By Louis Neipris, M.D., Staff Writer, myOptumHealth

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Neck pain is often not as simple as just a "pain in the neck." The origins of neck pain are as complex as the neck's design. The seven cervical vertebrae (bones in the neck) must hold up the weight of the head and allow free range of motion while protecting the delicate spine. Extra mobility leaves the neck more vulnerable to injury, since it is not as well protected as the rest of the spine. Most neck pain is temporary and goes away with rest. Sometimes, neck pain can become chronic and restrict motion.

What causes neck pain?

Common causes of neck pain include:

• Overextension from poor posture. Cradling the phone in your neck, or sleeping in the wrong position, are examples.
• Sudden injury, such as whiplash. This is due to rapid extension and flexion of the neck. Whiplash usually occurs as a result of an automobile accident.
• Cervical disc problems. In between the vertebrae in the spine are cushions that act as shock absorbers. With age, the gel-like substance in the middle of the discs breaks down and the space between vertebrae narrows. The rim of the disc can also weaken, allowing the disc to protrude (disc herniation) and press on nearby nerves.
• Rheumatoid arthritis is an inflammatory disease that destroys joints in the body. It can also affect the neck joints, causing stiffness and pain.

What are the symptoms of neck pain?

Unless you have a sudden injury such as a car accident, neck pain usually starts out mild and gradually get worse. Neck pain might include:

• Aching and stiffness
• Pain that spreads to your shoulder and arms, or shoulder blades
• Numbness or tingling in the fingers
• Headache

Call 9-1-1 right away for:

• Neck pain after a major fall or car accident
• Severe neck pain
• Loss of bladder or bowel function
• Sudden weakness or numbness in the arms or legs
• Inability to walk
• Loss of consciousness
• Any sudden neck pain that is related to shortness of breath, lightheadedness, or pain or pressure in the chest, upper back, shoulders, jaw or arms

How is neck pain diagnosed?

See your doctor for any neck pain that does not improve or is related to any other symptoms.

Your doctor will want to do a physical exam to check for tenderness and how well you can move your neck. If you've been in an accident or you've had pain for more than a few weeks, your doctor may do additional tests such as x-ray or an MRI (magnetic resonance imaging).

• X-ray of the neck can show fractures in the bones of the neck, joint dislocations or signs of arthritis.
• MRI of the neck can show pinched nerves and damage to soft tissues, such as muscles and ligaments.

How is neck pain treated?

Treatment depends on the cause of the pain. Treatment for the more common neck problems may include a combination of:

• Rest, immobilization and pain relievers. Most soft tissue injuries heal gradually with rest. Pain relievers, such as aspirin, acetaminophen (such as Tylenol) and over-the-counter NSAIDs like ibuprofen (Motrin, Advil) can help ease pain. (Never give aspirin to anyone age 19 or younger due to risk for Reye's syndrome). Pain relievers are not safe for everyone. Ask you doctor which one is right for you. For the first two or three days after the injury, you can apply an ice pack wrapped in a towel for no more than 15 to 20 minutes at a time several times a day to reduce inflammation and discomfort. Your doctor may suggest a neck collar to support the head, reduce movement and give the ligaments a chance to heal.
• Stronger pain relievers and anti-inflammatory medicines. Chronic pain, such as from arthritis, may be treated with medicines that relax the neck muscles or reduce inflammation. Prescription strength nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants may be prescribed.
• Physical therapy. This may include massage therapy, hot or cold therapy or yoga to help relieve muscle spasm.
• Surgery may be offered for cervical disc herniation to relieve pressure on spinal nerves in cases where other treatments are not effective

How can I prevent neck pain?

Practice healthy neck habits:

• Maintain good sitting posture. Sit with your back straight with your head centered over your spine. Adjust your desk chair so your hips are slightly higher than your knees. When traveling for long periods, keep the normal curve in your neck by placing a small pillow or rolled towel between your neck and headrest.
• Avoid hyperextension when sleeping. Don't rest your head on more than one pillow. Don't fall asleep with your head resting on the arm of the couch.
• Take walking and stretch breaks. Avoid sitting for long periods without breaks. Get up from time to time to walk around or to stretch.
• Watch your phone use. Don't cradle the phone in your neck - hold it with your hand. For long conversations, use a hands-free device or speaker phone.
• Stay fit. Walking is actually good for the neck. Even walking at a slow, steady pace rotates the spine and gives you a natural neck workout. Include stretching and muscle strengthening exercises in your fitness routine.

View the original Neck pain causes, symptoms and treatment article on myOptumHealth.com 

SOURCES:

• National Institute of Neurological Disorders and Stroke. Whiplash information page. Accessed: 02/12/2010

• American Academy of Orthopedic Surgeons. Neck pain. Accessed: 02/12/2010

• American Academy of Orthopedic Surgeons. Neck sprain. Accessed: 02/12/2010

• National Institute of Arthritis and Musculoskeletal and Skin Diseases. Questions and answers about sprains and strains. Accessed: 02/12/2010

• National Institute of Neurological Disorders and Stroke. Repetitive motion disorders information page. Accessed: 02/12/2010

• American Academy of Physical Medicine and Rehabilitation. What a pain in the neck! Accessed: 02/12/2010