Neck Pain

Fast Facts

• Whiplash from motor vehicle accidents is a common cause of neck pain.
• Diagnosis is determined by medical history and physical examination, and rarely requires expensive or uncomfortable tests.
• Most improve by taking over-the-counter medication and remaining active.
• Most individuals are better in 1–2 weeks; more than 90% have no more pain after 8 weeks.

Neck pain can signal overuse problems, most commonly with the structures of the cervical spine (neck). 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 people with neck pain improve within 1–2 weeks, and the vast majority is over their episodes in 8–12 weeks.

Pain can be localized to the cervical spine or may travel down an arm (radiculopathy). All age groups are at risk of developing neck pain. People who sit in one location staring at computer screens for long periods of time may be at an increased risk. About 30% of the population has an episode of neck pain each year. Neck pain may occur slightly more frequently in women than men.

What Causes Neck Pain?

Only 10% of neck pain is associated with systemic illnesses, such as polymyalgia rheumatica, spondyloarthritis, rheumatoid arthritis, tumors, and infections.

The common mechanical disorders that cause neck pain are the following:

• Muscle strains - related to prolonged physical activity such as sitting at computer or sleeping in an awkward position.
• Osteoarthritis resulting from the narrowing of the intervertebral discs (cartilage between bone) of the spine. Bones grow spurs (growths of bone) in response to the increasing pressure placed on them. The bony growths can cause pain in the neck or arm related to nerve compression.
• Herniated intervertebral discs cause arm pain more frequently than neck pain. The pinching of a nerve in the neck causes severe arm pain.
• Spinal stenosis is narrowing of the spinal canal that causes compression of the spinal cord (cervical myelopathy). Sometimes it is associated with leg numbness, weakness, and loss of bladder or rectum control.
• Whiplash is a sudden and fast forward and backward injury to the soft tissues of the neck, most commonly caused by rear-impact car accidents. The pain and stiffness associated with these accidents generally develop 24–48 hours after the injury.

Diagnosing Neck Pain and Treating Neck Pain

A medical history and physical examination are the key parts of an evaluation. Individuals who do not respond to initial therapy may undergo plain X-rays, magnetic resonance imaging (MRI), or computerized tomography.

Maintaining motion is an important part of therapy for neck pain. The use of neck braces should be kept to a minimum. You may also consider seeing a physical therapist or occupational therapist. Ice applied to a painful area within the first 48 hours of the start of pain can help relieve pain as can heat, which relaxes the muscles. Over-the-counter pain relievers such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), frequently are enough to control episodes of neck pain. A small number 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 to live with neck pain is to try to prevent it. Take stretch breaks if at the computer for long. Smoking is a predisposing factor for neck pain. If you are overweight, try to increase your activity level and eat healthier to get into shape.

Updated April 2023 by Kanika Monga, MD, and reviewed by the American College of Rheumatology Communications and Marketing Committee.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.