What causes neck pain?
Sometimes referred to as cervical pain, pain located in the neck is a common medical condition. Neck pain can come from a number of disorders and diseases of the tissues in the neck, such as muscle strain, ligament sprain, whiplash, a herniated or degenerated disc, joint arthritis and a pinched nerve.
Neck pain causes significant impairment. Sedentary lifestyle and occupational factors including prolonged computer keyboarding and cell phone texting play a large role in the increased prevalence of neck pain in the past 20 years.
How is neck pain diagnosed?
In reviewing symptoms, the health care provider will note the location, intensity, duration and radiation of the pain. Any past injury to the neck is noted. Aggravating and/or relieving positions or motions are also recorded. The neck is examined at rest and in motion. Tenderness is detected during palpation of the neck. An examination of the nervous system is performed to determine whether or not nerve involvement is present.
Further testing of undiagnosed neck pain can include X-ray evaluation, CAT scan, bone scan, MRI scan, myelogram, and electrical tests such as electromyography (EMG) and nerve conduction velocity (NCV).
How is neck pain treated?
The treatment of neck pain depends on its precise cause. Treatment options include rest, heat/ice applications, soft collar, physical therapy (posture training, exercise combined with mobilization/manipulation, traction), massage therapy, acupuncture, chiropracty, local injections of cortisone or anesthetics, topical anesthetic creams or pain patches, prescription medications such as anti-inflammatories, muscle relaxants or analgesics, and various surgical procedures.
Even with this wide variety of treatment options available for the management of neck pain, not all treatments are equally effective. Current evidenced-based neck care guidelines categorize neck pain by the following five sub-types:
Examples of Treatment Approaches
|Neck Pain||Non-surgical Treatment|
|Chronic "mechanical" neck pain||
Joint mobilization/manipulation combined with exercise
Exercise alone: stretch and strengthen
Low-level laser therapy for associated degenerative changes
Acupuncture for short-term pain relief
Short-wave diathermy (deep heat) for short term pain relief
|Neck pain associated with acute whiplash||
Home exercise program, active range-of-motion exercises
Steroid injections for short-term pain relief
Short-wave diathermy (deep heat) for short-term pain relief
|Chronic neck pain with cervicogenic headache||
Exercise: strengthen neck flexion and stretching
|Chronic myofascial neck pain||Intramuscular anesthetic injection|
|Chronic neck pain with radicular pain into the arm and/or hand||
Epidural steroid injection
Acupuncture for short term-pain relief
Gross AR et.al. Cervical Overview Group of the Cochrane Collaboration. Knowledge to action: a challenge for neck pain treatment. JOSPT. 2009;39(5):351-363.