Overview

Most people will have a minor neck problem at one time or another. Our body movements usually don't cause problems. But sometimes symptoms can develop from everyday wear and tear, overuse, or injury. Neck problems and injuries most often occur during sports or recreation activities, work-related tasks, or projects around the home.

Neck pain may feel like a "kink," stiffness, or severe pain. Pain may spread to the shoulders, upper back, or arms. Or it may cause a headache. Neck movement may be limited, usually more to one side than the other. Neck pain means pain anywhere from the area at the base of the skull into the shoulders. The neck includes:

Neck pain may be caused by an injury to one or more of these areas. Or it may have another cause. Home treatment will often help relieve neck pain caused by minor injuries.

Activities that may cause neck pain

Neck pain is often caused by a strain or spasm of the neck muscles or inflammation of the neck joints. Examples of common activities that may cause this type of minor injury include:

• Holding your head in a forward posture or odd position while you work, watch TV, or read.
• Sleeping on a pillow that's too high or too flat or that doesn't support your head, or sleeping on your stomach with your neck twisted or bent.
• Spending long periods of time resting your forehead on your upright fist or arm ("thinker's pose").
• Stress. Tension may make the muscles that run from the back of the head across the back of the shoulder (trapezius muscle) feel tight and painful.
• Work or exercise that uses your upper body and arms.

Sudden (acute) injuries

Minor neck injuries may occur if you trip, fall a short distance, or twist your spine too much. Severe neck injuries may be caused by whiplash in a car crash, a fall from a high place, a direct blow to the back or the top of the head, a sports-related injury, a penetrating injury such as a stab wound, or external pressure applied to the neck, such as strangulation.

Pain from an injury may be sudden and severe. Bruising and swelling may occur soon after the injury. Acute injuries include:

• An injury to the ligaments or muscles in the neck. Examples of this are a sprain or strain. When neck pain is caused by muscle strain, you may have aches and stiffness that spread to your upper arm, shoulder, or upper back. Shooting pain that spreads down the arm into the hand and fingers can be a symptom of a pinched nerve (nerve root compression). Shooting pain is more serious if it occurs in both arms or both hands rather than just one arm or one hand.
• A fracture or dislocation of the spine. This can cause a spinal cord injury that may lead to lifelong paralysis. It's important to use correct first aid to immobilize the injured person and then move the person the right way to reduce the risk of lifelong paralysis. If you think that the spinal cord may be injured, don't try to move the person.
• A torn or ruptured disc. If the tear is large enough, the jellylike material inside the disc may leak out (herniate) and press against a nerve or the spinal cord (central disc herniation). You may have a headache, feel dizzy or sick to your stomach, or have pain in your shoulder or down your arm.

Emergency care is required for a neck injury that causes damage to the spinal cord. Symptoms of a spinal cord injury include loss of movement or feeling, numbness, tingling, trouble controlling the muscles of the arms or legs, and loss of bowel or bladder control.

Conditions that may cause neck problems

Neck problems may not be related to an injury.

• Arthritis or damage to the discs of the neck can cause a pinched nerve. Neck pain caused by a pinched nerve most often affects one side of the neck and the arm on that side. Other symptoms may occur, such as numbness, tingling, or weakness in the arm or hand.
• Meningitis is a serious viral or bacterial illness. It causes inflammation around the tissues of the brain and spinal cord. Symptoms come on quickly and include a severe headache, a stiff neck, a fever, and sometimes vomiting. The neck stiffness makes it hard or impossible to touch the chin to the chest.
• The flu, which usually is not serious, can cause symptoms similar to meningitis. When neck pain is caused by flu, the neck and the rest of the body tend to ache all over. But there is no severe neck stiffness.
• Neck pain that occurs with chest pain may be caused by a serious problem with the heart, such as a heart attack.
• Stress and tension may make the muscles that run from the back of the head across the back of the shoulder (trapezius muscle) feel tight and painful. You may not be able to move your head without pain.
• Torticollis is caused by severe muscle contraction on one side of the neck. This causes the head to be tilted to one side. The chin is usually rotated toward the opposite side of the neck. Torticollis may be present at birth (congenital) or caused by injury or disease.

Treatment

Treatment for a neck problem or injury may include first aid, physical therapy, manipulative therapy (such as chiropractic or osteopathic), and medicine. In some cases, surgery is needed. Treatment depends on:

• The location and type of injury, and how bad it is.
• Your age, health condition, and activities (such as work, sports, or hobbies).

Self-Care

First aid for possible spinal injury

The possibility of a spinal injury must be considered anytime an accident involves the head, face, neck, or back. Permanent paralysis may be avoided if the injured person is kept from moving (immobilized) and is transported correctly.

Do not move the person.

If you think the person may have a spinal injury, do not move them unless there is an immediate threat to their life, such as a fire. If there is immediate danger, keep the person's head and neck supported and in a straight line while you move them to a safe place.

Do not remove the person from the water if they were in a diving accident. Float the person face up in the water until help arrives.

Call emergency services.

Call 911 or other emergency services to transport the injured person if you think they may have a spinal injury. This will reduce the risk of more injury to the spinal cord.

Caring for a minor neck problem or injury

Try the following tips to help relieve minor neck pain, swelling, and stiffness.

• Try using heat or ice.
  • Use a heating pad on a low or medium setting for 15 to 20 minutes every 2 to 3 hours. Try a warm shower in place of one session. You can also buy single-use heat wraps that last up to 8 hours.
  • You can also use an ice pack for 10 to 15 minutes every 2 to 3 hours.
• Do your normal daily activities.

  Keep doing your usual daily activities unless you have severe neck and back pain. Make changes to or avoid any activity that makes your pain worse.

• Rub the area.

  Gently massage or rub the area to help relieve pain and to encourage blood flow. Don't massage the affected area if it causes pain.

• Watch your posture.

  Avoid slouching or a head-forward posture.

• Use a neck pillow.

  When you sleep, place a small support pillow under your neck, not under your head.

• Do neck exercises.

  When the pain starts to get better, do exercises such as neck stretch to the side, neck stretch to the diagonal, and dorsal glide stretch. Don't do any exercises that cause pain.

• Try a massage.

  If tension is adding to your neck pain, massage may help.

• Don't smoke or use other tobacco products.

  Smoking slows healing because it decreases blood supply and delays tissue repair.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• New or worse weakness or numbness in arms.
• Neck pain does not improve, or it gets worse.
• Symptoms occur more often or are more severe.

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