6 Common Causes and Treatments

How is neck pain diagnosed?

Usually, a medical history and a physical exam are enough for a healthcare provider to diagnose the cause of neck pain. A healthcare provider will first eliminate serious causes of neck pain, like pressure on your spinal cord, myelopathy, an infection or cancer.

• Medical history: Your provider will ask about previous neck injuries that may have caused whiplash or a herniated disk. They may ask about work or other activities that could strain your neck. They’ll ask about your pain, including when it started, where it’s located, how long it lasts and how intense it is.
• Physical exam: Your provider will check your head and neck alignment and observe your range of motion when you move your neck. They’ll feel your neck and supporting muscles to check for tenderness and signs of strain.
• Imaging tests usually aren’t necessary to identify what’s causing neck pain. Still, a provider may take images of the inside of your neck if they suspect a serious injury or if you’re experiencing severe pain that doesn’t improve.
• X-rays: X-rays can show problems with your bones or soft tissues that may be causing neck pain. An X-ray can show issues with cervical alignment, fractures and slipped disks, and they can detect arthritis.
• Magnetic resonance imaging (MRI): An MRI can show problems with your spinal cord, nerves, bone marrow and soft tissue. It can show if a disk has slipped out of place, signs of infection and masses that may be causing neck pain, like a cyst or tumor.
• Computed tomography (CT) scan: A CT scan may be used if an MRI isn’t available. It can show bone spurs and signs of bone deterioration.

In rare instances, your provider may order additional tests, including:

• Electrodiagnostic tests: These tests check the function of nerves and your muscle response. Tests include nerve conduction studies and, rarely, a myelogram if an MRI is contraindicated.
• Lab tests: These tests can help your provider identify causes of neck pain other than musculoskeletal injuries, like infections, rheumatological conditions or cancers. Tests include a complete blood count (CBC), urinalysis and markers of inflammation, among others.

How is neck pain managed or treated?

Treatment aims to relieve your pain and improve movement in your neck. Most causes of neck pain eventually improve and can be managed at home. Your provider will suggest treatments to manage your symptoms, including:

• Pain medications and muscle relaxers: Medicines, including nonsteroidal anti-inflammatory drugs (NSAIDs) to ease neck pain and inflammation, and muscle relaxants to help your neck muscles heal, are common first-line treatments for neck pain.
• Physical therapy: You may work with a physical therapist or a fitness trainer to learn exercises and movements that strengthen the muscles and tendons in your neck and improve flexibility.
• Transcutaneous electrical nerve stimulation (TENS) unit: A TENS unit applies a low-level electrical current to your skin near your nerves to disrupt the pain signal causing discomfort. Always check with a healthcare provider before using a TENS unit.
• Steroid injections: A shot near the nerve roots can reduce inflammation and relieve pain.
• Alternative therapies: Your provider may recommend acupuncture to relieve pain, or massage to help loosen tightened muscles contributing to your discomfort. You may see an osteopath or chiropractor to align your spine.
• Surgery: Most causes of neck pain don’t require surgery. Still, you may need surgery if one or more of the vertebrae in your spine has shifted out of place or is putting pressure on your nerves.

If your pain is severe, you may need to work with a spine or pain specialist.

What can I do to relieve neck pain at home?

In addition to taking pain relief medications, you can take steps at home to relieve neck pain, including:

• Hot therapy: Take a hot shower or place a hot towel or heating pad (on the lowest setting) on the site of your pain for 15 minutes every few hours. The heat loosens your muscles and promotes blood flow.
• Cold therapy: Place a cold pack or a bag of frozen vegetables (wrapped in a thin towel to protect your skin) for 15 minutes every few hours. The cold narrows your blood vessels, reducing inflammation and swelling. Use cold instead of heat immediately after an injury.
• Exercise: Follow your healthcare provider’s guidance on neck exercises you can try to relieve neck pain and improve your range of motion. Don’t attempt exercises if you have a serious neck injury or a pinched nerve.
• Stress reduction techniques: Mindfulness, meditation, breathing exercises and yoga can help relieve tension in your body that may contribute to neck pain.
• Quit smoking: Smoking damages bone structure, accelerates degenerative disk disease and slows healing.

How long does neck pain (cervicalgia) take to heal?

Healing time depends on what’s causing your neck pain. Neck pain caused by common issues like strains and stress usually improves within a week or two. It may take a few months before the pain disappears entirely.

How can I prevent neck pain?

You can take steps to prevent neck pain related to strains and tense muscles.

• Practice good posture. Position electronic devices, like computers and phones, so you don’t have to slouch or strain your neck when using them. Keep your shoulders aligned and your back straight when seated so you’re not straining your neck. Adjust the seats in your car to maintain good posture while traveling.
• Adjust your sleep position.Maintain good posture when you’re asleep. If you sleep on your back or side, use a pillow to support your head so your head and neck are aligned with the rest of your body. If you sleep on your back, place a pillow underneath your knees to take additional pressure off your low back. Avoid sleeping on your stomach with your head turned.
• Stay active.You can use many of the same exercises used to relieve neck pain to prevent it. If you work a job that involves sitting for long periods, take occasional breaks to move around and stretch your entire body, including your neck muscles.
• Don’t carry heavy weight on your shoulders.Avoid carrying heavy objects like book bags or suitcases over your shoulder. Instead, consider using luggage or bags with wheels.
• Exercise your upper back extensor muscles. It’s normal to lose strength in your upper back as you age. As a result, your shoulders rock forward, and your head tips forward in a position in front of your spine. This positioning puts additional strain on your neck and upper back.

Exercises that can help strengthen your upper back extensor muscles include:

• Scapular squeezes: Pinch your shoulder blades together 10 times.
• Standing push-ups: Do push-ups in a doorframe, allowing your shoulders to go past your hands 10 times.
• Theraband rowing: Wrap the middle of a theraband around a doorknob so it’s stable. While standing, grab an end with each hand. Pull your hands toward your waist 10 times.