pain is a common problem, especially in older
adults. About 50% of people older than 50 have
neck pain at some time. Neck pain is pain that
occurs anywhere from the bottom of your head to
the top of your shoulders. The pain may spread
to the upper back or arms and may cause limited
neck and head movement.
The spine consists of interlocking bones
(vertebrae) and discs that separate the
vertebrae. The portion of the spine that runs
through the neck is known as the cervical spine.
Muscles and ligaments in the neck hold the
cervical spine together. Injury to any of these
structures may result in neck pain.
Neck pain may become long lasting (chronic) when
it occurs in combination with other health
conditions, such as conditions associated with
increasing age. These include narrowing of the
spinal canal (cervical spinal stenosis) and
arthritis of the neck (cervical spondylosis). In
some cases, chronic neck pain can be caused by
repetitive and/ or prolonged movements, such as
long hours working at a computer.
Chronic neck pain may result in increased
irritability, fatigue, sleep disturbances, and
poor quality of life. If treatment fails, neck
pain may lead to depression, chronic pain
syndrome, or drug dependence.
WHAT CAUSES NECK PAIN?
Risk factors for neck pain that you cannot
Age. People older than 50 are more likely to
have breakdown (degeneration) of discs or
joints, as well as bone spurs in the vertebrae
of the neck (cervical spondylosis).
Recent injury or history of injury. A common
injury to the neck is whiplash caused by a car
Conditions that affect the bones and soft
tissues of the neck and back, such as rheumatoid
arthritis, a narrowing of the spinal canal
(cervical spinal stenosis), or a severely curved
A history of having headaches.
Risk factors that you can control include:
Awkward positions that put stress on the neck.
Stress and poor posture, at home or at work.
Heavy physical work.
Boredom at or unhappiness with work.
Poor physical condition and lack of exercise.
Most neck pain is caused by activities that
result in repeated or prolonged movements of the
neck's muscles, ligaments, tendons, bones, or
joints. This can result in a strain (an
overstretched or overused muscle), a sprain
(injury to a ligament), a spasm of the neck
muscles, or inflammation of the neck joints.
These activities include:
Holding your head in a forward or odd position
for long periods of time while working, reading,
watching TV, or talking on the telephone.
Sleeping on a pillow that is too high or too
flat or doesn't support your head, or sleeping
on your stomach with your neck twisted or bent.
Spending long periods of time resting your
forehead on your upright fist or arm ("thinker's
Work or exercise that uses the upper body and
arms, such as painting a ceiling or other
Minor injuries may occur from tripping or
falling a short distance or from excessive
motion of the cervical spine. Severe neck
injuries may occur from whiplash in a car
accident, falls from significant heights, direct
blows to the face or the back or top of the
head, sports-related injuries.
Neck pain may be caused by or related to other
medical conditions. These can include:
Conditions associated with increasing age,
such as the narrowing of the spinal canal
(cervical spinal stenosis) and arthritis of the
neck (cervical spondylosis).
Illnesses such as meningitis, which causes
inflammation around the tissues of the brain and
spinal cord, and the flu (influenza). When neck
pain is caused by flu, the neck and the rest of
the body tend to ache all over, but there is no
severe neck stiffness.
Chronic conditions such as fibromyalgia,
rheumatoid arthritis, or ankylosing spondylitis.
Torticollis (wryneck). Torticollis is caused
by severe muscle tightness or a shortened muscle
on one side of the neck, causing the head to be
tilted to one side. Torticollis is usually a
symptom of another medical problem.
Referred pain. Referred pain occurs when a
problem in one place in the body causes pain in
another place. For example, a problem with your
jaw (temporal mandibular disorder) or your heart
(such as a heart attack) can cause neck pain.
Infection or a tumor in the neck area.
Side effects of some medications include neck
You may feel a "kink," stiffness, or severe pain
in your neck. The pain may spread to your
shoulders, upper back, or arms, and it may cause
a headache. You may not be able to move or turn
your head and neck normally. If there is
pressure on a spinal nerve root, you may have
pain that shoots down the arm. You may also have
numbness, tingling, or weakness in your arm.
If your neck pain is long lasting (chronic), it
may be difficult to cope with daily life. Common
side effects of chronic pain include fatigue,
depression, and anxiety.
Characteristics of neck pain include:
Pain that occurs from the bottom of your head
to the top of your shoulders. Pain may spread to
the upper back or arms.
Pain that is worse with movement.
Limited head and neck movement. The neck may
be stiff or tender.
Headaches. These are common and may persist
Nerve-related symptoms caused by pressure on the
spinal nerve roots or spinal cord include:
Numbness, tingling, or weakness in the arm or
A burning feeling when touched on the skin of
the arm or hand.
A shock like pain that extends into the arm or
Leg numbness or weakness, and loss of the
ability to control urination (bladder control).
This occurs when there is considerable pressure
or injury to the spinal cord.
Physical therapy treatment for neck pain
consists of: the use of heat, ice, ultrasound,
and electrical muscle stimulation, improving
neck strength, movement and flexibility with
exercises, and avoiding further neck injury
through education about spinal mechanics and
positioning. The specific treatment may depend
on whether your neck pain is caused by
activities, an injury, or another medical
Neck pain caused by stress or muscle strain can
often be prevented by using good posture,
getting regular exercise, and avoiding long
periods in positions that stress the neck, such
as prolonged computer work or painting a
If neck pain is worse at the end of the day,
evaluate your posture and body mechanics.
Avoid slouching or a head-forward posture. Sit
straight in your chair with your lower back
supported, feet flat on the floor, and shoulders
relaxed. Avoid sitting for long periods without
getting up or changing positions. Take short
breaks several times an hour to stretch your
If you work at a computer, adjust the monitor
so the top of the screen is at eye level. Use a
document holder that puts your work at the same
level as the screen.
If you use the telephone a lot, consider using
a headset or speakerphone. Do not cradle the
phone on your shoulder.
Adjust your car seat to a more upright
position that supports your head and lower back.
Make sure that you are not reaching for the
steering wheel while driving. Your arms should
be in a slightly flexed, comfortable position.
Use proper lifting techniques. Lifting with
your knees, not your back, can also help prevent
If neck pain is worse in the morning, check
your pillow and sleeping posture.
Use a pillow that keeps your neck straight,
neither too high nor too flat. Special neck
support pillows called cervical pillows or rolls
may relieve neck stress. You can also fold a
towel lengthwise into a pad that is 4 in. (10
cm) wide, wrap it around your neck, and pin it
in position for good support.
Use a pillow that doesn't force your head
forward when you lie on your back and that
allows you to align your nose with the center of
your body when you lie on your side.
Avoid sleeping on your stomach with your neck
twisted or bent.
If you read in bed, prop the book up so you
are not using your arms to hold it up and
bending your neck forward. Consider using a
wedge-shaped pillow to support your arms and
keep your neck in a neutral position.
If stress is contributing to your neck pain,
practice muscle relaxation exercises.
Strengthen and protect your neck by doing neck
exercises once a day.
You can also help prevent neck pain by
maintaining a healthy body weight.