Neck pain – your questions answered!

We asked Mr David Bell, one of London Neurosurgery Partnership’s complex spine experts, to explain a bit about neck pain, why we get it, what causes it and how to help.

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Neck pain is very common among individuals of all ages. It can be linked to the simple straining of neck muscles from hunching over a computer, moving awkwardly or as a result of conditions such as osteoarthritis. Less commonly, neck pain can be a symptom of an underlying problem.

What are the symptoms of neck pain?

  • Pain that becomes worse when the head is in one position for a long time such as driving or working at a computer.

  • Muscle stiffness and sometimes spasms.

  • Limited range of movement (especially side to side or up and down).

  • Headache.

When should you seek medical advice?

Usually, neck pain improves within a couple of weeks with at home treatment. If it doesn’t improve then it is always a good idea to see your doctor.

You should always seek medical advice if neck pain is:

  • As a result of a trauma – like a trip, fall or car accident.

  • Very severe.

  • Persistent for over a few days/a week without relief.

  • Spreads down your arms or legs.

  • Is accompanied by weakness, tingling or numbness.

So what actually causes neck pain?

The neck supports the weight of the head (which isn’t that light!) yet is flexible to allow movement which makes it susceptible to conditions which can cause pain, including:

  • Muscle strains: Over use of the muscles such as poor posture at a computer or sitting awkwardly for a while can strain neck muscles.

  • Joint wear and tear: Just like the rest of the spine and other joints in the body, the joints in the neck can wear down over time. When this happens it can contribute to neck pain.

  • Nerve compression: Disc bulges (called herniations) or little bony spurs can press down on and compress the nerves which branch out from the spinal cord to the arms. This can lead to neck pain, tingling, numbness and weakness.

  • Injuries: Trauma, such as trips, falls, car accidents and other actions which result in rapid jerking of the neck can result in soft tissue (muscles, tendons and ligaments) in the neck being strained which can contribute to neck pain.

  • Diseases: Much less frequently, diseases such as meningitis, cancer or arthritis can be the underlying cause of neck pain.

Can you prevent neck pain?

Given that most neck pain is associated with poor posture and/or wear and tear there are some simple life style changes which can help prevent some neck pain:

  • Improve posture when standing and sitting.

  • Take frequent breaks to get up and move around.

  • Adjust desk and screen height so the screen is at eye level.

  • Quit smoking!

  • Sleep in a good position.

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What are the treatment options?

Mostly neck pain will cure itself over a couple of weeks. Alternate hot and cold on your neck may help relieve the pain alongside over the counter pain relievers. If it persists your doctor may prescribe some stronger pain relief. Physical therapies can often help persistent neck pain.

If these do not work and your neck pain continues over several weeks into months your doctor may suggest steroid injections. These involve injecting corticosteroid near the nerve roots and into the facet joints to help relieve pain.

If the pain is really persistent the specialist consultant may recommend decompression surgery as a very last resort. This might be recommended for neck pain resulting from a compressed nerve. The aim of surgery would be to release the pressure on the nerve root. 

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.