The neck—or cervical spine—is a coordinated network of nerves, bones, joints, and muscles. It has the important job of providing support and mobility for the head, but sometimes it can become painful.
There are a number of problems that cause pain in the neck. Irritation along nerve pathways in the neck can cause pain in the shoulder, head, arm, and/or hand. Additionally, irritation of the spinal cord can cause pain into the legs and other areas below the neck.
Neck pain usually goes away within a few days or weeks, but pain that persists for months could signal an underlying medical cause that needs to be addressed. In some cases, early intervention may be necessary for the best results.
Neck Pain Range of Symptoms
Neck pain can range from being minor and easily ignored to excruciating and interfering with daily activities, such as the ability to dress, concentrate, or sleep. Sometimes neck pain can lead to a stiff neck and reduced range of motion.
The duration of neck pain is commonly classified as follows:
- Acute. Pain that lasts less than 4 weeks.
- Subacute. Pain that lasts 4 to 12 weeks.
- Chronic. Pain that lasts 3 or more months.
Neck pain may be sharp and located in one spot, or it might feel less intense but spread across a broader region. Sometimes the pain gets referred up to the head or accompanies a headache. Other times it can be accompanied by muscle spasms in the neck, upper back, or around the shoulder blade. Less commonly, shock-like pain or tingling may radiate down into the shoulder, arm, and/or hand.
The Cervical Spine and What Can Go Wrong
The cervical spine begins at the base of the skull and consists of a series of 7 vertebral segments, named C1 though C7. It connects to the thoracic (chest) region of the spine at the C7-T1 level.
Ligaments, muscles, and tendons help stabilize and move the cervical spine. The most common cause of neck pain occurs when one of these soft tissues becomes strained or sprained from overuse or overextension. This type of injury typically heals within a week or two.
With the exception of the top level of the cervical spine, which primarily provides rotation for the skull, most levels of the cervical spine can be described as follows:
- A pair of facet joints connect two vertebrae, enabling forward, backward, and twisting motions
- Between the vertebrae is a disc, which provides cushioning, spacing, and coordination
- Nerve roots extend from the spinal cord and exit through the intervertebral foramina (gaps in the bones) located on the left and right sides of the spine
Various problems in the cervical spine can irritate a nerve root or the spinal cord, causing longer-lasting neck pain and/or neurological deficits. Some examples include a degenerated disc pushing into a nerve, or a bone spur growing on facet joints that encroach on a nerve.
The Course of Neck Pain
Neck pain is common among adults, but it can occur at any age. In the course of 3 months, about 15% of U.S. adults have neck pain that lasts at least one full day.1
Neck pain can develop suddenly, such as from an injury, or it may develop slowly over time, such as from years of poor posture or wear and tear.
The pain can usually be alleviated with self-care, such as rest, icing the area, or improving posture. Sometimes medical treatments are needed, such as medication, physical therapy, or injection therapy. If nonsurgical treatments are not helping, surgical options may be considered. Before deciding on surgery, it is important that the surgeon answer all of the patient’s questions. The procedure’s potential risks, benefits, and possible alternatives must be carefully explained.
A doctor should be consulted if pain persists or continues to interfere with routine activities, such as sleeping through the night.
When Neck Pain Is Serious
Some signs and symptoms associated with neck pain could indicate the health of a nerve root or the spinal cord is at risk, or perhaps there is an underlying disease or infection. These “red flag” signs and symptoms may include fever or chills, pain or tingling that radiates into the arm(s) or leg(s), problems with balance or coordination, or other troublesome signs. A doctor must be consulted for an accurate diagnosis and effective treatment plan.
Severe neck pain from a trauma, such as a hard fall or car crash, needs emergency care.