According to a recent report in the Annals of Internal Medicine, roughly 13 percent of American adults suffer from neck pain at any given time.
About two thirds of people will experience neck pain at some time in their lives. Prevalence is highest in middle age. In the United Kingdom, about 15 percent of hospital-based physiotherapy, and in Canada 30 percent of chiropractic referrals are for neck pain. In the Netherlands, neck pain contributes up to 2 percent of general practitioner consultations.
The disc is the major cause of chronic neck pain in about 25% of patients, and there can be both disc pain and facet pain in some people.
Neck pain can be caused by problems with the soft tissues of the neck (muscle, ligaments, and nerves) or by problems with the bones and joints. Infections, tumors, and congenital abnormalities can also cause neck pain, but these are less common.
Problems of the soft tissues include:
- Injury or trauma which is most commonly caused by automobile or diving accidents, contact sports, or falls.
- Muscle strains caused by stress, poor posture (including postural changes due to scoliosis, leg-length differences, and pelvic torsion), and teeth grinding or clenching.
- Nerves trapped by bulging or herniated discs or a narrowing of the disc space.
Problems of the bones or cervical disks include:
- Degenerative and inflammatory diseases such as osteoarthritis and rheumatoid arthritis.
- Cervical disc degeneration, bone spurs, and spinal stenosis.
- Cervical disc bulge and herniation.
Neck pain can range from mild to severe, acute, lasting from one day to three weeks, to chronic, lasting longer than three months. “Most uncomplicated neck pain is associated with poor posture, anxiety and depression, neck strain, occupational injuries, or sporting injuries. With chronic pain, mechanical and degenerative factors (often referred to as cervical spondylosis) are more likely. Some neck pain results from soft tissue trauma, most typically seen in whiplash injuries. Rarely, disc prolapse and inflammatory, infective, or malignant conditions affect the cervical spine and present as neck pain with or without neurologic features.
Treatment of neck pain depends on its cause, severity, and duration. For acute neck pain caused by muscle strain or minor injury, the best treatment is often home care, including rest, over-the-counter anti-inflammatory pain relievers such as aspirin, ibuprofen, and naproxen sodium, ice (for inflammation), or heat (to relax sore muscles). For pain that does not respond to home care or becomes chronic, treatment may consist of the following:
- Physical therapy and exercise. Treatment may include heat, ice, ultrasound, muscle stretching, and muscle strengthening.
- Cervical traction. This may be particularly helpful in cases of nerve root irritation.
- Chiropractic or osteopathic manipulation.
- Modifications to daily activities that exacerbate pain.
- Short-term immobilization with a cervical collar.
- Pain medications. These may include narcotics, opioid analgesics, muscle relaxants, and tricyclic antidepressants that may reduce nerve root pain.
- Corticosteroid medications or nerve root block injections to reduce nerve root pain caused by herniated disks.
- Surgery. A last-ditch option for those with problems of the cervical vertebrae that cause nerve root pain.
Some people are now using yoga to relieve neck pain. “Of respondents using yoga in the previous 12 months, 64% reported using yoga for wellness, 48% for health conditions, and 21% specifically for back or neck pain.”
Seek immediate medical attention for neck pain and stiffness accompanied by headache and fever, especially when the neck is so stiff that the chin cannot be brought toward the chest. These are symptoms of spinal meningitis. A doctor’s visit is also warranted for pain that is continuous, persistent, and/or severe, pain that radiates into the shoulder, arms, or hands, pain that is accompanied by headaches, numbness, tingling, loss of strength, and/or changes in bladder or bowel habits. These may be signs of a neurological problem.
