Neck Pain

Explore the different types, possible causes and treatment options for neck pain
Written by Leon Mao
Physiotherapist, University of Melbourne
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on March 10, 2022
Contributed by Jamie Page
Physiotherapist, Salford University

Man clutching neck in pain sitting in front of his laptop

This article was written, reviewed and contributed to by some of Australia’s leading experts in the field of injuries and neck pain specifically. Our goal is to empower you to understand what is causing your neck pain and alleviate any worries that you may have.

If you have been dealing with neck pain for a long time, then perhaps we may be able to provide you with some new information to help your recovery.

Included in this article is a practical and actionable plan, with tips and information backed by the latest medical research to treat your neck pain - including things you can do at home to help you feel back to your best.

Read on as we guide you to understand the different types of neck pain and discover what type you may have.

What is Neck Pain?

Neck pain is a term used for describing conditions or issues that lead to discomfort around the cervical spine (neck). Injuries to structures, such as muscles, nerves and ligaments can lead to neck pain. Examples of neck conditions include strains, sprains and neuropathy (nerve pain).

According to the Australian Institute of Health and Welfare, neck pain is categorised as Australia’s second leading burden of disease and affects 4 million people.[1] Additionally, the University of Sydney has also produced research showing that up to 49% of Australian office workers can experience neck pain within a 1 year period.[2]

Some people with neck pain can also experience neuropathy (nerve pain) in their arms, forearm pain and hand pain. Associated symptoms include pain, tingling, numbness and weakness. This phenomenon is also known as cervical radiculopathy or referred pain.

Neck pain is usually categorised as either acute or chronic back pain

Acute neck pain: (0 days - 6 weeks)

Acute neck pain is pain that arises quite suddenly, usually due to an injury. This pain can be the result of something as simple as a bad night’s sleep or something more serious like whiplash or a car accident. Acute pain is a normal response and should subside anywhere between a few days and several weeks.

Subacute neck pain: (6 weeks - 3 months)

Sub-acute neck pain is defined as pain that doesn’t resolve in the first six weeks following injury. Sub-acute injuries usually involve more tissue injury and can be a bit slower to heal. Injuries are more likely to progress from acute to sub-acute if you continue to aggravate your neck pain, either with exercise or painful movements.

Chronic neck pain: (3 months +)

Chronic neck pain is pain that has gone beyond the three-month mark. This type of pain can be difficult to deal with as it may not have responded well to initial treatment options. Sometimes chronic pain is due to the severity of the injury and which needs more time to heal, other times it can be a sign of other underlying factors that are hindering the recovery time. This includes things like stress and anxiety, other pain or injury or lack of sleep.

What are the symptoms of neck pain?

Pain in the neck is the primary symptom resulting from an injury or musculoskeletal issue in the neck. Neck pain is usually accompanied by stiffness and difficulty moving the neck, especially when trying to turn the head from side to side.

Common complaints of pain in the neck

People may experience

Pain areas: in the neck, shoulder, and muscles

Sensory: pins and needles down the arm, headaches

Also common: muscle spasms, tight upper back

What causes neck pain?

Neck pain is most often caused by muscle strains and overuse injuries, like spending too much time sitting at the computer. In more serious cases, neck pain can be caused by degeneration, usually in older adults, and may result in conditions like osteoarthritis.

According to the British Medical Journal, neck pain is defined as "pain and discomfort below the base of the skull and above the shoulders and upper back, with or without referred arm pain”.[3]

Neck pain can result from a problem in one or several parts of the neck, including:

  • Muscles (strain)

  • Ligaments (sprain)

  • Nerves

  • Bone injuries - in the neck, the bones are referred to as vertebrae

  • Discs - the shock absorbers between each vertebra

Common reasons why people experience pain in the neck

  • Chronic stress

  • Excessive use of computer

  • Sporting injuries

  • Motor vehicle accidents

  • Trauma to the neck or head.

Prolonged computer work tends to fixate your head in a forward position (protraction). This position puts an extreme amount of stress and tension on the neck muscles and ligaments, leading to neck pain.

Common injuries that cause neck pain

Neck Strain or Sprain

A sprain usually happens when the neck ligaments are torn, while strain refers to a “pull” of the muscles or tendons. This usually occurs when the muscles or the ligaments are stretched beyond their capacity or sudden large head movements.

Muscle stiffness

Neck stiffness is common when keeping the neck in the same position for a prolonged time. This usually happens after sleeping on a high pillow.

Herniated Disc

Whilst rare, herniated discs can occur in the neck. A herniated disc is when the disc’s outer layer is torn, which can result in compression and irritation of the nerve roots around your spine.

Pinched Nerve

Muscles, tendons, and bones can compress the nerves around your neck and upper back. This causes pain around the structures of the neck.

Spondylosis

Spondylosis is a degenerative condition of the spine. Structures of the cervical spine are also prone to wearing down as you get older.

Fractures

Probably the most serious and concerning injury of the neck is a fracture. Neck fractures (also known as cervical spine fractures) can happen due to sudden back-and-forth movement of the neck (whiplash) like in motor vehicle accidents. Compression fractures on the spine can also occur when a heavy object falls directly to the top of your head.

Cervicogenic Headaches

This type of headache is caused directly by issues with the muscles of the neck. Cervicogenic headaches can cause neck pain along side traditional headache symptoms.

Common conditions that cause neck pain

Several medical conditions may also present neck pain. If you have any of these conditions, neck pain could be one of the symptoms:

  • Osteomyelitis

  • Meningitis

  • Fibromyalgia

  • Rheumatoid Arthritis.

Sports that increase the risk of neck pain

Your neck is a vital structure of your body that allows you to move your head. In sport, the most frequent neck injuries are caused by high impact sports:

  • Australian Rules Football

  • Soccer

  • Hockey

  • Wrestling

  • Diving

How is neck pain diagnosed?

There are several options available when it comes to diagnosing the underlying cause of your neck pain. One of the most common, and one that is most recommended by Australian GP’s, is an assessment from a physiotherapist.

Through years of intensive clinical experience, physiotherapists can effectively diagnose the root cause of musculoskeletal conditions like neck pain. The process of physiotherapy assessment is simple yet comprehensive.

Like visiting a GP, your assessment will start with a physiotherapist asking you vital questions about your health, this is referred to as a consultation. Your consultation will last for about 30 to 60 minutes. It would help if you took this time to discuss relevant issues relating to your neck pain.

After establishing the background of your condition, your physiotherapist will perform specific physical tests to determine the best possible cause of your pain and rule out other conditions.

Following your initial assessment, you will be provided with a specific treatment plan based on your condition.

From here, your physiotherapist will give you the details of your treatment program, this will include:

  • Number of treatment sessions

  • List of exercises you need to do at home

  • Strategies to manage the pain and prevent worsening of the condition

  • Timeline of your full recovery.

How is neck pain treated?

Neck pain can be distressful and limit your work efficiency or prevent you from doing what you love to do. Neck pain will in most cases alleviate on its own, though may present again unless the root cause of your neck pain rectified. Specific issues in your neck region such as posture, muscle weakness and muscle imbalance can only be addressed by physical intervention.

There are several options when it comes to treating neck pain. One of the more common, and the treatment option that is referred to by most Australian GP’s, is physiotherapy.

Neck pain is an injury that physiotherapists come across regularly, and the process of treating it is straightforward. Following an initial consultation, the physiotherapist will be in the best position to determine your treatment plan.

A combination of manual therapy, stretching, and specific movement exercises will be provided by your physiotherapist who is an expert in treating neck pain and other musculoskeletal conditions.

Depending on the severity of your neck pain, a physiotherapist may provide you with a combination of the following types of treatments:

  • Therapeutic Exercises - Specific exercises tailored to improve your knee pain

  • Manual Therapy - Hand-on physiotherapy, used to help lower pain and increase range of motion

  • Stretching Exercises - Stretching will help lengthen muscles and increase range of motion

  • Spinal Mobilisation / Manipulation - Specific joint mobilisations are used to reduce stiffness in particular areas

  • Dry Needling - A technique used to help alleviate pain and reduce muscle tension

  • Heat Therapy - Used to reduce tension and pain in acute situations

  • Traction Treatments - A specific stretching technique used to reduce tension on the neck.

A typical physiotherapy session with your local physiotherapist will last anywhere between 30-60 minutes, and it is not uncommon for patients to feel the benefits in just one session.

Next step - Creating a treatment plan made for you

Following your initial appointment, the physiotherapist will craft a tailored treatment plan that will highlight the course of action required, including what exercises you need to do at home and provide you with a timeline for how long it should take for a full recovery.

Self-care strategies

Things to do:

  • Hot Compress or Hot Shower

Heat will promote blood flow towards the area. This will also relieve stiffness and facilitate natural relaxation of the tensed muscles around your head and neck. Be careful not to apply too much heat as it may cause burns.

  • Gentle Stretching

Stretching of your neck muscles can help relieve the tension. A physiotherapist will provide you with effective stretching techniques for the neck.

  • Relaxation / Massage

A gentle massage on your neck and upper back can help relieve tension in the area and decrease pain.

  • Practice Good Posture

Maintaining good posture will decrease the stress and pressure on your neck muscles and spine. It will also promote overall spinal health, which will prevent injuries.

Things to avoid:

  • Avoid activities that worsen the pain

Take rest and let the symptoms subside. If you are working on a computer, be sure to take frequent rest in between and observe proper posture. Keep your head aligned with your torso.

  • Avoid sleeping on high pillows at night

You sleep for almost six to eight hours at night. This is long enough to cause strain and injury to your neck when kept in an awkward position for a long time.

  • Do not use unprescribed neck braces

Neck braces limit the movements of your head. Improper use of these devices can do more harm than good.

Do I need a specialist or surgery?

Neck pain can be caused by something more serious. Motor vehicle accidents and direct trauma to the head and spine is an emergency.

Diagnostic imaging may be done such as Xray, CT scan, or an MRI to rule out fractures of the spine and other severe medical conditions. You may also get a blood test to make sure the problem isn’t a disease that causes pain.

If your doctor determines that your neck pain is of musculoskeletal origin, they may coordinate with your physiotherapist to provide you with proper treatment.

What is the recovery time / prognosis for neck pain?

Recovery time for neck pain depends on the severity of the underlying injury. Some neck pain can be relieved within a few hours, while sometimes it can take up to a few weeks to resolve.

Physiotherapy generally leads to good outcomes and better overall function leading to a faster recovery. You may immediately feel signs of relief during your first physiotherapy session.

Important factors in your recovery post-treatment:

  • Ensuring you comply with the prescribed exercises from your physiotherapist

  • Returning to normal activity such as sport gradually

  • Being mindful of pain, and not pushing yourself too hard.

Other factors that may influence your recovery time:

  • Injury severity - If your injury is more extensive than patience is key as recovery may take longer than you would like it to.

  • Age - Age can be a factor, as tissues tend to be slower to heal as we get older.

  • General health - Underlying fitness and health can help improve healing time.

Can pain in the neck be prevented?

Guaranteeing the prevention of neck pain is impossible, however there are some things you can do to at least minimise the risk.

  • Manage your screen usage: Computers and mobile devices tend to fixate your head in an awkward position which causes strain and stress on the neck muscles and ligaments. Limiting your screen time or frequent short breaks will help decrease the chance of having neck pain.

  • Don’t sleep on high pillows: Sleeping on high pillows may cause excessive pressure on the skull base and the muscles around it.

  • Keep a good posture: Having a good posture can go a long way. It decreases the stress on your neck muscles and promotes overall physical health.

  • Stop smoking: Smoking generally increases the risk of having an inflammatory response in the body. It also clogs vital blood vessels that supply blood and nutrients to your body.

The outlook and the main takeaways

If there is one main takeaway from this article, it’s that there are many types, causes and severities of neck pain, and the most important thing you can do is listen to your body and act on these pain signals (you’re getting them for a reason). Book a time, and have your neck pain diagnosed by a physiotherapist today.

Anatomy of the cervical region

The cervical spine consists of seven vertebrae, eight cervical nerves, muscles, and ligaments.

The first two vertebrae have unique shapes and functions. They form the upper cervical spine. Each pair of cervical nerves passes through each segment of your cervical vertebra.

Cervical nerves also provide sensation to different parts of the head, neck, and arms.

Any issues and injuries associated with these structures can lead to neck pain.

  • Fractures or trauma on the upper cervical spine

  • Cervical nerve impingement

  • Muscle spasm/tightness

  • Sprain / strain

  • Muscle imbalance in the neck and shoulder region

Written by Leon Mao
Physiotherapist, University of Melbourne
Published on March 7, 2022
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on March 10, 2022
Contributed by Jamie Page
Physiotherapist, Salford University
Sources
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Last medically reviewed on March 10, 2022
BookPhysio.com has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our contect is accurance and current by reading our editorial policy.
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