Neck pain

Arthritis, pinched nerve, or muscles or ligament strains are some factors causing neck pain. Around 10% of adults experience neck pain at one time or another. Usually, neck pain can be relieved with conservative therapy.

Types of neck pain

Acute neck pain (less than 6 weeks)
Subacute neck pain (6-12 weeks)
Chronic neck pain (more than 12 weeks)

Symptoms

Headaches and weakness in the neck
Unable to turn the head or have pain when tilting or turning the head
Stiffness in the neck, upper back, arms, and shoulders
Tingling sensation or numbness in the arms or shoulders
Difficulty walking
Urinary or fecal incontinence

Causes

It is hard to pinpoint the root cause through physical examination and imaging tests. However, potential causes of neck pain include:

Cervical strain
Poor posture, bad sleeping habits, and muscle tension due to physical and psychological stress and sport-related injuries are the causes of cervical strain or spasms of cervical and upper back muscles. You may experience pain, tightness, or stiffness in your shoulders or upper back for up to 6 weeks.
Cervical spondylosis
Cervical spondylosis arises from age-related degenerative changes, including gradual narrowing of the disc space and bone spurs which puts pressure on surrounding tissues, resulting in pinched nerves. Some people have neck pain, neck weakness, restricted neck movement, numbness in the arms and shoulders, headaches, or ear pain.
Cervical discogenic pain
The degenerative changes in the structure of the cervical vertebral discs can cause muscle spasms and tightness, leading to neck pain when tilting or turning or doing activities without changing position for a long time such as reading, driving, or working in front of a computer. Some people experience referred pain in the arms or shoulders.
Cervical facet syndrome
The common cause of cervical facet syndrome is a job requiring you to extend your neck most of the time. This prolonged posturing can affect the facet joints on the sides of the vertebrae and cause arthritis, leading to pain in the side or middle of the neck. Some people may have pain in the ear, jaw, arm, shoulders, shoulder blades, and at the base of the head.
Whiplash injury is a neck injury due to forceful and abrupt back-and-forth neck motion, such as a car accident or sudden sports-related blow to the body. People with whiplash may have muscle pain and spasm, ear pain, jaw pain, headaches, and the limited ability to move the neck.
Cervical myofascial pain
Cervical myofascial pain is a condition with localized tender points of muscle and its surrounding connective tissue that are sensitive to pressure. It can result from trauma, stress, anxiety, depression, or insomnia.
Diffuse idiopathic skeletal hyperostosis (DISH)
It occurs when there is bone deposition in the tendons and ligaments along the cervical spine; therefore, the involved tissues become hardened. Some people do not develop any symptoms, while others experience pain, loss of mobility, and stiffness. This condition may affect the thoracic (middle) and lumbar (lower) spine.
Cervical spondylotic myelopathy
It is caused by the narrowing of the central spinal canal due to degenerative changes. The narrowing irritates the cervical spinal cord and leads to pain, loss of movement coordination, weakness, trouble walking, incontinence, or erectile dysfunction.
Cervical radiculopathy
The condition is mainly a result of age- or injury-related degeneration and cervical disc herniation. A protruding disc, cyst, mass, or spinal arthritis may press and irritate the nerve root, leading to pain, tingling sensation, and weakness.

Diagnosis

If you have neck pain, severe head and neck injury, numbness in your arms or legs, or urinary or fecal incontinence, seek immediate medical care.

A physical examination, including observing for head and neck posture and movement; and feeling your head, neck, shoulders, and upper back muscles for tension and pain, as well as reflex, strength, and sensation tests, may be performed. Your doctor may order an X-ray, CT scan, MRI, or EMG, depending on your age, symptoms, medical history, and the result of the physical examination.

Lifestyle modification and home remedies

Exercise and stretching can strengthen your neck, shoulder, and back muscles. Ask your doctor which exercise can help relieve your symptoms.
Adjust your posture often, especially when your work requires you to sit for a long time.
When sleeping, keep your head and neck in line with your body. Do not sleep on your stomach with your head turned to the side.
Practice relaxation or meditation to help lower your stress. Stress can worsen the pain and symptoms.
Use a warm compress or take a hot bath or shower to relieve pain and stiffness.
In some people applying a cold compress for 15 minutes, 2-3 times a day, can help reduce neck pain. However, always protect your skin with a thin towel before placing a cold object.
Pain relievers are beneficial if you have mild or moderate neck pain.

Other treatments

Acupuncture involves inserting fine needles into specific points. Discuss with your doctor if you would like to try this method.
Massage can relieve muscle spasms. However, it is best to consult a licensed massage therapist with experience in neck pain treatment.
Movement-based therapy involves stabilizing, strengthening, and stretching your muscles. A physical therapist can teach you an exercise regimen you can practice at home. Yoga and Tai Chi can also be beneficial. The exercise can strengthen your muscle, improve your pain, and regain the ability to resume your daily activities. Staying active can reduce stress and anxiety.
Trigger point injection with a local anesthetic into the muscles with stiffness or tenderness. There is no adequate evidence showing that this method can speed up healing or reduce pain. If other treatments are not helpful, a trial of this procedure is reasonable.
Cervical collar or neck brace may be used if you have increasing neck pain interfering with your sleep. However, long-term use is not advisable as it can weaken the neck muscles or delay recovery.
Transcutaneous electrical nerve stimulation (TENS) sends a mild electric current to the skin to reduce pain and improve strength and mobility; consult your doctor if you like to try this method.
Surgery is advisable for herniated disc patients -- suffering from cervical radiculopathy or cervical spondylotic myelopathy -- unresponsive to conservative therapies. However, in general, surgery is not necessary.

Always consult your doctor before trying new treatment approaches. If you have chronic neck pain which does not improve, you may be referred to an orthopedic specialist.