Neck pain

The neck supports the head#

The neck is made up of 7 bones (vertebrae) stacked one on top of the other. The vertebrae are connected by 2 facet joints and a disc, and are also bound together with ligaments. Muscles provide movement and vital support for all the structures of the neck.

The neck is very mobile, allowing us to see in all directions. This mobility also makes it vulnerable to injury. Strains from poor posture, trauma and degenerative conditions such as osteoarthritis are among the most common causes of neck pain.

There is good evidence that exercise helps reduce these symptoms. If you need short-term pain relief from medication, talk to your doctor or pharmacist.

Treatment for neck pain depends on the cause, but may include:

• advice on how to look after your neck and prevent unnecessary strain from work and everyday activities
• relaxation techniques
• exercise to retrain and strengthen the neck muscles

Poor posture and neck pain#

Poor sitting or working posture can contribute to neck pain by putting extra strain on the joints and muscles. Sitting or working with the shoulders slouched and the chin poking forward, such as when working for many hours at a computer, may strain the neck. So can looking down at a handheld device for long periods. Sleeping on your stomach with your head turned to one side to breathe can also strain the neck.

Suggestions to help prevent posture-related neck pain include:

• Set up your workstation so you can sit in a good, supported posture.
• When using a computer, position the screen at a height where your head stays upright and you view the centre of the screen by lowering your eyes only slightly.
• Change your posture regularly, whether sitting or standing.

A simple posture correction can help. ‘Grow tall’ by rolling up from your pelvis, then gently lengthen the back of your neck and draw your shoulders back. Use no more than about 10% effort. Hold the position for around 10 seconds, then relax. Repeat this a few times an hour while you are working.

This exercise helps keep tone in the muscles that support the neck and can ease the tight or tired feeling that builds up during the day. Get up and walk around regularly to vary your posture and keep your muscles and joints moving.

Try not to sleep on your stomach, as this requires your neck to be fully turned to one side. A neutral neck position supported by a comfortable pillow is usually preferable. Check that your pillow is the right size for you. Pillow choice is very individual, and no single pillow suits everyone. The distance between the side of your neck and your shoulder gives an idea of the pillow height you need to keep your head and neck supported when you sleep on your side.

Osteoarthritis and neck pain#

Osteoarthritis is a common type of arthritis that affects many people, and it becomes more common as we grow older. Contributing factors can include a genetic tendency in some people, previous joint injury and overuse.

Symptoms of osteoarthritis include pain, stiffness and weakening of the muscles. Commonly affected areas include the neck, lower back, hands, hip and knee.

There is no cure for osteoarthritis, but it can be managed well. Keeping the joints mobile and the muscles strong are the best ways to manage it. In the neck, osteoarthritis commonly causes local neck pain. If the upper joints of the neck are affected, the pain may also lead to headache. Occasionally osteoarthritis can irritate the nerves as they exit the neck.

If you experience shooting pains down your arm, or numbness or loss of power in your arm or hand, see your doctor, as you may need further investigation such as medical imaging.

You can manage neck pain related to osteoarthritis with:

• pain-relieving medication or a heat pack, after speaking with your doctor
• gentle exercises to maintain neck movement
• exercises focused on retraining and strengthening the neck muscles

Whiplash#

Whiplash is an injury to the neck that typically occurs as a result of a rear-end motor vehicle collision, in which any structure of the neck might be strained.

Common symptoms of whiplash include neck pain, headache and neck stiffness. Some people may also feel unsteady or light-headed. Recovery depends on the individual and the extent of the injury, and can vary from a few weeks to months.

Early treatment for whiplash may include:

• advice and education on how to care for your neck and help recovery
• pain-relieving or anti-inflammatory medication
• relaxation and stress-management techniques
• gradual return to your usual activities as your neck tolerates

Keeping up as many of your normal daily activities as you can is ideal, although some modifications may be necessary in the early stages. Be adaptable and try to remain positive. If pain is severe or persists, or if you have unusual symptoms, further examination or investigation by a healthcare professional may be required.

Wry neck#

Wry neck describes a condition in which the neck temporarily becomes stiff and painful. It can occur at any age, but is more common in teenagers and young adults.

Turning your head to the side (usually one side more than the other) and looking up can produce a sharp pain. One or both sides of the neck may go into spasm, and pain may be felt from the top of the neck down to the shoulder blade and even out to the top of the shoulder.

There are many possible causes, including:

• sleeping in an awkward position
• a sudden flicking or jerking of the head
• carrying heavy, unbalanced loads, such as a suitcase
• viral infection

In most cases, if treated early, wry neck responds well within a few days. Heat and passive joint mobilization can be used to loosen the neck joints and reduce pain and muscle spasm. In rare cases, particularly for people over 40 and very rarely in infants, wry neck can be caused by an underlying medical condition. Your doctor or therapist can help with the diagnosis and refer you for appropriate care.

While you are recovering from wry neck:

• use a small heat pack at home or at work for pain relief, or let a hot shower help keep the area warm
• keep moving your neck as much as pain allows
• avoid sitting or lying with your neck in an awkward position
• talk to your doctor or pharmacist about pain medication if your pain is severe

Treatment for neck pain#

Neck pain can generally be treated successfully by physiotherapists and your primary care doctor, although other options such as osteopathy, chiropractic or remedial massage are available. Treatment may include:

• information on what may be contributing to your neck pain
• advice to stay active as able
• exercise programs to retrain and strengthen the neck muscles and encourage movement
• posture training exercises
• passive joint mobilization or manipulation
• soft-tissue massage
• taping to help guide correction of posture

Key points#

• Strains from poor posture, trauma and degenerative conditions such as osteoarthritis are among the most common causes of neck pain.
• There is good evidence that exercise helps reduce these symptoms.
• Osteoarthritis is a common type of arthritis that affects many people.
• Symptoms of osteoarthritis include pain, stiffness and weakening of the muscles.
• Commonly affected areas include the neck, lower back, hands, hip and knee.

Where to get help#