Neck pain

Neck pain, sometimes called cervicalgia, is pain, stiffness or discomfort in or around the spine beneath your head. It's very common, affecting around two in three people at some point in their life, and usually gets better on its own within a few weeks.

What causes neck pain?

Most neck pain is what's known as 'non-specific' or 'mechanical' neck pain, meaning there's no single clear cause. It's usually related to muscle strain or tension, often from:

• sleeping with your neck in an awkward position
• poor posture, such as sitting at a desk or looking at a screen for long periods
• stress, which can make you tense your neck muscles without realising it
• a pinched nerve.

An injury, such as whiplash from a car accident or a fall, is another common cause. As you get older, natural wear and tear in the bones of your neck (cervical spine) can also lead to pain, sometimes alongside a herniated disc or a pinched nerve. Less often, neck pain is linked to a wider health condition.

Are there different types of neck pain?

Doctors often describe neck pain by where you feel it:

• Axial pain: Felt mainly in your neck itself
• Radicular pain: Shoots or radiates from your neck into your shoulder, arm or the back of your head, usually because a nerve is irritated or compressed.

And by how long it lasts:

• Acute neck pain: Lasting from a few days up to 6 weeks
• Chronic neck pain: Lasting longer than 3 months.

How is neck pain diagnosed?

Most neck pain can be diagnosed from your medical history and a physical examination alone, without the need for scans. Your doctor will ask about how the pain started, whether you've had a recent injury, and what makes it better or worse. They'll also check how well you can move your neck, and feel for tenderness or muscle tightness.

Scans such as X-rays, an MRI or a CT scan aren't usually needed for everyday neck pain, as they rarely change how it's treated. Many people have some visible wear and tear in their neck without any pain at all, so imaging is generally only used if your doctor suspects a more serious cause, or if severe pain isn't improving as expected.

How is neck pain treated?

Most neck pain can be treated at home and improves within a week or two, although it can take a few months to disappear completely. Things that can help include:

• Paracetamol or ibuprofen, taken as tablets or as a gel rubbed onto your neck
• A hot water bottle or heat pad, or a covered ice pack, held against the painful area
• Using a low, firm pillow, and keeping your neck moving rather than resting it in a collar
• Gentle neck stretching and flexibility exercises.

If your pain doesn't improve, your doctor may suggest physiotherapy, or occasionally a steroid injection to reduce inflammation around an irritated nerve.

Surgery is rarely needed for neck pain, and is usually only considered if a scan finds a specific problem, such as a disc pressing on a nerve, that hasn't improved with other treatments.

When should you see a doctor?

See a GP if your neck pain or stiffness hasn't improved after a few weeks, if painkillers haven't helped, or if you're worried about it.

Get urgent medical attention if your neck pain:

• started after an accident or injury
• comes with numbness, tingling or weakness in your arms, hands or legs
• is the same whether you're moving or keeping still
• comes with a severe headache, dizziness, nausea or vomiting
• comes with a fever, chills or unexplained weight loss
• is affecting your bladder or bowel control, or your balance when walking.

These can be signs of something more serious that needs checking straight away.