Neck Pain

WHAT’S THE CAUSE? 

Neck muscles can be strained from poor posture — whether it’s leaning into your computer at work or hunching over your workbench at home. Wear-and-tear arthritis also can result in neck pain. Rarely, neck pain is a symptom of a more serious problem.

Common causes of neck pain include

• Muscle strain. Overuse, such as too many hours hunched over a steering wheel, can trigger muscle strain. Even such minor things such as reading in bed or gritting your teeth can strain your neck muscles.
• Arthritic joints. Just like all the other joints in your body, your neck joints tend to undergo wear and tear with age, which can cause osteoarthritis in your neck or cervical spondylosis. Cervical spondylosis is a general term for age-related wear and tear affecting the spinal disks in your neck.
• Nerve compression. Herniated disks or bone spurs in the vertebrae of your neck can take up too much space and press on the nerves branching out from the spinal cord.
• Injuries. Rear-end auto collisions can result in whiplash injuries, which occur when the head is jerked backward and then forward, stretching the soft tissues of the neck beyond their limits.
• Diseases. Neck pain can sometimes stem from diseases such as rheumatoid arthritis or meningitis.

 WHAT TESTS TO EXPECT 

In addition to a physical exam, your doctor may order imaging tests to get a better picture of what might be causing the pain. These may include:

• X-rays. X-rays can reveal areas in your neck where your nerves or spinal cord may be pinched by bone spurs or a bulging disk.
• Computerized tomography (CT) scan. A CT scan provides detailed views of the internal structures of your neck.
• Magnetic resonance imaging (MRI). An MRI may be used to get detailed views of the spinal cord and the nerves coming from the spinal cord.

If your doctor suspects that your neck pain may be related to a pinched nerve, he or she may suggest a test called electromyography (EMG). It involves inserting very fine needles through your skin into a muscle to determine whether specific nerves are functioning properly. Blood tests may be ordered if an infection or inflammation is thought to be at fault. If you have a stiff neck and fever and meningitis is suspected, he or she may recommend a lumbar puncture (spinal tap) to analyze your spinal fluid.

TREATMENT 

Most neck pain responds well to self-care. If the pain persists, your doctor may recommend other treatments.

Self-care

1. Over-the-counter pain relievers
2. Heat and cold. To reduce inflammation, apply cold to your neck for up to 20 minutes several times daily. You can use an ice pack or ice wrapped in a towel. You might alternate the cold treatment with heat, such as a heating pad on the low setting. Heat can help relax sore muscles, but it sometimes aggravates inflammation, so use it with caution.
3. Rest. Lie down from time to time during the day to give your neck a rest from holding up your head. But avoid prolonged rest. Too much inactivity can cause increased stiffness in your neck muscles.
   
4. Gentle stretching. Gently move your neck to one side and hold it for about 30 seconds. Then move it to another position. Stretch your neck in as many directions as your pain allows.

Medications

If over-the-counter medications aren’t helpful, your doctor may prescribe prescription pain medicine. Muscle relaxants or tricyclic antidepressant medications also may be used to treat pain.

Therapy

Possible treatments include:

Neck exercises and stretching. A physical therapist can teach you about neck exercises and stretches. Exercises may improve pain by restoring muscle function, optimizing posture to prevent overload of muscle, and increasing the strength and endurance of your neck muscles.

Traction. Traction uses weights and pulleys to gently stretch your neck and keep it immobilized. This therapy, under the supervision of a medical professional and physical therapist, may provide relatively fast relief of some neck pain, especially pain related to nerve root irritation.

Short-term immobilization. A soft collar that supports your neck may help relieve pain by taking pressure off the structures in your neck. If used for more than two weeks, however, a collar may do more harm than good.

Surgery and other procedures
Possible treatments include:

Steroid injections. Corticosteroid medications may be injected near the nerve roots, into the small facet joints in the bones of the cervical spine or into the muscles in your neck to help with the pain. Numbing medications, such as lidocaine, also can be injected to relieve your neck pain.

Surgery. Surgery is rarely needed for neck pain, but it may be an option for relieving nerve root or spinal cord compression.

Excerpt From: The Mayo Clinic. “Mayo Clinic A to Z Health Guide”.