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Neck Pain: Causes and Treatment

The most common source of neck pain is the musculoskeletal system. The neck muscles, discs between the cervical vertebras, ligaments binding the bones, facet joints joining the posterior part of the vertebras, layers surrounding the spinal cord and nerves may cause pain.

The possibility of neck pain within a year is approx. 40% for any individual. Although there are many etiological factors of neck pain, most of them are not related to any serious disease.


The mean weight of the head is 5-6 kg. Our neck has not only to carry this weight, but has to coordinate movements in right-left and up-down directions. The cervical part of the spine has less support compared to the rest of the spine. Furthermore, we tend to live with postures, which are very uncomfortable for the neck due to the working environment and habits. All these loads and tensions cause injuries in the abovementioned structures. This is the reason for the high incidence of neck pain. Fortunately, it may be treated with simple precautions.


When is a neck pain serious?


If you have persistent and progressive neck pain, if it lasts more than 6 weeks, if you feel severe pain even with a slight touch, if you have fever, fatigue, nausea, weight loss, you should visit a physician. If the pain spreads to your arms, if you have paresis, weakening and tingling in legs and arms, you should consider a visit to a physiatrist. These symptoms do not necessarily point at a serious disease but, they mean that you should visit a physician.

The Causes of the Neck Pain Related to the Musculoskeletal System


  • Trauma: For example, accidents causing whiplash injury, in which the neck injury is caused by a sudden movement of the head forward and backward (like in a road accident), sports injuries.
  • Anxiety and stress (cause muscle spasm)
  • Myofascial pain syndrome
  • Teeth grinding or clenching
  • Jaw joint deformities
  • Tension-type headaches (neck pain can trigger a headache)
  • Carrying heavy bags on shoulder
  • Sitting and sleeping with an unsuitable posture
  • Looking at the monitor for a long time
  • Increased curvature of the spine in the developmental period (scoliosis)
  • Joint calcification (spondylosis, facet arthritis)
  • Cervical disc hernia
  • Nerve compression (due to the herniation or calcification)
  • Rheumatic diseases (ankylosing spondylitis, rheumatoid arthritis, fibromyalgia)


How Can The Neck Pain Be Prevented?


Correction of the postural problems, adjustment of the chair and table, so that monitor and the eyes are at the same level, going around and yawning in every 20-30 minutes are useful precautions. You should never carry heavy loads on your shoulder with a shoulder strap; you should use headphone or speaker during phone calls; changing the pillow, if you wake up with a stiff neck (relatively thinner pillows with neck support should be preferred); lying on your side or in the supine position instead of facedown position can be considered. You can decrease significantly the risk of neck pain, if you regularly exercise and stretch your neck muscles and strengthen your waist and abdomen muscles.


What To Do If You Have Neck Pain?


If you have neck pain, we recommend to increase your daily activity as much as possible. You may continue with all your daily activities. However, it is better to avoid extensive exercises. No need for the bed rest. Most of the neck pains recover within a week.

First-line analgesics, heat and cold applications (it is usually more useful if you apply cold first day and then heat), stretching exercises with smooth left-right movements of the head and massage may help to recover. If you cannot find relief with these methods within a week, you should visit a physician. After a complete anamnesis and physical examination, your physician may request further examinations like x-ray, MRI, EMG (electromyography) and hemogram.


How Is The Physiotherapy Performed?


The treatment depends on the etiology of neck pain. Methods such as electrotherapy targeted to the pain, superficial and deep heating methods, massage, exercise, manual therapy, traction, acupuncture, trigger point injections, dry needling, prolotherapy and steroid injections may be used.