Neck Pain

We're sorry you have pain in the neck.

Please take a few minutes to answer some questions and this guide will provide some of the more likely causes and provide some helpful information. The guide is not intended to replace a face-to-face evaluation with your doctor.

Neck pain may be a symptom of a serious or even dangerous condition that requires prompt evaluation. The first question is designed to identify these rare cases.

Click here to begin.

Do you have one or more of the following:

  • Weakness or inability to move one or both hands, arms, or legs

  • Numbness or tingling in one or both hands, arms or legs

  • Severe neck pain that moves from the neck down one or both arms

  • Neck pain that moves into the jaw, shoulder or chest associated with exertion

  • Fever

  • Difficulty swallowing

  • Difficulty breathing

  • Incontinence of urine or stool

  • Marked pain when pressing on one area of the neck

  • Neck pain that followed significant trauma, such as car accident or sports injury?

Yes, I have one or more of these symptoms.

No, I do not have any of these symptoms.

Good. That makes a serious or urgent cause of neck pain less likely. However, if you have unusual symptoms not covered here, are not improving over time, or have concerns about the possibility of a serious condition, contact your physician right away.

Here are just a few questions that can help sort out which of the common reasons for neck pain might apply to you.

The first question is about your age because the most common causes of neck pain are different in people of different ages.

Are you at least 40 years old?

Yes, I am at least 40 years old.

No, I am younger than 40.

The duration of your neck pain is also helpful to know, because many conditions, such as muscle spasm, tend to last only a short time.

Has your neck pain lasted at least 14 days?

Yes, I've been in pain for at least 14 days.

No, I've been in pain less than 14 days.

Some forms of neck pain can be brought on by pressing on the neck, while others cannot.

Does it hurt more when you press on the back or sides of the neck?

Yes, it hurts more when I press on my neck.

No, it does not hurt more when I press on my neck.

For people under the age 40 with neck pain less than two weeks that does not worsen with the application of pressure, the most common causes are

  • muscle spasm or strain

  • disc disease - often associated with radiating pain, numbness or tingling into one arm

  • osteoarthritis - this is a relatively rare cause in a person under the age of 40.

Fortunately, there is usually a good response to treatment in these conditions - that is, the prognosis is generally good.

Click here to learn more.

For people under the age 40 with neck pain less than two weeks that worsens with the application of pressure, the most common causes are

  • muscle spasm or strain

  • osteoarthritis (often with muscle spasm).

Neck arthritis as a cause of neck pain is relatively uncommon in persons under the age of 40, however.

There is usually a good response to treatment in these conditions--that is, the prognosis is generally good.

Click here to learn more.

Some forms of neck pain can be brought on by pressing on the neck, while others cannot.

Does it hurt more when you press on the back or sides of the neck?

Yes, it hurts more when I press on my neck.

No, it does not hurt more when I press on my neck.

For people younger than age 40 with neck pain more than two weeks that does not worsen with the application of pressure, the most common causes are

  • muscle strain

  • minor injury (as may occur with sports or a minor fall)

  • osteoarthritis - less likely if under age 30, no prior arthritis or injury in the neck.

Fortunately, there is usually a good response to treatment in these conditions - that is, the prognosis is generally good.

Click here to learn more.

For people younger than age 40 with neck pain more than two weeks that does worsen with the application of pressure, the most common causes are

  • muscle spasm or strain

  • minor injury (as may occur with sports or a minor fall).

Fortunately, there is usually a good response to treatment in these conditions - that is, the prognosis is generally good.

Click here to learn more.

The duration of your neck pain is also helpful to know, because many conditions, such as muscle spasm, tend to last only a short time.

Has your neck pain lasted at least 14 days?

Yes, I've been in pain for at least 14 days.

No, I've been in pain less than 14 days.

Some forms of neck pain can be brought on by pressing on the neck, while others cannot.

Does it hurt more when you press on the back or sides of the neck?

Yes, it hurts more when I press on my neck.

No, it does not hurt more when I press on my neck.

For people age 40 and older with neck pain for less than two weeks that does not worsen with the application of pressure, the most common causes are

  • minor injury (as may occur with sports or a minor fall)

  • osteoarthritis

  • disc disease - often associated with radiating pain, numbness or tingling into one arm.

Muscle strain or spasm is possible (mostly because it's so common) but these tend to be painful with the application of pressure.

Fortunately, there is usually a good response to treatment in these conditions--that is, the prognosis is generally good.

Click here to learn more.

For people at least age 40 with neck pain less than two weeks that does worsen with the application of pressure, the most common causes are

  • muscle spasm or strain

  • minor injury (as may occur with sports or a minor fall).

Fortunately, there is usually a good response to treatment in these conditions - that is, the prognosis is generally good.

Click here to learn more.

Some forms of neck pain can be brought on by pressing on the neck, while others cannot.

Does it hurt more when you press on the back or sides of the neck?

Yes, it hurts more when I press on my neck.

No, it does not hurt more when I press on my neck.

In persons age 40 and older, with neck pain that lasts at least two weeks but is not painful with the application of pressure, the most common causes of neck pain are

  • osteoarthritis

  • disc disease - often associated with radiating pain, numbness or tingling into one arm.

  • Muscle strain or spasm is possible (mostly because it's so common) but these tend to be painful with the application of pressure.

In most people with these conditions, treatment is often effective--that is, the prognosis is good.

Click here to learn more.

In persons at least age 40 with neck pain that lasts at least two weeks and is painful with the application of pressure, the most common causes of neck pain are

  • muscle spasm or strain

  • osteoarthritis, with associated muscle spasm

  • disc disease, with associated muscle spasm.

In most people with these conditions, treatment is often effective--that is, the prognosis is good.

Click here to learn more.

Here are a number of non-medication treatment options for neck pain to consider. The best one or more of these treatments will depend on what you have already tried, your other medical problems and medications and the preferences of you and your doctor -- there is no one best choice in most situations.

  • Stretch often; for example, while reading, don't stay in one position too long.

  • Adjust your computer screen so you don't have to turn your head or look upward or downward to view it.

  • Use a heating pad on the sore area or a cool compress -- it is difficult to predict which will work best.

  • Use a soft cervical collar or special pillow designed for persons with neck pain.

  • Your doctor can suggest appropriate referrals, such as physical therapy; among the many ways a physical therapist treats neck pain are specific exercises, electrical stimulation, ultrasound therapy, traction or a custom-fit neck collar.

  • Massage, and other alternative and complementary approaches, such as acupuncture.

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Each person's neck pain is different and each person responds to pain differently, so review with your doctor which may work best for you.

The medications that may help include:

  • over-the-counter medication for pain such as acetaminophen, or a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen or naproxen

  • an ointment or cream applied to the painful area, such as Icy-hot or BenGay

  • prescription medicines such as muscle relaxants (diazepam, cyclobenzaprine, or methocarbamol) and higher doses of ibuprofen and naproxen

  • powerful pain relievers, such as narcotics (codeine, propoxyphene, oxycodone and others); side effects, such as sedation, constipation and nausea, are common and limit the use of these; they are also habit forming, so low doses and short duration of use are recommended if these medications are prescribed

  • tramadol (Ultram), a non-narcotic medication that acts in a similar way to narcotic medicines

  • injections of cortisone and long-acting anesthetic agents; these are occasionally offered for certain causes of neck pain (such as osteoarthritis, disk disease or spinal stenosis).

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Rarely, surgery is necessary for neck pain. For example, if a disc has ruptured and is pressing on a nerve or the spinal cord, an operation may be required for significant pain relief. This is usually a last resort and only if symptoms are not improving or are getting worse over time.

Fortunately, your answers do not suggest a condition for which surgery is likely to be recommended.

Click here to continue.

You have completed the neck pain decision guide. We hope your neck pain goes away quickly but if it does not, see your doctor and return here to update your symptoms or find more information. Remember, if your neck pain is severe, you should see your doctor right away or even proceed to an emergency room.

You have symptoms that may be present with a serious cause of neck pain, such as infection, nerve injury, or fracture.

While many people have these symptoms without a serious cause of neck pain, it is important that you contact your doctor promptly to be evaluated. It may be helpful to return to this decision guide after evaluation.