Most episodes of acute neck pain or stiff neck settle after a few days or weeks and is rarely a sign of anything serious.
Neck pain can come on often after :
- sleeping in a bad position
- neck muscle strain, e.g. bad posture whilst reading or using a computer
- episode or stress or anxiety leading to muscle tension
Early management of neck pain at home includes taking simple painkillers, carrying on with usual activities, and keeping active. Sometimes heat packs, neck stretches or exercises are all that are required. Also consider changing pillow and adjusting computer workstation to improve posture.
If despite these simple measures your neck pain doesn't settle or is too severe, go and see your GP. Your GP will examine you and may prescribe stronger painkillers, or refer you to physiotherapy. Your GP may refer to a specialist if the pain is particularly severe or doesn't improve.
In my clinic you will receive a full assessment and thorough neurological examination. If needed, MRI imaging will be obtained of your neck in order to determine the cause of your symptoms and plan treatment. Causes of neck pain and stiffness include but not limited to :
- wear and tear (cervical spondylosis)
- this is a type of arthritis that occurs naturally with age
- twisted or locked neck (torticollis)
- this is due to muscle spasm and most episodes settle in 24-48 hours spontaneously
- often caused by an RTA, this is where the muscle and ligaments of the neck are overstretched by a sudden movement of the head forwards, backwards or sideways. This can lead to neck pain, stiffness or headaches
- trapped nerve causing neck and arm pain
Cervical radiculopathy is the name given to arm pain due a pinched or squashed nerve in the neck.
As each nerve emerges from the neck, they can be pinched due to either :
- an acute disc prolapse
- this can occur when one of the discs in the neck splits open and the soft nucleus spills out and bulges onto a nerve
- a bone spur due to wear and tear
- natural ageing of the neck bones and joints causes bone spurs to form. These can protrude into the path of the nerve and squash it causing arm pain
The arm pain of often associated with pins and needles and/or numbness. Less often there is weakness of one or more muscle in the arm as well. This type of arm pain does generally settle but if it doesn't or the pain is too severe, treatment for the nerve can be started. This may include strong painkillers, physiotherapy, nerve root block cortisone injection or sometimes surgery to fix the problem. In most cases, one way or another, we can get rid of the pain.
Sometimes, if the cause of the pain is not clear on the MRI, we may ask a Consultant Neurophysiologist to do nerve conduction studies. There are rarer causes of nerve pain not due to compression of the nerve root in the neck.