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

Illustration showing back of the neck highlighted in red.

Pain, stiffness, and reduced range of motion are common symptoms of an acute neck injury.

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.

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The Cervical Spine and What Can Go Wrong

Medical illustration of the pain areas of different compressed nerve roots in the cervical spine

Compression of nerve roots in the cervical spine can cause pain and numbness in the shoulder and arm.

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.

Watch Cervical Spine Anatomy Video

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

    Watch Cervical Disc Anatomy Animation

  • 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

    Watch Cervical Nerve Anatomy Animation

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.

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The Course of Neck Pain

An illustration showing poor sitting posture.

Neck pain develops over time, often due to poor posture.

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 Severe headache or migraine, low back pain, and neck pain among adults age 18 and over, by selected characteristics: United States, selected years 1997-2014. Centers for Disease Control and Prevention website. http://www.cdc.gov/nchs/data/hus/2015/041.pdf. Published 2015. Accessed June 20, 2016.

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.

See Specialists Who Treat Back Pain

When Neck Pain Is Serious

Medical illustration showing both arms and legs highlighted in red.

Radiating neck pain associated with loss of balance and coordination warrants immediate medical attention.

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.

Dr. Scott Curtis is a sports medicine specialist at Princeton Spine and Joint Center, where he serves as the center’s Director of Sports Medicine, specializing in sports-related injuries and general musculoskeletal care.

  • 1 Severe headache or migraine, low back pain, and neck pain among adults age 18 and over, by selected characteristics: United States, selected years 1997-2014. Centers for Disease Control and Prevention website. http://www.cdc.gov/nchs/data/hus/2015/041.pdf. Published 2015. Accessed June 20, 2016.

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