Neck pain can be characterized by whether or not it is in response to an injury, which is correlated with how long the pain might last. Typically, neck pain falls into one of the following two categories:
- Acute pain usually starts as an immediate response to an acute injury, such as a neck strain or sports injury. It typically lasts less than 4 weeks.
- Chronic pain commonly starts gradually and may or may not have an identifiable underlying cause. Pain is usually considered chronic once it has lasted at least 3 months.
Pain that has lasted longer than 4 weeks but less than 3 months is sometimes considered to be in a gray zone, known as subacute pain.
Acute Neck Pain
Most episodes of acute neck pain are due to a muscle strain or ligament sprain. This type of injury can be caused in various ways, including:
- Sleeping with the neck at an awkward angle
- Poor posture while looking at a laptop screen or texting on a mobile phone
- Carrying a heavy bag or purse on one side of the body
- Sudden impact (such as from whiplash)
Acute pain typically starts suddenly, and it can feel anywhere from sharp and excruciating to dull or achy. It may be accompanied by stiffness that makes it difficult to rotate the head and/or look up or down.
Acute neck pain serves as both a protective warning and a natural part of the inflammatory healing process. The pain provides motivation to rest and avoid further damage while the body is healing.
Most minor injuries to the ligaments, tendons, and muscles in the neck heal with time (a couple of days or weeks) because these soft tissues have a good blood supply to bring the necessary nutrients and proteins for healing. Nonsurgical care, such as ice and/or heat, massage, spinal manipulation, physical therapy, and/or medications can help alleviate the pain while the injury is healing.
Chronic Neck Pain
Chronic neck pain may be related to an underlying medical condition—such as cervical degenerative disc disease or cervical osteoarthritis—or it may develop with no known or identifiable cause. In some cases, chronic pain is an extension of acute pain that persists long after the initial injury has healed. Regardless of whether or not an underlying medical cause can be found, the pain is still real and needs to be managed.
Chronic pain can have a wide range of possible characteristics. It can be experienced as dull and achy, or as sharp or searing, and may extend into the arm. It could be constant and unrelenting, or come and go intermittently and progress gradually over time.
A complicating factor of chronic neck pain is that it is commonly accompanied by depression. Chronic pain makes it difficult to participate in the activities of daily living, such as social gatherings, productive work or study, and sports participation. Over time, these losses can lead to feelings of social isolation and diminished quality of life. In order to effectively treat chronic pain, a screening for depression is advised, with subsequent treatment as needed.
Differing Definitions of Acute and Chronic Pain
While acute pain is commonly considered pain that lasts less than 4 weeks, and chronic pain is the label typically given to pain that lasts at least 3 months, there is some variance in how different medical professionals use these terms. For example, some medical professionals might consider pain that has persisted for more than 2 weeks to be chronic if it is severe enough, whereas others might consider pain less than 6 months old to still be acute if the cause of pain can be identified.