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Neck pain is a fairly 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.
What are the signs and symptoms of the condition?
When someone complains of neck pain, the doctor will need more information. Questions may be asked related to:
What are the causes and risks of the condition?
- when the pain started
- the exact location of the pain, such as whether it is on one or both sides of the neck, or whether the pain goes anywhere else outside the neck
- whether there has been any injury or trauma to the neck area
- whether there is any family history of neck pain
- whether the neck pain is constant or comes and goes
- what medications, herbs, or illegal drugs a person takes, if any
- what other medical conditions a person has, if any
- if anything makes the neck pain worse or better, such as turning the head to one side or aspirin
- any other symptoms, such as arthritis, fever, weight loss, or weakness in the arms
Neck pain has many possible causes, including:
Other causes are also possible. Sometimes no cause can be found.
- arthritis, or bony 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 disc in the spine located in the neck, sometimes called cervical disc disease
- muscle strain, such as occurs during whiplash or from lifting heavy objects
- a broken or dislocated bone in the neck, such as in the spine
- 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 tumour, 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 gastro-oesophageal 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
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.
How is the condition diagnosed?
The first step in figuring out the cause is a history and physical examination. This may be all that is needed to make the diagnosis. In other cases, further tests may be needed.
Different tests may be ordered, depending upon the suspected cause of the neck pain. For instance, blood tests can be used to help diagnose some infections in the thyroid gland. Neck x-rays are commonly used, and can detect arthritis in the neck or broken and dislocated bones in the neck. Special x-ray tests, such as a CT scan, may be needed in certain cases. For instance, a CT scan can help detect bulging discs or tumours in the neck.
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 disc 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.
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.
What are the treatments for the condition?
There are treatments available to reduce pain. These include aspirin, paracetamol, and nonsteroidal anti-inflammatory medications, such as ibuprofen. Stronger analgesics, 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.
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 disc. Surgery, chemotherapy, or radiation therapy may be needed to treat a tumour or cancer.
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 carries a risk of bleeding and infection.
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 disc. Other causes, such as cancer, may result in death if treatment is not successful.
How is the condition monitored?
Any change or response to treatment can be reported to the doctor. 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.
Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request