Neck pain - symptoms, causes and treatment

Neck pain and how to manage and treat it

Many people experience neck pain at some point in their life but it generally goes away on its own. Some causes include:

ageing, where the spine and the structures around it gradually wear out over time
trauma/injury
sprain, strains and tears
muscle tension
poor posture
overweight, which puts pressure on the spine and discs
joint problems
being less active and sitting for too long

Some rarer causes include:

disease
neurological conditions
infection
cancer

However, it’s important to be aware that it can sometimes be difficult to work out the cause of some neck pain, and sometimes a person may have a medical condition without any neck pain at all.

What symptoms indicate problems with the neck?

There are several symptoms that indicate problems with the neck including:

sharp or dull neck pain, tenderness or stiffness
neck pain that may spread to the arms and hands
numbness or pins and needles
headache
shoulder pain

Serious problems with the neck are rarer but symptoms that indicate serious problems include:

fever
unexplained weight loss
unrelenting neck pain at night
weakness in your arms, hands, legs or feet
neck pain with problems with bladder or bowel control

What should I do if I have seriously hurt my neck?

If you think you’ve had a serious neck injury, get medical help immediately. Symptoms of a serious neck injury include:

severe neck pain
difficulty breathing or shortness of breath
numbness, weakness or pins and needles in the arms, hands, legs or feet
paralysis
dizziness
nausea
fever
difficulty urinating or blood in the urine
difficulty passing stool
difficulty concentrating
difficulty swallowing
changes to seeing or hearing

If you are with someone who has seriously injured their neck, do not move them unless they are in danger.

How is neck pain treated?

Neck pain may be treated in different ways, depending on the cause, level of pain and your circumstances.

It’s important to see a doctor if:

the pain does not get better after a week or two
the pain is very bad
you’ve had a serious injury or you’ve had an injury and you’re worried
you have numbness, pins and needles, or weakness, in your arms, hands, legs or feet
you have loss of control of your bladder / bowel function (incontinence)
you have a fever

The doctor will assess your pain. If it’s likely that the cause is not serious, usually they won’t send you for imaging such as an x-ray, CT, MRI or bone scans. This is because serious neck problems are rare, and scans will often only show changes to your spine that are normal for your age and may not be the cause of your pain, even if it is severe.

Most people recover from neck pain with a non-serious cause, but it’s important to stay active and at work. Do gentle exercises to keep your spine strong. You may also need to change the way you do activities that cause you pain.

Persisting pain

If your pain is severe or chronic, or you would like support, you can see a physiotherapist or exercise physiologist who can help you to recover. Applying a heat or cold pack may also provide relief, as may over-the-counter pain-relief medication like paracetamol and ibuprofen. Follow the instructions on the packet.

Your doctor may recommend other medication if appropriate. Sometimes, seeing a pain-management or rehabilitation specialist or counsellor may also be helpful.

If you need to, the doctor may refer you to a specialist doctor, such as a neurosurgeon, neurologist or chronic-pain specialist. Depending on your circumstances, they may recommend steroid or cortisone injections, or targeted local anaesthetic to help manage the pain. However, the effects and duration of this treatment varies.

If a neurosurgeon finds changes to your spine and surrounding structures, they may recommend surgery to correct these and to give your spine more support.

How can I prevent neck pain?

Not everyone can avoid neck pain, but here are some things you can do to help keep your neck healthy and lessen the risk of neck pain:

Exercise regularly and stay active – this will help to keep your spine flexible and strong.
Keep a good posture (keep your back and neck straight), whether your sitting, standing or moving.
Do gentle neck stretches.
Don’t sit for too long. If you work in an office or are driving long distances, take regular breaks where you move around or stretch.
Avoid lifting heavy things, and keep your spine straight if you do lift anything heavy.
Maintain a healthy weight and make sure you have enough calcium and Vitamin D.
Avoid smoking.

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