The neck muscles constantly work to hold up the head. The head itself is quite heavy, and without proper posture, the neck muscles can be unnecessarily strained to hold the head up. Gradual tightening of the neck muscles can cause neck pain, or cervicalgia, also known as a stiff neck. This is different from neck strain, which is normally short-lived.
There are three types of neck pain: axial, radiculopathy and myelopathy.
- Axial neck pain is pure neck or soft tissue pain. It is commonly caused by muscle strain or whiplash.
- Radiculopathy neck pain occurs in the arms and neck, and is caused by nerve root compression. This can cause pain, numbness, or weakness in the arms.
- Myelopathy is caused by pressure on the spinal cord. Symptoms include neck pain with arm or leg weakness, numbness or difficulty walking.
All three types of neck pain can be either chronic or acute. Acute pain happens unexpectedly, often due to injury, and usually stops after a short amount of time. Chronic pain is continuous and spans over at least three months.
Wellness & Prevention
Neck pain can stem from a large array of causes:
- Stiff neck
- Muscle strain
- Poor posture
- Overuse of neck muscles
- Pinched nerve
- Carotid artery dissection (a tear in a neck artery resulting in blood entering the artery wall)
- Herniated discs
- Spondylosis (spinal degeneration or spinal arthritis)
- Spinal stenosis (narrowing of the open spaces in your spine, causing pressure on the spinal cord and nerves)
- Pain from acute coronary syndrome (blocked blood supply to the heart)
- Bone or joint abnormalities
- Pain from upper back problems
- Spinal tumors
- Degenerative diseases
Because of the wide range of possible causes, neck pain is not always preventable. A stiff neck can come from another, unrelated health problem. However, practicing good posture by maintaining the head in an upright position over the neck instead of forward tilting can help prevent overuse of the neck muscles and unnecessary strain.
There are a variety of tests that can be used to diagnose neck pain:
- X-rays capture an image of bones and other skeletal structures. They can help pinpoint narrowed disc space, fractures, bone spurs, arthritis and other abnormalities.
- Magnetic Resonance Imaging (an MRI scan) produces detailed pictures of the organs and tissues in the body. It is used for detecting defects in the spinal cord, such as bulging discs, pinched nerves, disc herniation and soft tissue.
- Myelography uses dye combined with an X-ray to examine the spinal canal. This is used to find irregularities in the spinal cord, spinal canal and nerve roots.
- Computed Tomography (CT) scans use a computer to view the spine and neck from different angles.
- Electromyography (EMG) can detect nerve damage by assessing the health and function of the nerves that control the muscles and provide sensation.
Because the spine is such a complex part of the body, not all cases of neck pain are identical. With so many components, factors and possibilities in spine care, it’s very important to create individualized treatment plans for each person’s needs. Customized treatment plans lead to more effective treatments and better outcomes.
Acute neck pain can often be treated with rest, heat or ice therapy, and over-the-counter pain relief medication. For chronic neck pain, surgery may be considered if conservative treatments are unsuccessful.
Typically, conservative treatments are considered first. A conservative treatment is one that does not involve surgery. These neck pain treatments may include:
- Exercise that loosens and stretches the muscles around the neck area to reduce stiffness, pressure and pain.
- Joint manipulation to help restore full joint mobility by stretching and relaxing muscles and connective tissue. This can involve massage therapy, chiropractic treatment and physical therapy.
- Medications that are appropriate for neck pain can include non-steroid anti-inflammatory drugs, acetaminophen, muscle relaxers, antidepressants and over-the-counter topical creams and patches. It is important to consult a physician before self-medicating, as every medication can have potential risks.
- Spinal injections to reduce pain and inflammation.
- Spinal cord stimulators may be recommended to relieve chronic neck pain.
If neck pain fails to respond to conservative treatment, surgery may be an option. There are several types of neck surgery:
- Anterior Cervical Discectomy: A discectomy performed to help the cervical spine.
- Chiari Decompression: The bone at the back of the skull and spine is removed to relieve pressure.
- Corpectomy: Surgery that removes all or part of a vertebrate to decompress the spinal cord and nerves.
- Disc Replacement: A device is placed in the spine to mimic the functions of a disc.
- Discectomy: Removal of a spinal disc that is out of alignment, which causes it to press on the nerves
- Foraminotomy: Widens the nerve root opening to relieve pressure.
- Laminectomy: Removes the back part of the vertebra that covers your spinal canal.
- Microdiscectomy: When a special microscope is used to aid in performing a discectomy.
- Spinal Fusion: Allows two or more vertebrae to grow together to stop excess motion between them.
- Surgery for Spinal Deformity: The exact technique varies depending on each person’s condition.
Living with a stiff neck or constant neck pain is challenging and uncomfortable. To manage and recover from neck pain, you are recommended to rest, practice proper posture and possibly wear a special neck collar to help the muscles relax and maintain correct positioning. If neck pain becomes chronic or worsens, you should see a doctor.