Neck Pain - An Overview

Most Cases Resolve in Less Than 3 Months

neck pain
Photo by Amanda Rohde (iStockphoto)

Neck pain can originate from various parts of the anatomy, including soft tissue next to the spine, intervertebral joints and disks, compression of the spinal cord or nerve roots, and referred pain. Determining the cause can be difficult because there are several possibilities: trauma or injury, tumor, degenerative changes, infection, and autoimmune diseases (e.g., rheumatoid arthritis, ankylosing spondylitis).

Neck pain can be a sticky wicket for diagnosticians -- not only must they determine the cause of the pain, they must determine which patients can get relief from conservative approaches and which require more aggressive treatment.

Neck pain can be quite severe, but most people improve within 1-2 weeks and many are fully resolved in 8-12 weeks, according to the American College of Rheumatology. About 10% of the population experience some degree of neck pain each year. While neck pain may be slightly more prevalent among women than men, it can occur in anyone of any age.

Anatomy and Symptoms

There are 7 vertebrae in the cervical spine, numbered C1 through C7. C1 (atlas) and C2 (axis) differ in their anatomy than C3-C7. Neck pain can be localized to the cervical spine area or it can radiate down an arm, a condition known as radiculopathy.

Symptoms of neck pain can be simply that, pain in the neck.

There also can be stiffness of the neck and limited range of motion. If nerves are involved, there can be numbness, tingling, or weakness in the arm or hand.

Diagnosing Neck Pain

Initially and most importantly, the diagnosis of neck conditions is based on findings from a patient's medical history and a physical examination.

That's usually enough to decide upon a course of therapy. If other conditions need to be ruled out, such as soft tissue problems, herniated discs, spinal stenosis, tumors, or nerve injury, it may be necessary to have x-ray, MRI, or CT scan.

Causes of Neck Pain

The majority of neck pain issues are associated with mechanical disorders, not systemic disease. Only about 10% of neck pain cases are systemic. There can be common causes, resulting in neck strain: overuse of the neck and arms, bending over a desk for a prolonged period, wrong position of a computer monitor causing neck strain, sleeping in the wrong position. Neck pain can also be associated with aging. Accidents or falls can cause vertebral fracture, whiplash, or paralysis. Other causes of neck pain include:

Cervical disc herniation - Intervertebral disc herniation of the cervical spine causes radicular pain which radiates from the shoulder to the forearm to the hand.

Cervical spondylosis (Cervical disc degeneration) - Osteoarthritis of the cervical spine is synonymous with disc degeneration.

The gelatin-like center of cervical discs degenerates and the space between the vertebrae narrows. As it narrows, more stress is applied to the joints in the cervical spine, causing more degeneration.

Spinal stenosis - Spinal stenosis is a condition caused by narrowing of the spinal canal. If the narrowing occurs in the cervical region of the spine, the neck is involved.

Myelopathy (spinal cord dysfunction) - Myelopathy usually develops because of spinal cord compression by osteophytes, ligamentum flavum (ligaments of the spine), or spinal stenosis.

Treating Neck Pain

The two primary goals of treatment are relieving neck pain and preserving motion in the neck. Gradual, gentle movement through the neck's full range of motion is essential. Other modes of treatment for neck pain include:

  • 5 to 10 minute ice massages in the first 48 hours of a pain episode.
  • Heat application for neck pain lasting more than 48 hours.
  • Over-the-counter medications, including acetaminophen and NSAIDs, to relieve pain.
  • Muscle relaxants may help in some cases.
  • Massage therapy.
  • Cervical spine surgery in rare cases.


Neck Pain. American College of Rheumatology. David Borenstein, M.D. February 2012.

Neck Pain. OrthoInfo. December 2013.

Neck Pain. MedlinePlus. 4/16/2013.

Mechanical Disorders of the Cervical Spine. Primer on the Rheumatic Diseases. Thirteenth edition. P.64.

Clinical Features and Treatment of Gout. Burns and Wortmann. Chapter 95. Kelley's Textbook of Rheumatology. Volume II. Elsevier Saunders.

Continue Reading