Causes Of Neck Pain: Discovering Why You Need To Concern

 What is Neck Pain

Neck Pain
Neck Pain
Anatomically, neck is consisted of 7 cervical vertebrae. These cervical vertebrae and its associated intervertebral discs, ligaments and muscles are responsible for the stability and mobility of the neck. 

Neck pain or stiffness can be caused by any awkward posture, overuse, muscle imbalance, inflammation, or injury like whiplash injury. Neck pain can be localised and limited to neck region only. 

However, in some cases it may radiate towards other region like shoulder or arm which is then called a radicular neck pain. 

It can be classified as acute pain (duration up to 6 weeks) or chronic pain (duration more than 3 months to years). When neck pain is severe it hampers the activities of daily living and decrease quality of life. 

Neck pain is mostly treated effectively by correcting posture, using hot/cold packs at home and to some extent by over-the-counter medications. However, a severe, unbearable and radicular neck pain requires a thorough examination and treatment by qualified healthcare provider.

Causes of Neck Pain

There are a number of causes which may be responsible for Neck pain. Age related degeneration of disc, arthritis, narrowing of the spinal canal, muscle strain, poor posture and direct injury to neck are few to start with. 

Aging:  Neck pain can occur at any age however; it is more common among adults. There is degeneration of intervertebral disc and osteophyte formation as we grow old. This change in normal anatomy of the cervical spine can cause neck pain. 

Sleeping In An Awkward Position: Neck pain is very common in the morning if the head is positioned at a bad angle while sleeping.  There is bidirectional relationship between sleep quality and neck pain. Lack of proper sleep can cause neck pain and neck pain can result in sleepless nights 😊

Poor Posture and Physical strain:  Working in poor and awkward postures results in overuse of the neck muscles. Repetitive movements or strenuous motion is also responsible for neck pain. Working with a computer/mobile for long duration, repetitive movements, prolonged static loads may cause neck pain. Regardless of other conditions, neck pain is also an associated with eyestrain.

Injury: Direct trauma to cervical spine or neck region is another factor which can cause neck pain.  Whiplash injury is triggered by a sudden force which stretches the neck muscles and tendons leading to neck pain. However, patient with Whiplash injury also exhibits other complications like nonspecific headache, dizziness, and temporomandibular joint pain.

Cervical Spondylosis: Cervical spondylosis is an umbrella term which is used for a collection of abnormalities. These anomalies involve progressive degenerative changes which affect cervical spine including disc, vertebrae, ligaments and muscles. The probability of cervical spondylosis increases with age. It is mostly seen in the fourth decade of life.  In due course more than one intervertebral disc are affected due to its progressive nature.

Fibromyalgia: Patient with fibromyalgia have chronic widespread musculoskeletal pain. The most common complaint in fibromyalgia is neck pain. In addition to these other symptoms like extreme tiredness, sleep disturbance, cognitive dysfunction, and mood problems are also seen.

Autoimmune diseases: Rheumatoid arthritis, polymyalgia rheumatic, multiple sclerosis (MS), ankylosing spondylitis, systemic lupus erythematosus (SLE), myositis, and psoriatic spondylitis are some autoimmune diseases where neck pain is common complaint.

Psychological factors: Studies have found relationship between neck pain and stress, depression, anxiety, mood and emotions, cognitive functioning, and pain-related behaviors. Anxiety disorders were found to be the second most common comorbid disease associated with neck pain. Stress and depression may manifest a remote hyperalgesia. Sensitivity to pain is increased in individuals in hyperalgesia.

Other Factors:  Tumors, cysts and bone spurs can cause neck pain.

Common Symptoms of Neck Pain

  • Stiffness/tightening in neck muscles.
    Common Symptoms of Neck Pain
    Common Symptoms
  • Muscle spasm.
  • Dull aching to sharp stabbing or burning pain.
  • Pain on neck movement.
  • Pain can be localised to neck region or may radiate upwards (causing Headache) or downwards (causing shoulder or pain in arm).
  • Increase in pain on palpation.
  • Restrictive movements of head and neck.
  • In more severe and chronic neck pain, numbness, tingling and weakness in arm and forearm may be seen.

Diagnosis of Neck Pain

History and physical examination are first to perform by health care provider to narrow down the cause of neck pain. Physical examination may include palpation, compression and distraction of cervical spine.

Radiological Studies: This may include X-rays, MRI and CT scan. Radiological examination is done to find out damage to the vertebrae, intervertebral disc bulge, stenosis and/or involvement of ligaments and muscle.

Other Studies: Electromyography (EMG), nerve conduction velocity (NCV) and myelogram are other choice to get the status of the affected muscles and nerves. 

How Can I Prevent Occurrence of Neck Pain

We have seen that two main cause of neck pain are poor posture and age-related wear and tear. We cannot revert our age certainly however we can adopt or change work habits to prevent neck pain:
  • Maintaining a good posture. Keep your neck in neutral position when standing and/or sitting. Avoid bending your neck to look down at computer/mobile or other device.
  • Take frequent breaks. Do not work long hours at your computer. Try to take short break and perform stretching of neck and shoulders muscles
  • Adjust the height of desk, chair and computer to keep the monitor is at eye level. Use chair's armrests to avoid hanging your arms.
  • Be cautious while carrying heavy bags or luggage. The excessive weight can strain the neck muscles.
  • Sleep in good position. Avoid thick pillows. Use a small and comfortable pillow under your neck.
  • Do some exercise. Exercise to strengthen your neck and shoulder muscles and slow down age-related wear and tear.

Home Management for Neck Pain

When neck pain is not devastating and is not caused by severe injury or trauma the pain can be treated with self-care.
  • Take rest: Stop performing strenuous activities and movements which can worsen pain.
  • Hot and Cold Packs: Icing will reduce inflammation, swelling and pain. Hot packs are helpful to relax muscles and increase blood flow resulting in more supply of nutrients to the injured area. 
  • Gentle Stretching: If any movement or stretch aggravates pain, stop immediately.
  • Drugs: Go for over-the-counter medicines to relieve pain and inflammation.

Non Invasive Management Options for Neck Pain

Nonsteroidal anti-inflammatory drugs, muscle relaxants as well as physical therapy involving strengthening, stretching, and potentially traction and massage are all nonoperative treatment options available for neck pain. Epidural steroid injections may be considered for treatment however, risk of serious complications is high.

Nonsteroidal anti-inflammatory drugs and muscle relaxants are frequently given for treatment of acute cervical radiculopathy.

Studies supports exercises for the treatment of chronic neck pain. The type of exercise may vary from general land-based or aquatic exercise to neck-specific exercise focusing on endurance, strength, stretching or McKenzie exercises. 

Mobilisation and manipulation are the main component of manual therapy. The efficacy of manual therapy is well established for the treatment of neck pain.

Massage techniques are found to be beneficial in the treatment of patients with neck pain.


The use of  intermittent cervical traction is also a treatment option to manage chronic neck pain. 10% of total body weight (TBW) for cervical traction (CT) is established as ideal weight.

Therapeutic ultrasound is another choice for non invasive and conservative treatment for neck pain. It is safe to use and may reduce pain sensation. 

Transcutaneous electrical nerve stimulation (TENS) is the noninvasive method or application of electrical stimulation to yield analgesia. It is a simple, low-cost and safe intervention which is commonly used in clinical practice as an adjunct treatment for chronic neck pain.

Steroid injection can be considered for patients whose symptoms continue after four to six weeks of conservative treatment. Research showed substantial improvement in pain and function with epidural steroid injections for at least one year.

Surgery for Neck Pain

Surgery should be considered as last option only when conservative treatment for neck pain does not provide relief. The two most common surgery options for neck pain are

  • Anterior cervical discectomy and fusion
  • Cervical artificial disc replacement 

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  1. Good detailed information about neck pain. Thanks for sharing.

  2. I sometimes get neck pain from sleep positions and also poor posture so it was great to understand better the causes and ways I can improve this — thanks for sharing!

  3. I have a tens machine but never thought to use it for neck pain! Will definitely try this the next time it gets sore!

  4. Some great points. I was always a lover of ALL THE PILLOWS but recently cut down to one smaller pillow and it has made a significant difference in the way that my neck is feeling when I wake up in the morning.

  5. Great content.. I myself have frequent neck pains due to computer based job... Got to know a lot on how I can manage them now...

  6. As someone who experiences a lot of neck pain, I never realized that anxiety was linked to it. That’s new.

  7. Very informative! I personally cannot even use high pillows any more as they destroy my neck. It's kind of frustrating when I travel I have to say :(. Thanks for sharing this!

  8. I’ve always got some sort of neck pain because my posture is crap and I’m constantly working from my computer! There’s plenty of stretches I do to help it and I like to go for regular massages x


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