Neck pain - Treatment
Pain - neck; Neck stiffness
For minor, common causes of neck pain:
- Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).
- Apply heat or ice to the painful area. One good method is to use ice for the first 48 - 72 hours, then use heat after that. Heat may be applied with hot showers, hot compresses, or a heating pad. Do not fall asleep with a heating pad or ice bag.
- Stop normal physical activity for the first few days. This helps calm your symptoms and reduce inflammation.
- Perform slow range-of-motion exercises -- up and down, side to side, and from ear to ear -- to gently stretch the neck muscles.
- Have a partner gently massage the sore or painful areas.
- Try sleeping on a firm mattress without a pillow or with a special neck pillow.
- Use a soft neck collar for a short period of time to relieve discomfort. Using one too long can make your neck muscles weaker.
You may want to reduce your activity only for the first couple of days. Then slowly resume your usual activities. Do not perform activities that involve heavy lifting or twisting of your back or neck for the first 6 weeks after the pain begins. After 2 - 3 weeks, slowly resume exercise. A physical therapist can help you decide when to begin stretching and strengthening exercises and how to do them.
Avoid the following exercises during your initial recovery, unless your doctor or physical therapist says it is okay:
- Weight lifting
- Leg lifts when lying on your stomach
- Sit-ups with straight legs (rather than bent knees)
Call your health care provider if:
Seek immediate medical help if:
- You have a fever and headache, and your neck is so stiff that you cannot touch your chin to your chest. This may be meningitis. Call your local emergency number (such as 911) or get to a hospital.
- You have symptoms of a heart attack, such as shortness of breath, sweating, nausea, vomitting, or arm or jaw pain.
Call your health care provider if:
- Symptoms do not go away in 1 week with self care
- You have numbness, tingling, or weakness in your arm or hand
- Your neck pain was caused by a fall, blow, or injury -- if you cannot move your arm or hand, have someone call 911
- You have swollen glands or a lump in your neck
- Your pain does not go away with regular doses of over-the-counter pain medication
- You have difficulty swallowing or breathing along with the neck pain
- The pain gets worse when you lie down or wakes you up at night
- Your pain is so severe that you cannot get comfortable
- You lose control over urination or bowel movements
What to expect at your health care provider's office:
Your doctor will perform a physical examination and ask detailed questions about your neck pain, including how often it occurs and how much it hurts. Other questions may include:
- Is your pain in the front, back, or side of your neck?
- Are both sides of your neck affected equally?
- When did the pain first develop?
- Is it painful all the time or does the pain come and go?
- Can you touch your chin to your chest?
- What makes your neck feel worse? What makes your neck feel better?
- Do you have neck weakness or neck stiffness?
- Do you have any accompanying symptoms like numbness, tingling, or weakness in your arm or hand?
- Do you have swollen glands or a lump in your neck?
These questions help your doctor determine the cause of your neck pain and whether it is likely to quickly get better with simple measures such as ice, mild painkillers, physical therapy, and proper exercises. Most of the time, neck pain will get better in 4 - 6 weeks using these approaches.
Your doctor will probably not order any tests during the first visit, unless you have symptoms or a medical history that suggests a tumor, infection, fracture, or serious nerve disorder. In that case, the following tests may be done:
If the pain is due to muscle spasm or a pinched nerve, your doctor may prescribe a muscle relaxant and possibly a more powerful pain reliever. Over-the-counter medications often work as well as prescription drugs. The doctor may prescribe a neck collar or, if there is nerve damage, refer you to a neurologist or neurosurgeon for consultation.
If meningitis is suspected, you will be sent to an emergency department for further tests, antibiotics, and hospital admission.
The following steps can prevent neck pain or help your neck pain improve:
- Use relaxation techniques and regular exercise to prevent unwanted stress and tension to the neck muscles.
- Learn stretching exercises for your neck and upper body. Stretch every day, especially before and after exercise. A physical therapist can help.
- Use good posture, especially if you sit at a desk all day. Keep your back supported. Adjust your computer monitor to eye level. This prevents you from continually looking up or down.
- If you work at a computer, stretch your neck every hour or so.
- Use a headset when on the telephone, especially if answering or using the phone is a main part of your job.
- When reading or typing from documents at your desk, place them in a holder at eye level.
- Evaluate your sleeping conditions. Make sure your pillow is properly and comfortably supporting your head and neck. You may need a special neck pillow. Make sure your mattress is firm enough.
- Use seat belts and bike helmets to prevent injuries.
- Reviewed last on: 6/4/2011
- David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery.
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Graham N, Gross A, Goldsmith CH, Klaber Moffett J, Haines T, Burnie SJ, et al. Mechanical traction for neck pain with or without radiculopathy. Cochrane Database Syst Rev. 2008;(3):CD006408.
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