As we get older, we start to notice that our bodies do too. We may wake up one morning with a stiff neck, or after a long day sitting at our laptop, we feel pressure on our backs. Neck pain affects almost all of us at least once in our lives. In fact, studies have found that one in five people every year experience neck pain. While sometimes we can attribute it to a certain event, other times it may appear as if out of thin air.
For the most part, neck pain will go away on its own with adequate self-care. However, in some circumstances, neck pain could point to a more serious underlying issue that requires medical attention. In this article, we will address possible causes of neck pain, when to see a doctor, and treatments for chronic neck pain.
Causes of Neck Pain
When determining neck pain causes, it is important to keep in mind that every person’s spine is unique and can be shaped around their daily routine. The neck is a part of the body where several important muscles, bones, blood vessels, and nerves are grouped closely together. Therefore, the cause of neck pain can be attributed to any injury or illness affecting one or more of these areas.
Some common causes include:
- Muscle strain from carrying heavy loads or overworking the body at the gym
- Sleeping on your stomach with your head turned at a bad angle
- Holding the head at a bad angle while working or using the phone (craning the neck down excessively)
- Trauma from an injury or fall
- Pinched nerves due to spinal stenosis, cervical spondylosis, or a herniated disc
- Emotional stress
- Osteoarthritis or rheumatoid arthritis involving the cervical spine
When To See a Doctor for Neck Pain
Mild cases of neck pain should go away on their own with proper self-care. Under some circumstances, some or all of your symptoms may suggest you need medical attention. In rare cases, you may need to visit the emergency room. You should speak with a medical professional if any of the following situations apply to you.
Your pain keeps you up at night
Back pain at night is usually not life-threatening, but when it is accompanied by a fever, it can be a sign of an infection such as meningitis. Infections can spread quickly throughout the body, so it is important to go to the emergency room for an exam.
You’ve had cancer
First-time back pain combined with a history of cancer can be a warning sign of cancer recurrence. Growing cancer can put pressure on organs, nerves, and/or blood vessels, resulting in back pain. This pain may not emerge until the tumor becomes large, so it’s important to get checked out by a medical professional if you have a history of cancer.
You are over 50
As we get older, the likelihood of experiencing back pain greatly increases. Aging can be accompanied by a more sedentary lifestyle resulting in weight gain and even obesity. The extra weight can put pressure on our spines, triggering back and neck pain.
Studies have found that perimenopause increases the prevalence of pain in people who menstruate. They are likely to experience back pain as a result of obesity when they go through this transition.
If you are over 50 and have back pain and have gone through perimenopause, your medical provider may recommend treatments to control the pain, such as medication, physical therapy, and weight management.
Incontinence or leg weakness
Although rare, back pain accompanied by incontinence or leg weakness can be a sign of a more serious health condition. If controlling your bladder or bowel has rapidly become a challenge, you have a loss of sensation in the seat area, and/or you notice that your legs have been growing progressively weaker, you should seek immediate care in the emergency room. These are symptoms of cauda equina syndrome, a very serious condition that typically requires back surgery.
You had a fall or accident
Regardless of whether you were able to walk away after a fall or accident, you should see a medical professional if you experience any new back or neck pain after a fall or other trauma. If you experience a fall or are in an accident and have osteoporosis, you are at greater risk of a spine injury.
Pain radiates down one leg or arm
A shooting pain that travels down one leg or arm is a symptom of sciatica. Sciatica is usually caused by pressure on a spinal nerve root (radiculopathy), but sometimes it can be due to a tight piriformis muscle (leading to piriformis syndrome).
A healthcare provider will be able to diagnose you with sciatica by testing your dermatomes, the areas of skin that are served by spinal nerve roots. This testing can help them pinpoint the exact spinal nerve root or roots that are causing the irritation.
Bending or flexing worsens symptoms
You may notice pain in your neck along with leg pain that worsens when you bend over or hug your knees to your chest. This could indicate disc problems such as bulging discs, herniated discs, or degenerative disc disease. It should be checked out by a medical professional to prevent further injury.
You are experiencing other spinal stenosis symptoms
If you notice any of the following symptoms, especially when you walk, you may have spinal stenosis:
- Pain and/or tingling in your legs, especially when you walk, are classic symptoms of spinal stenosis.
These symptoms are called neurogenic claudication, and it is recommended that you seek medical attention to determine whether you have spinal stenosis.
Your pain persists
Neck pain that persists for several weeks without easing up is referred to as chronic neck pain. Resulting from an injury, neck pain may ease during the healing phase, but in some circumstances, it may continue and point to a more serious issue. Your healthcare provider will be able to help determine the underlying cause and develop a treatment plan for you after an exam.
Treatments for Chronic Neck Pain
Mild to moderate cases of neck pain usually ease up after two to three weeks of self-care. Your pain may respond to heat and pain-relievers, resolving itself on its own.
In some cases, neck pain doesn’t go away. When this happens, it turns into chronic neck pain and may require more serious methods of treatment, so please see your doctor for an exam.
To relieve your pain, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve), or acetaminophen (Tylenol, others), are commonly prescribed. Your doctor may prescribe muscle relaxers such as cyclobenzaprine if your neck pain is caused by muscle spasms – when the muscle tightens up or cramps suddenly.
You should take these medications only as directed by your doctor or pharmacist. Always read the label. Overuse can cause side effects.
Therapy for neck pain can take on many forms. Your healthcare provider may refer you to a physical therapist or an orthopedist to develop a treatment plan for you.
Physical therapy: A physical therapist can teach you correct posture, alignment, and neck-strengthening exercises. They may use heat, ice, ultrasound, massage, and cupping to help ease the pain. They may also try transcutaneous electrical nerve stimulation (TENS), which are electrodes in the form of patches that are placed on the skin near the painful areas. These patches deliver tiny electrical impulses that may relieve pain, although there is little evidence to support their effectiveness.
Soft neck collar: A soft collar that supports the neck can take some of the pressure off and may be useful when you are traveling or having a particularly tough day. However, it is important that you don’t become dependent on a soft neck collar. In the long-term, it can cause neck muscles to atrophy, and your neck may become accustomed to not having to work hard to hold the head up. Try not to use a soft neck collar for more than three hours at a time or for more than one to two weeks.
Alternative therapies: There are also an array of alternative therapies you can explore to relieve neck pain. Trigger-point therapy, acupuncture, massage, and chiropractic care can help reduce pain and inflammation. You may want to try yoga or pilates to improve your balance and posture. This can also help you develop stronger muscles to alleviate some pressure off the neck. Discuss alternative therapies with your medical professional and test them out to see which ones may work for you.
There are various surgical treatments available for people with chronic neck pain. These include:
Steroid injections: Offering usually only temporary relief, steroid medications can be injected near the nerve roots, into the spinal joints, or into the muscles in the neck. Numbing medications, such as lidocaine, also can be injected to relieve neck pain. A healthcare provider usually administers this in a facility where the patient is awake for the procedure.
Radiofrequency ablation: This treatment is usually prescribed to patients who have tried therapeutic injections and found no long-term resolution for their neck pain. Radiofrequency ablation involves a hot needle from high-energy electromagnetic waves administered into the neck targeting the nerves that carry pain impulses. These nerves are burnt off so that the body no longer responds to pain receptors.
Surgery: For more serious cases of neck pain that are usually the result of a serious fall or accident, spinal surgery may be required. This typically involves spinal cord compression or removing part of a damaged disc. Spinal surgery reduces mobility in the neck and can lead to greater health complications further down the line. It is generally considered a last resort.
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Frequently Asked Questions
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Low back pain in women before and after menopause. (2015).
The epidemiology of neck pain. (2010).
When to seek immediate medical attention for neck pain. (2021).