Neck Pain Causes

  • Amy Murtagh, Postgraduate Degree, Science Communication and Public Engagement, The University of Edinburgh

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Are you looking to overcome the discomfort of that constant ache in your neck? Neck pain is the cumulative effect of several factors and should not be taken lightly or ignored. Often a musculoskeletal problem, there are many remedies to neck pain once the cause has been identified.1

Neck pain is often caused by straining the neck muscles during various activities - anything from rigorous movements during exercise to repetitive strain, for example, from something as simple as looking down at your phone or screen too often. Abnormal posture, such as bending and slouching, can also place strain on the vertebrae and muscles in the neck. More serious causes of neck pain are also possible, such as cancer and meningitis.2,3 

Neck pain is a common ailment that can last for many years, depending on the cause; therefore, it is best to get diagnosed by your doctor and follow a suitable rehabilitation plan that works for you. Overcoming neck pain can ultimately reduce whatever limitations you're currently experiencing and can help you get back to normal life activities such as sports or work. 

What is neck pain?

Neck pain is a feeling of pain in the muscles or bones in the neck. Pain can result from injuries or general strain and can be acquired by both active and non-active people. Neck pain is often constant and can make it hard to do regular things without experiencing discomfort and further strain. Neck pain can also be worsened by anxiety, stress and activities such as exercise and sports. These things may also hamper your ability to recover from musculoskeletal neck pain.2

In some rare cases, neck pain may be due to illness rather than muscle strain or injury. This includes, for example, meningitis - a serious infection of the central nervous system (spine) tissue.3 

What does neck pain feel like?

Neck pain can feel like anything from discomfort when moving your neck muscles to stinging or sharp pains. Sometimes, the pain is not just localised to the neck but also affects the muscles in the back, chest, and shoulder.

Types of neck pain and other associated pain sensations include:

  • Muscle pain - aching soreness in the neck, shoulders, back, and chest due to overexertion and/or injury
  • Muscle spasm - sudden and strong tightening of the neck muscles, possibly due to overexertion and/or injury
  • Headache - typically dull or aching when related to a neck injury in contrast to a sharp headache 
  • Facet joint pain - deep, sharp, or aching pain in the vertebrates of the neck (particularly in arthritis) that worsens as your head leans toward the affected area, radiating pain to the shoulder and upper back
  • Nerve pain - pins and needles and/or sharp, fleeting and severe pain resulting from irritation/pinching of the roots of the spinal nerves. In some cases, the pain can shoot down your arms down to your hands.
  • Referred pain - pain that arises from a pre-existing issue 
  • Bone pain - pain and tenderness in neck vertebrae (requires medical attention and could be a sign of a more serious issue) 

Causes of neck pain?

Musculoskeletal

Most cases of neck pain result from mild to severe issues/injuries to the neck muscles, joints and/or bones. This includes:

  • Muscle strain caused by maintaining one body position for too long, sleeping in an awkward position and having bad posture4
  • Neck injuries due to accidents or physical overexertion can cause pain around the area due to damaged muscles and nerves4 
  • Vertebrae (bone components of the spine) malformations that may result in pinching of the spinal nerves and subsequent nerve pain.5
  • Arthritis in the neck joints (also called cervical spondylosis) due to degeneration of the cartilage between bones6

Meningitis 

Meningitis is an infection of the meninges (tissue that covers the brain and spinal cord). Neck pain due to meningitis will feel like a stiff neck. 

Other symptoms of meningitis include:

  • Fever
  • Nausea and vomiting 
  • Sore head
  • Light sensitivity 
  • Rash that does not dissipate when a glass is pressed against it 
  • Excessive tiredness
  • Blacking out 
  • Seizures 

Meningitis can be life-threatening and requires emergency care. The NHS also recommends not waiting for all signs of meningitis to appear (including the rash) to seek advice and treatment. 

Cancer 

Neck cancer (including cancer of the voicebox (larynx), throat and/or salivary glands) is a rare cause of neck pain. It will usually be accompanied by other symptoms such as neck swelling, respiratory symptoms, sore throat and/or difficulty drinking and swallowing food.

Who is affected by neck pain?

All people, regardless of age and other factors, can be burdened with neck pain. However, being affected by some specific health conditions and life circumstances can increase your chance of experiencing neck pain.

These include:

  • Pre-existing neuromuscular pain conditions2
  • Autoimmune disorders (such as vitamin D uptake deficiency)2
  • Psychological factors such as long-term stress, anxiety and depression7
  • Social factors such as a job that requires prolonged sitting and looking down at a screen7
  • Lots of strenuous activity, including manual labour and athletics7 

Your neck pain may be due to a combination of these factors, especially if you identify yourself as having bad posture habits or a recent neck injury. However, you should also consider the more serious causes of neck pain, as these can be life-threatening. 

Diagnostics

There are various tools used to assess and diagnose someone's neck pain. These include:

  • CT or CAT scan
  • Spine imaging 
  • Electrical stimulation of muscles
  • Electrical nerve conduction tests 
  • MRI scan
  • X-rays3

How is neck pain treated?

Neck pain can be treated at home in several ways, including: 

  • Taking medication to reduce pain and inflammation
  • Steroid injection at the spinal root to block nerve pain
  • Staying active to relax and improve the mobility of muscles 
  • Measures to reduce stress and anxiety3 

Alternative options that can help neck pain include:

  • Massage therapy
  • Applying heat/cold packs to the affected area
  • Acupuncture 
  • Chiropractic treatment 
  • Traditional eastern medicine 
  • Gentle exercises such as walking and yoga

All of these are fine for pain relief and should be used alongside staying active, frequent stretching and resting in optimal positions.

If your neck pain is not musculoskeletal, you should receive treatment and diagnosis for another condition. For example, meningitis requires emergency medical treatment with antibiotics, fluids and oxygen support. Bacterial meningitis is more serious and may require a hospital stay, whereas viral meningitis may be manageable at home once you have been checked by a doctor.  

How long does neck pain last?

This is dependent on the type of neck pain, although there is no definite answer as to how long it will last. In some cases, neck pain it can last for weeks or months or can reoccur throughout your life. Fortunately, though, there are plenty of treatment options that can help to alleviate and sometimes completely rid you of musculoskeletal neck pain.

With more serious conditions, neck pain should disappear after you’ve received treatment for, for example, meningitis or cancer. 

Prevention

Neck pain can be reasonably prevented by:

  • Being careful while exercising 
  • Avoiding injury
  • Maintaining good posture
  • Stretching and moving often to avoid straining in one position
  • Avoiding stress

You can also prevent the worsening of existing neck pain by performing gentle exercise and any other rehabilitation plan your doctor or physiotherapist has recommended to you. This will also help to heal the affected muscles and hopefully prevent any future neck pain.

Meningitis is reasonably preventable from infant age as there are various different types of meningitis vaccinations available. These are usually given during the first year of life but can be administered to teenagers and younger adults if they have not yet been vaccinated. You should discuss meningitis prevention with your healthcare provider if you are unsure of your or your child's current vaccination status. 

When to seek medical attention

Neck pain can be hard to cope with and a hindrance in your daily life. Simple neck strain can usually be alleviated at home and disappear with time; however, according to the NHS, if your neck pain lasts for more than two weeks, you should see your doctor for advice. 

More serious injuries to the neck, such as a fall or crash, should be seen immediately as the neck muscles or vertebrae could be damaged. It is always best to be checked by a doctor after you’ve been involved in any accident or injury incident so your neck issue can be better and quicker resolved.3

Having a sore neck may also indicate a more pressing health issue, such as meningitis. You should receive urgent medical attention if you have any or a combination of the above-mentioned symptoms. 

Other issues related to neck pain which should be investigated by a doctor include arthritis, skeletal abnormalities and cancer of the neck. If you have any concerns about your neck pain, don’t hesitate to contact your healthcare provider, as they will easily be able to help assess your condition, whether it is mild or potentially serious. 

Summary

Neck pain is a complex problem for which there is no single or definite solution. Foremostly, if you have been in an accident or received an injury to your neck, it is imperative that you receive urgent medical care. Other conditions, such as meningitis, should also receive emergency medical attention. Consult your doctor if you are unsure or have been consistently dealing with neck pain for a prolonged amount of time (a few weeks would be considered prolonged). However, neck pain is highly manageable and treatable with the right care and treatment plan, usually recommended by your doctor or a physiotherapist. Most pain conditions can be treated at home and with a number of different pharmaceutical and natural methods. While it is mostly up to you to try different treatment methods (most are trial and error, working for some and not so much for others), you should always follow your doctor's advice. 

References

  1. Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, et al. Neck pain: Global epidemiology, trends and risk factors - BMC musculoskeletal disorders [Internet]. BioMed Central. BioMed Central; 2022 [cited 2023Feb17]. Available from: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-021-04957-4 
  2. Brukner P. Brukner and Khan's Clinical Sports Medicine. Sydney: McGraw-Hill Education; 2017. 
  3. Michael AP. Neck pain [Internet]. AANS. [cited 2023Feb17]. Available from: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Neck-Pain 
  4. Hammond P. Search for Health Information [Internet]. Patient Family Education @ UHN. 2020 [cited 2023Feb17]. Available from: https://www.uhn.ca/PatientsFamilies/Health_Information/Health_Topics/ 
  5. Wagner PC, Grant BD, Reed SM. Cervical vertebral malformations. Veterinary Clinics of North America: Equine Practice [Internet]. 1987 Aug 1 [cited 2023 Jul 31];3(2):385–96. Available from: https://www.sciencedirect.com/science/article/pii/S0749073917306818 
  6. Cervical spondylosis (Arthritis of the neck) - ortho-info - aaos [Internet]. [cited 2023 Jul 31]. Available from: https://www.orthoinfo.org/en/diseases--conditions/cervical-spondylosis-arthritis-of-the-neck/ 
  7. Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, et al. Neck pain: Global epidemiology, trends and risk factors - BMC musculoskeletal disorders [Internet]. BioMed Central. BioMed Central; 2022 [cited 2023Feb17]. Available from: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-021-04957-4#:~:text=Results,neuromusculoskeletal%20disorders%20or%20autoimmune%20diseases.  

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Alejandro Lazaro Diaz Rojas Sesto

Bachelors of Science-BSc in Medical Physics with honours and a minor in mathematics, Toronto Metropolitan University

Hello, my name is Alejandro, I’m a recent graduate in medical physics looking to continue my pursuit in the field of health sciences. I’ve worked extensively in the field of healthcare alongside doctors, personal support workers, and physiotherapists ---one thing I’ve learned is that far too often people ironically leave appointments with more problems than they came in with. I believe in the power of education, equipping yourself with the information you need to devise your own solutions. Just as well to be able to ask your medical professional the right questions to leave with Klarity. I know that no matter how complex something is, it can always be simplified. With a world rampant with problems, let’s start finding some solutions and work together to build from there.

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