Neck Problems and Injuries

Topic Overview

Most people will have a minor neck problem at one time or another. Our body movements usually do not cause problems, but it's not surprising that symptoms develop from everyday wear and tear, overuse, or injury. Neck problems and injuries most commonly occur during sports or recreational activities, work-related tasks, or projects around the home.
Neck pain may feel like a "kink," stiffness, or severe pain. Pain may spread to the shoulders, upper back, or arms, or it may cause a headache. Neck movement may be limited, usually more to one side than the other. Neck pain refers to pain anywhere from the area at the base of the skull into the shoulders. The neck includes:

• The bones and joints of the cervical spine (vertebrae of the neck).
• The discs that separate the cervical vertebrae and absorb shock as you move.
• The muscles and ligaments in the neck that hold the cervical spine together.

Neck pain may be caused by an injury to one or more of these areas, or it may have another cause. Home treatment will often help relieve neck pain caused by minor injuries.

Activities that may cause neck pain

Neck pain is often caused by a strain or spasm of the neck muscles or inflammation of the neck joints. Examples of common activities that may cause this type of minor injury include:

• Holding your head in a forward posture or odd position while working, watching TV, or reading.
• Sleeping on a pillow that is too high or too flat or that doesn't support your head, or sleeping on your stomach with your neck twisted or bent.
• Spending long periods of time resting your forehead on your upright fist or arm ("thinker's pose").
• Stress. Tension may make the muscles that run from the back of the head across the back of the shoulder (trapezius muscle) feel tight and painful.
• Work or exercise that uses your upper body and arms.

Sudden (acute) injuries

Minor neck injuries may result from tripping, falling a short distance, or excessive twisting of the spine. Severe neck injuries may result from whiplash in a car accident, falls from significant heights, direct blows to the back or the top of the head, sports-related injuries, a penetrating injury such as a stab wound, or external pressure applied to the neck, such as strangulation.
Pain from an injury may be sudden and severe. Bruising and swelling may develop soon after the injury. Acute injuries include:

• An injury to the ligaments or muscles in the neck, such as a sprain or strain. When neck pain is caused by muscle strain, you may have aches and stiffness that spread to your upper arm, shoulder, or upper back. Shooting pain that spreads down the arm into the hand and fingers can be a symptom of a pinched nerve (nerve root compression). Shooting pain is more serious if it occurs in both arms or both hands rather than just one arm or one hand.
• A fracture or dislocation of the spine. This can cause a spinal cord injury that may lead to permanent paralysis. It is important to immobilize and transport the injured person correctly to reduce the risk of permanent paralysis. See first aid for a spinal injury.
• A torn or ruptured disc. If the tear is large enough, the jellylike material inside the disc may leak out (herniate) and press against a nerve or the spinal cord (central disc herniation). You may have a headache, feel dizzy or sick to your stomach, or have pain in your shoulder or down your arm.

Emergency care is required for a neck injury that causes damage to the spinal cord. Symptoms of a spinal cord injury include loss of movement or feeling, numbness, tingling, difficulty controlling the muscles of the arms or legs, and loss of bowel or bladder control.

Conditions that may cause neck problems

Neck problems may not be related to an injury.

• Arthritis or damage to the discs of the neck can cause a pinched nerve. Neck pain caused by a pinched nerve generally affects one side of the neck and the arm on that side. Other symptoms may develop, such as numbness, tingling, or weakness in the arm or hand.
• Meningitis is a serious viral or bacterial illness that causes inflammation around the tissues of the brain and spinal cord. Symptoms come on quickly and include severe headache, stiff neck, fever, and sometimes vomiting. The neck stiffness makes it hard or impossible to touch the chin to the chest.
• The flu, which usually is not serious, can cause symptoms similar to meningitis. When neck pain is caused by flu, the neck and the rest of the body tend to ache all over, but severe neck stiffness is absent.
• Neck pain that occurs with chest pain may be caused by a serious problem with the heart, such as a heart attack.
• Stress and tension may make the muscles that run from the back of the head across the back of the shoulder (trapezius muscle) feel tight and painful. You may not be able to move your head without pain.
• Torticollis is caused by severe muscle contraction on one side of the neck, causing the head to be tilted to one side. The chin is usually rotated toward the opposite side of the neck. Torticollis may be present at birth (congenital) or caused by injury or disease.

Treatment

Treatment for a neck problem or injury may include first aid measures, physical therapy, manipulative therapy (such as chiropractic or osteopathic), medicine, and in some cases surgery. Treatment depends on:

• The location, type, and severity of the injury.
• Your age, health condition, and activities (such as work, sports, or hobbies).

Check your symptoms to decide if and when you should see a doctor.

Home Treatment

Home treatment may help relieve pain, swelling, and stiffness related to a neck problem.

• Apply ice and cold packs to the injured area.
  • Apply ice or cold packs for 15 to 20 minutes, 3 or 4 times a day or up to once an hour for the first 24 to 48 hours. Cold decreases swelling and pain. Keep a towel between your skin and the ice to prevent frostbite. Do not fall asleep with the ice on your skin.
  • Try ice massage. Massage the painful area with ice for 2 to 7 minutes, long enough to numb the pain. Ice frozen in a foam cup works well. Be careful not to damage your skin (frostbite).
• Gently massage or rub the area to relieve pain and encourage blood flow. Do not massage the injured area if it causes pain.
• After 48 to 72 hours, if swelling is gone, apply heat. Use a warm pack or heating pad set on low. Some experts recommend switching back and forth between heat and cold treatments. You also can begin gentle exercise with the aid of moist heat to help restore and maintain flexibility.
• Continue with your usual daily activities unless you have severe neck and back pain. Modify or avoid any activity that makes your pain worse.
• Practice good posture. Avoid slouching or a head-forward posture.
• When sleeping, place a small support pillow under your neck, not under your head.
• When the pain begins to get better, start doing neck exercises. Do each exercise twice a day, 5 times each, and gradually increase to 10 times each. Do not do any exercises that cause pain.
• If tension is contributing to your neck pain, massage may be helpful.

Do not smoke. Smoking slows healing because it decreases blood supply and delays tissue repair. For more information, see the topic Quitting Smoking.

Medicine you can buy without a prescription

Try a nonprescription medicine to help treat your fever or pain:

Acetaminophen, such as Tylenol Nonsteroidal anti-inflammatory drugs (NSAIDs): Ibuprofen, such as Advil or Motrin Naproxen, such as Aleve or Naprosyn Aspirin (also a nonsteroidal anti-inflammatory drug), such as Bayer or Bufferin Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips

Be sure to follow these safety tips when you use a nonprescription medicine:

Carefully read and follow all directions on the medicine bottle and box. Do not take more than the recommended dose. Do not take a medicine if you have had an allergic reaction to it in the past. If you have been told to avoid a medicine, call your doctor before you take it. If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to. Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Other home treatment may help for problems that are related to neck pain, such as:

• Headaches. To learn more, see the topic Headaches.
• Back pain. To learn more, see the topic Low Back Pain or Back Problems and Injuries.
• Shoulder pain. To learn more, see the topic Shoulder Problems and Injuries.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

• New or increased weakness or numbness in your arms or legs develops.
• You lose control of your bowels or bladder.
• Pain becomes severe or lasts longer than 2 weeks.
• Symptoms do not improve with home treatment.
• Symptoms become more severe or frequent.