems with reflexes, sensation, or strength) may be experienced in the arm due to nerve root compression.
- Trouble with gripping or lifting objects – this can happen if numbness or weakness goes into the arm or fingers.
Neck pain requires immediate attention if related to a more serious underlying condition such as infection, spinal cord compression or cancer, accompanied by the following symptoms:
- Radiating pain, numbness or weakness into both arms or legs
- Problems with balance or coordination
- Loss of bowel or bladder control
- Unintended weight loss
- Fever or chills
- Severe headache with stiff neck
Risk Factors
Common risk factors associated with neck pain are:
- Reduced neck strength
- Previous neck problems
- Poor posture
- Smoking
- Labor-intensive occupation
- Gender
- Feelings of low support from work, family, or friends
- Psychological distress/stress
- Poor perceived general health
Diagnosis
Neck pain is diagnosed through a history and physical examination. Certain imaging tests are also helpful, including x-ray, CT scan or MRI. Other diagnostic tests that may be helpful include electrodiagnostic studies and blood tests.
Treatment
Treatments for neck pain may include:
- Relative rest, application of ice or heat and gentle stretches
- Physical therapy
- Medications
- Trigger point injections
- Photobiomodulation
- Acupuncture
- Mind-body medicine techniques to manage stress and improve resilience
- Lifestyle medicine interventions to manage behaviors that directly impact pain and musculoskeletal health – such as dietary changes to reduce inflammation and sleep strategies to promote restful sleep and healing
- Massage therapy
- Postural education
- Ergonomic modification
- Interventional pain management procedures or surgical options may be necessary in severe cases
Prevention
The following are tips to prevent neck pain from developing or worsening:
- Be mindful of your posture. To help prevent neck pain, keep your head centered over your spine.
- Take frequent breaks from sitting at your desk.
- Adjust your desk, chair, and computer so that the monitor is at eye level.
- Use a headset or speakerphone when possible to avoid poor posture related to phone use.
- Minimize time on your cell phone. Looking down at your mobile device for an extended period of time puts excessive strain on the neck muscles.
- Quit smoking. Smoking can put you at higher risk of developing neck pain and many other musculoskeletal and health disorders.
- Avoid carrying heavy bags with straps over your shoulder to avoid straining your neck muscles.
- Sleep in a good, comfortable position, on your back if you can.
- Engage in healthy behaviors (such as good eating habits) to optimize the body’s immunity and innate healing mechanisms.
- Exercise and stretch your neck.
- Stay hydrated.
- Stress is directly related to neck pain – minimize stress by practicing mindfulness, meditation, and breathing exercises
