How is the neck structured?
Your neck and back are made up of small bones called vertebrae. These are stacked on top of each other to form the spinal column.
The spinal column supports your head and protects the spinal cord. This is the main structure which links the network of nerves throughout your body. Messages travel along this network sending sensations, such as pain, to your brain.
The top seven bones in the spinal column form your neck, and these are called the cervical vertebrae. The bones are linked together by facet joints. These are small joints between your vertebrae that, together with your neck muscles, allow you to move your head in any direction.
Between the vertebrae are discs of cartilage. The discs act as shock absorbers and give the spine its flexibility. A slipped disc occurs when one of these discs slips slightly out of its natural position in the spine.
When to see a doctor
If your neck pain lasts more than a few days, you should see a healthcare professional. You should also speak to them if you:
- have symptoms other than pain and stiffness
- have pain, tingling, numbness or weakness in your arms or legs
- have sudden severe pain after a fall or injury
- suddenly develop neck stiffness along with difficulty lifting both arms above your head.
Some rare causes of neck pain include:
- a fracture
- an infection
- a tumour
- inflammation – which can happen in ankylosing spondylitis or meningitis.
If you suspect you have any of the above, see your doctor urgently.
The most common symptoms are:
Pain and stiffness
- You may feel pain in the middle or on either side of your neck, but it may also extend to the shoulder or to the upper chest.
- You may have pain or weakness in your arms.
- You may have tension headaches, where the pain can travel to the back of your head and sometimes into your ear or behind your eye.
- It may be painful to move your neck and your muscles may feel tight, especially if you’ve been sitting or sleeping in one position for a long time.
- You may notice that your neck won’t turn as far as it normally does, for example when you try to look over your shoulder while reversing the car.
If you have pain and stiffness in the neck that came on quickly, possibly overnight, and you have difficulty lifting both arms over your head, this could be a sign of a condition called polymyalgia rheumatica (PMR). This is an inflammatory condition of the muscles. It’s more common in people over the age of 65. If you think you have this condition, you should see a doctor as soon as possible.
Numbness or tingling
A nerve can become pinched when the muscles, bones or tissues surrounding it apply too much pressure. As a result, you may feel numbness, pins and needles or a tingling sensation that can be felt down your arm, sometimes right down to your fingers.
You’ll find that numbness and tingling will go away once the problem resolves itself. However, if your symptoms are severe, talk to your doctor; they may be able to prescribe drugs that target the pinched nerve, such as gabapentin or pregabalin.
Clicking and grating noises
You may hear or feel clicking or grating as you move your head. This is called crepitus, and it can be caused by air bubbles popping, or tissues and bones moving over each other, in the joint. Other joints often do this too, but noises from your neck usually seem louder because they’re happening closer to your ears. You may also find they’re more noticeable at night. While this is a common symptom and can sound alarming, it’s not serious.
Dizziness and blackouts
If you feel dizzy when looking up or turning your head, this may be due to pinching of the arteries that run alongside the spine, otherwise known as vertebral arteries. This can sometimes happen as a result of changes in the vertebrae. Pinching of these vertebral arteries can occasionally cause blackouts as the blood flow is temporarily reduced. However, blackouts can have other causes so it’s important to seek medical advice if this is happening to you.
Muscle spasms are the sudden stiffening of a muscle or groups of muscles in your body. Often there is no known cause and they can be very unpleasant. When it occurs in the neck it usually causes pain and stiffness down one side, which can make it difficult to turn your head.
jra diagnostic criteriahow to jra diagnostic criteria for It usually only lasts a few hours or days, although rarely it may continue for several weeks. You can try to ease the pain at home with gentle stretches, over-the-counter painkillers as well as heat or ice packs. People with muscle spasms report that applying heat is particularly soothing.
If you have long-lasting neck pain and stiffness, particularly if your sleep is disturbed, then you may feel very tired and, not surprisingly, you may start to feel rather down or low in mood. Talking about your pain with friends, family or your doctor may help.
Neck pain is very common and most of us will have it at some point in our lives. Usually, neck pain is the result of holding your neck in the same position for too long. However, other things can also cause or contribute to neck pain, such as:
- worry or stress
- sleeping awkwardly
- an accident, which can cause whiplash
- a sprain or a strain
- a flare-up of cervical spondylosis; which can happen as the discs and joints in the spine age.
Many people develop a stiff and painful neck for no obvious reason. It may happen after sitting in a draught or after a minor twisting injury, for example while gardening. This is called non-specific neck pain. This is the most common type of neck pain and usually disappears after a few days, providing you keep gently moving your neck and rest when you need to.
You can often manage short spells of neck pain yourself using over-the-counter painkillers and gentle stretches. However, if your neck problem persists or significantly affects your everyday activities then it’s sensible to see a doctor or other healthcare professional.
Most neck problems can be diagnosed and treated based on your symptoms and a simple examination, and it’s unlikely that you’ll need any special tests. Occasionally, your doctor may ask you to have an x-ray, a blood test or an MRI scan to rule out other important causes of neck pain.
Simple self-help treatments and a day or two’s rest are often enough to clear up a spell of neck pain. But if you have a more complex or a continuing neck problem, a healthcare professional will be able to recommend other treatments and therapies that should help. If your pain isn’t settling, your doctor may also be able to prescribe stronger painkillers, although these aren’t suitable for everyone.
Physiotherapists, chiropractors and osteopaths are all trained to treat neck problems. Treatment carried out by one of these therapists, along with home exercises, are often all that’s needed. They can suggest general or specific stretching and strengthening exercises for the neck.
It’s important to make the 1 last update 2020/08/05 sure that any physical treatments are given by qualified practitioners who are registered with the relevant body.It’s important to make sure that any physical treatments are given by qualified practitioners who are registered with the relevant body.
Manipulation is a type of manual therapy used to adjust parts of your body to treat stiffness. It can be uncomfortable at the time, so it’s important to understand what’s involved. Make sure you discuss your condition with your therapist and explain what symptoms you have been experiencing. This will enable them to make a more informed decision on what types of treatments you are most likely to benefit from.
It’s also a good idea to seek advice from a healthcare professional before you try manipulation as, even though some people report to have benefitted from it, it’s not suitable for everybody. If you have a condition such as osteoporosis, some therapies won’t be recommended.
The Alexander Technique
The Alexander technique is a method of teaching bodily awareness and reducing unwanted muscle tension. A qualified teacher will advise you on your standing and sitting posture and your patterns of movement. Some physiotherapists are trained in this technique, but it’s not always available on the NHS.
If you have spinal problems, such as a slipped disc, this technique might not be suitable for you.
TENS (transcutaneous electrical nerve stimulation)
A TENS machine is a small battery-driven machine which may help to reduce pain. Small pads are placed over the painful area and low-voltage electrical stimulation produces a pleasant tingling sensation. It’s suggested that this can interfere with pain signals from the nerves to the brain. You can buy TENS machines from pharmacies, but your physiotherapist may be able to let you borrow one to try first.
Some people find a special collar helpful to support the neck in cases of more serious or complex health problems. They are not routinely required.
jra diagnostic criteriahow to jra diagnostic criteria for During a session of acupuncture, very fine needles are inserted, virtually painlessly, at a number of sites on the skin. These are not necessarily at the painful area. Acupuncture seems to relieve pain in the short term by interfering with the signals to your brain and by causing the release of natural painkillers, known as endorphins.
In a very small minority of cases, especially if you have continuing pain in the back of your head or arm, a long-acting local anaesthetic or a steroid injection may help. The injection is usually given into the small facet joints of your neck. These injections tend to be given in an x-ray department so that the specialist can position the needle precisely.
jra diagnostic criteriahow to jra diagnostic criteria for Surgery is only rarely needed. It may be helpful if a nerve or the spinal cord is being squeezed and is causing weakness in the arm or severe pain that won’t go away. The surgeon will ask for a scan to look at the nerves and bones before discussing the pros and cons of surgery with you and whether to go ahead with an operation.
jra diagnostic criteriahow to jra diagnostic criteria for Amitriptyline
If over-the-counter painkillers alone aren’t effective, you may be prescribed an additional medication called amitriptyline. This is also prescribed as an anti-depressant drug, but in lower doses it can be used to relax muscles and improve sleep.
You shouldn’t take amitriptyline if you have glaucoma, prostate problems or urinary retention.
See Versus Arthritis’s amitriptyline leaflet (PDF, 117 KB) for more information on this drug.
Gabapentin and pregabalin
Gabapentin and pregabalin aren’t usually given as an initial treatment for ‘ordinary’ neck pain. However, if a pinched nerve in your neck is causing discomfort in your arm or arms, then these drugs can help by reducing nerve irritation. Depending on what drug you’re taking, you may need to trial it for a period of three to eight weeks to begin with. As with all drugs there can be side-effects, so they won’t be suitable for everyone. You should discuss this with your doctor.
Radiofrequency denervation may help with long-term neck pain that originates from your facet joints. The procedure uses electrical currents produced by radio waves to heat up the tip of a needle. This is then used to stop nerve endings sending pain signals to your brain.
Radiofrequency denervation is only considered after other treatments have failed and steroid injections have successfully reduced your neck pain for a short period of time. It‘s aimed at being a longer-term solution to persistent pain as regular steroid injections are no longer advised.
Simple self-help treatments and a day or two''s uncomfortably hard or soft
When you’re sitting, your feet should be flat on the floor and your knees should be slightly lower than your hips. Use a footrest if you think you’d be more comfortable.
A correctly adjusted chair will give you good support for your lower back. Hardback, upright chairs or straight-backed rocking chairs are better for your posture than low, soft, upholstered chairs or sofas. Using back supports can help your posture when sitting at home, at work or in the car. If you do a lot of reading, having the book or papers on a reading frame will often help to correct your posture.
If you use a desk at home or at work, you should check that the desk and computer screen aren’t too low and that your head isn’t bent forwards for long periods; as this can stretch your neck and may cause muscle pain. You should also check that your mouse and keyboard are comfortably positioned in relation to the screen. Regularly getting up to stretch and walk around will also help relieve tension and prevent aches and pains.
Some employers have occupational health specialists who can check that workstations are set up according to individual needs. Make sure you don’t spend a long time with your neck twisted sideways or cradling the telephone with your shoulder. If you find that this is happening to you, speak to your employer as they should be able to provide you with a headset.
If your pillow is too firm or thick, it can make neck pain worse. Changing the number or position of pillows may be helpful. Your head and neck should be supported so your head is level with your body in a neutral position. The pillow should fill in the natural hollow between the neck and shoulders – a soft or moulded pillow may be useful, or a supportive roll inside your pillow case can support the hollow of your neck.
If your mattress doesn’t give your back proper support, it can also make neck pain worse. You may want to consider replacing it if it’s old or uncomfortable.
If you have trouble sleeping, you should try to wind down before bed. You can do this by having a hot bath, listening to the radio or reading a book. Some people also find keeping a sleep diary particularly useful. Try different things and see what works best for you.
If night-time pain is making it difficult for you to get to sleep, you can take a painkiller, such as paracetamol, before you go to bed. It’s unlikely to last through the night but should ease pain for long enough for you to go to sleep.
If all else fails, you might benefit from discussing your sleeping patterns with your doctor or a sleep expert.
You may find a short period of rest is helpful initially to ease the pain and discomfort. But to prevent your neck muscles becoming weaker and your joints from stiffening, you should rest for as short a time as possible and certainly no more than a day or two. As soon as possible, start some gentle stretches and neck movements, as these can help the muscles and ligaments to relax and ease your pain and stiffness. You might want to consider seeing a physiotherapist as they can give you advice on some of the best exercises to do for your condition.
You should do some simple stretching and strengthening exercises every day. These can help to increase the strength of your muscles, ease stiffness, and restore your range of movement. Start by exercising very gently and gradually build up how much you do.
As with any physical activity, some aches or discomfort during or following exercise are normal and should be expected. But if an exercise makes your symptoms significantly worse for 1 last update 2020/08/05 you should stop doing it.As with any physical activity, some aches or discomfort during or following exercise are normal and should be expected. But if an exercise makes your symptoms significantly worse you should stop doing it.
jra diagnostic criteriahow to jra diagnostic criteria for It’s also important to find some form of exercise that you enjoy and to keep doing it. Walking, swimming, and exercise classes such as yoga or Pilates are all popular and will help with your general health and fitness.