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Neck Pain

Neck Pain

Alternate Names

  • cervical pain
  • Site of neck X-ray
  • Neck X-ray

Definition

Neck pain is a relatively common complaint with many possible causes.

What is going on in the body?

Many people have had mild neck pain from time to time that goes away in a day or two. In some cases, however, neck pain can persist or be more severe. The causes of neck pain range from mild to life threatening.

Risks

What are the causes and risks of the condition?

Neck pain has many possible causes, including:
  • arthritis, an inflammation in the part of the spine located in the neck, usually due to osteoarthritis. Rheumatoid arthritis can also cause neck pain.
  • bone infections, known as osteomyelitis
  • Paget's disease, which causes bone deformities
  • a bulging or ruptured disk in the spine located in the neck, sometimes called cervical disk disease
  • muscle strain, such as occurs during whiplash or from lifting heavy objects
  • a broken or dislocated vertebra in the neck
  • a pinched nerve in the neck, which may occur after sleeping in the wrong position or with overuse or misuse of the neck muscles
  • cancer or a tumor, such as from cancer in the thyroid gland, breast cancer, or lung cancer that spreads into the neck
  • referred pain, which is pain that comes from another part of the body. For instance, neck pain can occur with a heart attack or heartburn, also called gastroesophageal reflux disease.
  • infections in the neck, such as a group A streptococcal infection of the throat. Ear infections, such as acute otitis media, and a viral infection of the thyroid gland, called subacute thyroiditis, are other causes.
  • psychological causes, such as anxiety, depression, or psychosis
Other causes are also possible. Sometimes no cause can be found.

Prevention

What can be done to prevent the condition?

Prevention is related to the cause. For instance, avoiding overuse or injury of the neck muscles can prevent these causes of neck pain. Many cases cannot be prevented.

Diagnosed

How is the condition diagnosed?

In some cases, such as following a whiplash injury in a car crash, the cause of neck pain is obvious from the history and physical exam. In other cases, further tests may be needed, depending on what is suspected. Blood tests can be used to help diagnose some infections in the thyroid gland.
Neck x-rays are commonly used, and can detect arthritis or broken or dislocated bones in the neck. Special x-ray tests, such as a CT scan or MRI, may be needed in certain cases. For instance, a CT scan can help detect bulging disks or tumors in the neck.

Long Term Effects

What are the long-term effects of the condition?

Any pain, when severe, can disrupt a person's life. Sleep, work, and other activities may be difficult. Other long-term effects are related to the cause. For instance, cancer can result in death.
A bulging disk or severe arthritis may cause muscle weakness, numbness, or even paralysis in the arms or hands. A broken or dislocated bone in the spine of the neck may cause permanent paralysis and numbness of the body below the head if the spinal cord is injured.

Other Risks

What are the risks to others?

Neck pain itself is not contagious. But if the cause is an infection, such as strep throat, the infection may be contagious.

Treatments

What are the treatments for the condition?

There are treatments available to reduce pain. These include aspirin, acetaminophen (i.e., Tylenol), and nonsteroidal anti-inflammatory medications, such as ibuprofen (i.e., Advil, Motrin). Stronger pain medications, such as the narcotics codeine and morphine, may be needed in some cases.
Other remedies are also available for some conditions, such as over-the-counter muscle pain creams for muscle strain. In some instances, a soft neck collar or more rigid neck brace may be needed to help relieve the pain.
It is also important to treat the cause, when possible. For instance, antibiotics can be used to treat strep throat. Medications can be used to control heartburn. Surgery can be used to repair a bulging or ruptured disk. Surgery, chemotherapy, or radiation therapy may be needed to treat a tumor or cancer.

Side Effects

What are the side effects of the treatments?

Side effects depend on the treatments used. All medications have possible side effects. For instance, antibiotics may cause allergic reactions, stomach upset, or headache. Surgery can be complicated by bleeding, infection, or an allergic reaction to the anesthetic.

After Treatment

What happens after treatment for the condition?

Some cases of neck pain go away on their own, such as muscle strain or a pinched nerve, and no further treatment is needed. Others may resolve with treatment, such as strep throat or a bulging or ruptured disk. Other causes, such as cancer, may result in death if treatment is not successful.

Monitor

How is the condition monitored?

Any change or response to treatment can be reported to the healthcare professional. Other monitoring is related to the cause. For instance, a person with a heart attack may need close monitoring and treatment in the intensive care unit.

Sources

Harrison's Principles of Internal Medicine, 1998, Fauci et al.

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