Neck pain

1. Neck​ ​pain
Definition
Neck pain is a common complaint. Neck muscles can be strained from
poor posture-- whetherit's leaning over your computer or hunching over
your workbench. Osteoarthritis also is acommon cause of neck pain.
Rarely, neck pain can be a symptom of a more serious problem. Seek
medical care if yourneck pain is accompanied by numbness or loss of
strength in your arms or hands or if youhave shooting pain into your
shoulder or down your arm.
Symptoms
Signs and symptoms include:
● Pain that's often worsened by holding your head in one place for
long periods, such aswhen driving or working at a computer
● Muscle tightness and spasms
● Decreased ability to move your head
● Headache
When to see a doctor
Most neck pain improves gradually with home treatment. If not, see your
doctor.
Seek immediate care if severe neck pain results from an injury, such as
a motor vehicleaccident, diving accident or fall.
Contact a doctor if your neck pain:
● Is severe
● Persists for several days without relief

2. ● Spreads down arms or legs
● Is accompanied by headache, numbness, weakness or tingling
Causes
Your neck is flexible and supports the weight of your head, so it can be
vulnerable toinjuries and conditions that cause pain and restrict motion.
Neck pain causes include:
● Muscle strains​. Overuse, such as too many hours hunched over
your computer or smartphone,often triggers muscle strains. Even
minor things, such as reading in bed or gritting yourteeth, can
strain neck muscles.
● Worn joints​. Just like the other joints in your body, your neck
joints tend to wear downwith age. Osteoarthritis causes the
cushions (cartilage) between your bones (vertebrae) todeteriorate.
Your body then forms bone spurs that affect joint motion and
cause pain.
● Nerve compression​. Herniated disks or bone spurs in the
vertebrae of your neck can presson the nerves branching out from
the spinal cord.
● Injuries​. Rear-end auto collisions often result in whiplash injury,
which occurs when thehead is jerked backward and then forward,
straining the soft tissues of the neck.
● Diseases​. Certain diseases, such as rheumatoid arthritis,
meningitis or cancer, can causeneck pain.
Preparing for your appointment
You might initially contact your family doctor about your neck pain, and
he or she mayrefer you to:
A doctor who specializes in nonoperative treatment of musculoskeletal
conditions (physicalmedicine and rehabilitation).

3. A doctor who specializes in arthritis and other diseases that affect the
joints(rheumatologist).
A doctor who specializes in treating nerve-related disorders
(neurologist).
A doctor who operates on bones and joints (orthopedic surgeon).
What you can do.
Before your appointment, you may want to write a list of answers to the
followingquestions:
● When did your symptoms begin?
● Have you ever injured your neck? If so, when did the injury occur?
● Do any particular neck movements improve or worsen the pain?
● What medications and supplements do you take regularly?
What to expect from your doctor.
Your doctor might ask some of the following questions:
● Where exactly does your pain occur?
● Is the pain dull, sharp or shooting?
● Do you have numbness or weakness?
● Does the pain radiate into your arm?
● Is the pain made worse by straining, coughing or sneezing?
● Do you have other physical problems?
Tests and diagnosis.
Your doctor will take a medical history and do an exam. He or she will
check fortenderness, numbness and muscle weakness, as well as see
how far you can move your headforward, backward and side to side.
Imaging tests.
Your doctor might order imaging tests to get a better picture of the cause
of your neckpain. Examples include:

4. ● X-rays. X-rays can reveal areas in your neck where your nerves or
spinal cord might bepinched by bone spurs or other degenerative
changes.
● CT scan. CT scans combine X-ray images taken from many
different directions to producedetailed cross-sectional views of the
internal structures of your neck.
● MRI. MRI uses radio waves and a strong magnetic field to create
detailed images of bonesand soft tissues, including the spinal cord
and the nerves coming from the spinal cord.
It's possible to have X-ray or MRI evidence of structural problems in your
neck withouthaving symptoms. Imaging studies are best used as an
adjunct to a careful history andphysical exam to determine the cause of
your pain.
Other tests.
● Electromyography (EMG)​. If your doctor suspects your neck pain
might be related to apinched nerve, he or she might suggest an
EMG. It involves inserting fine needles throughyour skin into a
muscle and performing tests to measure the speed of nerve
conduction todetermine whether specific nerves are functioning
properly.
● Blood tests​. Blood tests can sometimes provide evidence of
inflammatory or infectiousconditions that might be causing or
contributing to your neck pain.
Treatments and drugs.
The most common types of mild to moderate neck pain usually respond
well to self-carewithin two or three weeks. If neck pain persists, your
doctor might recommend othertreatments.
Medications.

5. Your doctor might prescribe stronger pain medicine than what you can
get over-the-counter,as well as muscle relaxants and tricyclic
antidepressants for pain relief.
Therapy.
● Physical therapy​. A physical therapist can teach you correct
posture, alignment and neck-strengthening exercises, and can use
heat, ice, electrical stimulation and other measuresto help ease
your pain and prevent a recurrence.
● Transcutaneous electrical nerve stimulation (TENS)​.
Electrodes placed on your skin nearthe painful areas deliver tiny
electrical impulses that may relieve pain.
● Traction​. Traction uses weights, pulleys or an air bladder to gently
stretch your neck.This therapy, under supervision of a medical
professional and physical therapist, mayprovide relief of some
neck pain, especially pain related to nerve root irritation.
● Short-term immobilization​. A soft collar that supports your neck
may help relieve pain bytaking pressure off the structures in your
neck. However, if used for more than threehours at a time or for
more than one to two weeks, a collar might do more harm than
good.
Surgical and other procedures.
● Steroid injections​. Your doctor might inject corticosteroid
medications near the nerveroots, into the small facet joints in the
bones of the cervical spine or into the musclesin your neck to help
with pain. Numbing medications, such as lidocaine, also can
beinjected to relieve your neck pain.
● Surgery​. Rarely needed for neck pain, surgery might be an option
for relieving nerve rootor spinal cord compression.
Lifestyle and home remedies.
Self-care measures you can try to relieve neck pain include:​.

6. ● Over-the-counter pain relievers​. Try over-the-counter pain
relievers, such as ibuprofen(Advil, Motrin IB, others), naproxen
sodium (Aleve) and acetaminophen (Tylenol, others).
● Alternate heat and cold​. Reduce inflammation by applying cold,
such as an ice pack or icewrapped in a towel, for up to 20 minutes
several times a day. Or alternate the coldtreatment with heat. Try
taking a warm shower or using a heating pad on the low setting.
● Home exercises​. Begin daily gentle stretching, including neck
rolls and shoulder rolls,once the worst of your pain has subsided.
Gently tilt, bend and rotate your neck. Warmyour neck and back
with a heating pad or in the shower or bath before doing
theseexercises. Your doctor or a physical therapist can instruct
you in doing these exercises.
Alternative medicine.
Talk to your doctor if you're interested in trying alternative treatments for
your neckpain. Your doctor can discuss the benefits and risks.
Alternative treatments include:​.
● Acupuncture​. Acupuncture involves the insertion of thin needles
into various points onyour body. Studies have found that
acupuncture may be helpful for many types of pain. Butstudies in
neck pain have been mixed. For best results, you may need to
undergo severalacupuncture sessions. Acupuncture is generally
considered safe when performed by acertified practitioner using
sterile needles.
● Chiropractic​. Performed mainly on the spine, a chiropractic
adjustment applies acontrolled, abrupt force to a joint. Chiropractic
treatments to the neck can provideshort-term pain relief, and, for
many people, carry minimal risks.
● Massage​. During a massage, a trained practitioner manipulates
the muscles in your neckwith his or her hands. Little scientific
evidence exists to support massage in people withneck pain,

7. though it may provide relief when combined with your doctor's
recommendedtreatments.
Prevention.
Most neck pain is associated with poor posture combined with
age-related wear and tear. Tohelp prevent neck pain, keep your head
centered over your spine. Some simple changes inyour daily routine may
help. Consider trying to:​.
● Use good posture​. When standing and sitting, be sure your
shoulders are in a straight lineover your hips and your ears are
directly over your shoulders.
● Take frequent breaks​. If you travel long distances or work long
hours at your computer,get up, move around and stretch your neck
and shoulders.
● Adjust your desk, chair and computer​ so that the monitor is at
eye level. Knees should beslightly lower than hips. Use your
chair's armrests.
● Avoid tucking the phone​ between your ear and shoulder when
you talk. Use a headset orspeakerphone instead.
● If you smoke, quit​. Smoking can put you at higher risk of
developing neck pain.
● Avoid carrying heavy bags with straps over your shoulder​.
The weight can strain your neck.
● Sleep in a good position​. Your head and neck should be aligned
with your body. Use a smallpillow under your neck. Try sleeping on
your back with your thighs elevated on pillows,which will flatten
your spinal muscles.
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