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 use correct first aid to immobilize and transport the injured person correctly to reduce the risk of permanent paralysis.
  • 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.

Check Your Symptoms

Do you have a neck injury or other neck problem?
Yes
Neck problem or injury
No
Neck problem or injury
How old are you?
Less than 5 years
Less than 5 years
5 years or older
5 years or older
Are you male or female?
Male
Male
Female
Female
Have you had surgery on your neck in the past month?
Yes
Neck surgery in the past month
No
Neck surgery in the past month
Could you be having symptoms of a heart attack?
If you're having a heart attack, there are several areas where you may feel pain or other symptoms.
Yes
Symptoms of heart attack
No
Symptoms of heart attack
Have you had a major trauma in the past 2 to 3 hours?
Yes
Major trauma in past 2 to 3 hours
No
Major trauma in past 2 to 3 hours
Do you have any numbness, tingling, or weakness or any moderate to severe pain that started after the trauma?
Yes
Symptoms after major trauma
No
Symptoms after major trauma
Have you had a neck injury in the past month?
Yes
Neck injury in the past month
No
Neck injury in the past month
Are you having trouble moving your neck or either arm normally?
Yes
Difficulty moving neck or arm
No
Difficulty moving neck or arm
Are you able to move your arm or hand?
Yes
Able to move arm or hand
No
Unable to move arm or hand
Have you had trouble moving your neck or arm for more than 2 days?
Yes
Difficulty moving neck or arm for more than 2 days
No
Difficulty moving neck or arm for more than 2 days
Do you have numbness, tingling, or weakness in your arms or hands?
Weakness is being unable to use the arm or hand normally no matter how hard you try. Pain or swelling may make it hard to move, but this is not the same as weakness.
Yes
Numbness, tingling, or weakness in arms or hands
No
Numbness, tingling, or weakness in arms or hands
Did the numbness and weakness start right after the injury?
Yes
Numbness and weakness began immediately after injury
No
Numbness and weakness began immediately after injury
Have the symptoms lasted for more than an hour?
Yes
Numbness, tingling, or weakness for more than 1 hour
No
Numbness, tingling, or weakness for more than 1 hour
Do you have a deep wound in your head or neck?
This is more than a minor cut. This type of injury usually is caused by an object going through all the layers of skin to the tissue beneath.
Yes
Deep wound to head or neck
No
Deep wound to head or neck
Has sudden, severe weakness or severe numbness affected the whole arm or the whole hand?
Weakness is being unable to use the arm or hand normally, no matter how hard you try. Pain or swelling may make it hard to move, but that is not the same as weakness.
Yes
Severe or sudden numbness or weakness in the whole arm or hand
No
Severe or sudden numbness or weakness in the whole arm or hand
Do you have trouble moving your neck?
Yes
Difficulty moving neck
No
Difficulty moving neck
Is it very hard to move or somewhat hard to move?
"Very hard" means you can't move it at all in any direction without causing severe pain. "Somewhat hard" means you can move it at least a little, though you may have some pain when you do it.
Very hard
Very hard to move
Somewhat hard
Somewhat hard to move
How long have you had trouble moving your neck?
Less than 2 days
Difficulty moving neck for less than 2 days
2 days to 2 weeks
Difficulty moving neck for 2 days to 2 weeks
More than 2 weeks
Difficulty moving neck for more than 2 week
Has the loss of movement been:
Getting worse?
Difficulty moving is getting worse
Staying about the same (not better or worse)?
Difficulty moving is unchanged
Getting better?
Difficulty moving is improving
Are you having trouble breathing (more than a stuffy nose)?
Yes
Difficulty breathing more than a stuffy nose
No
Difficulty breathing more than a stuffy nose
Would you describe the breathing problem as severe, moderate, or mild?
Severe
Severe difficulty breathing
Moderate
Moderate difficulty breathing
Mild
Mild difficulty breathing
Is your ability to breathe quickly getting worse?
Yes
Breathing problems are quickly worsening
No
Breathing problems are quickly worsening
Do you have any swelling or a lump in your neck?
Yes
Swelling or lump in neck
No
Swelling or lump in neck
Is it quickly getting worse?
Yes
Lump or swelling in neck is rapidly increasing
No
Lump or swelling in neck is rapidly increasing
Are you hoarse or having trouble swallowing?
Yes
Difficulty swallowing or hoarseness
No
Difficulty swallowing or hoarseness
Is there any neck pain?
Yes
Neck pain
No
Neck pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
5 to 10: Moderate to severe pain
Moderate to severe pain
1 to 4: Mild pain
Mild pain
Has the pain:
Gotten worse?
Pain is increasing
Stayed about the same (not better or worse)?
Pain is unchanged
Gotten better?
Pain is improving
Do you have any neck pain?
Yes
Neck pain
No
Neck pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
How long has the pain lasted?
Less than 2 full days (48 hours)
Pain less than 2 days
2 days to 2 weeks
Pain 2 days to 2 weeks
More than 2 weeks
Pain more than 2 weeks
Has the pain:
Gotten worse?
Pain is getting worse
Stayed about the same (not better or worse)?
Pain is unchanged
Gotten better?
Pain is getting better
Do you think that the neck problem may have been caused by abuse?
Yes
Neck problem may have been caused by abuse
No
Neck problem may have been caused by abuse
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Yes
Symptoms of serious illness
No
Symptoms of serious illness
How long have you had neck symptoms?
Less than 1 week
Symptoms for less than 1 week
1 to 2 weeks
Symptoms for 1 to 2 weeks
More than 2 weeks
Symptoms for more than 2 weeks

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

  • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
  • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
  • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Severe trouble breathing means:

  • The child cannot eat or talk because he or she is breathing so hard.
  • The child's nostrils are flaring and the belly is moving in and out with every breath.
  • The child seems to be tiring out.
  • The child seems very sleepy or confused.

Moderate trouble breathing means:

  • The child is breathing a lot faster than usual.
  • The child has to take breaks from eating or talking to breathe.
  • The nostrils flare or the belly moves in and out at times when the child breathes.

Mild trouble breathing means:

  • The child is breathing a little faster than usual.
  • The child seems a little out of breath but can still eat or talk.

Symptoms of serious illness may include:

  • A severe headache.
  • A stiff neck.
  • Mental changes, such as feeling confused or much less alert.
  • Extreme fatigue (to the point where it's hard for you to function).
  • Shaking chills.

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Do not move the person unless there is an immediate threat to the person's life, such as a fire. If you have to move the person, keep the head and neck supported and in a straight line at all times. If the person has had a diving accident and is still in the water, float the person face up in the water.

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Severe trouble breathing means:

  • You cannot talk at all.
  • You have to work very hard to breathe.
  • You feel like you can't get enough air.
  • You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

  • It's hard to talk in full sentences.
  • It's hard to breathe with activity.

Mild trouble breathing means:

  • You feel a little out of breath but can still talk.
  • It's becoming hard to breathe with activity.

Major trauma is any event that can cause very serious injury, such as:

  • A fall from more than 10 ft (3.1 m) [more than 5 ft (1.5 m) for children under 2 years and adults over 65].
  • A car crash in which any vehicle involved was going more than 20 miles (32 km) per hour.
  • Any event that causes severe bleeding that you cannot control.
  • Any event forceful enough to badly break a bone.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Symptoms of a heart attack may include:

  • Chest pain or pressure, or a strange feeling in the chest.
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
  • Lightheadedness or sudden weakness.
  • A fast or irregular heartbeat.

The more of these symptoms you have, the more likely it is that you're having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, numbness, tingling, or a strange feeling in your chest or other areas.

Symptoms of difficulty breathing can range from mild to severe. For example:

  • You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
  • It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Pain in children 3 years and older

  • Severe pain (8 to 10): The pain is so bad that the child can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain. No one can tolerate severe pain for more than a few hours.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and sleep, but the child can tolerate it for hours or days.
  • Mild pain (1 to 4): The child notices and may complain of the pain, but it is not bad enough to disrupt his or her sleep or activities.
Postoperative Problems

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

After you call 911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

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:

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:

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 develops.
  • Pain becomes severe or lasts longer than 2 weeks.
  • Symptoms do not improve.
  • Symptoms become more severe or frequent.

Prevention

To help prevent neck pain caused by posture or body mechanics:

  • Avoid slouching or a head-forward posture. Sit straight in your chair with your lower back supported, feet flat on the floor, and shoulders relaxed. Don't sit for long periods without getting up or changing positions. Take short breaks several times an hour to stretch your neck muscles.
  • If you work at a computer, adjust the monitor so the top of the screen is at eye level. Use a document holder that puts your work at the same level as the screen. For more information, see the topic Office Ergonomics.
  • If you use the telephone a lot, use a headset or speaker phone. Don't cradle the phone on your shoulder.
  • Adjust the seat of your car to a more upright position that supports your head and lower back. Make sure that you are not reaching for the steering wheel while driving. Your arms should be in a slightly flexed, comfortable position.
  • Use proper lifting techniques. Lift with your knees, not your back.
  • Make sure children and teenagers use school bags and backpacks correctly.

To help prevent neck pain caused by your sleep habits:

  • Use a pillow that keeps your neck straight. Special neck support pillows called cervical pillows or rolls may relieve neck stress. You can also fold a towel lengthwise into a pad that is 4 in. (10 cm) wide, wrap it around your neck, and pin it in position for good support.
  • Don't sleep on your stomach with your neck twisted or bent.
  • If you read in bed, prop up the book so you aren't using your arms to hold it up and bending your neck forward. Consider using a wedge-shaped pillow to support your arms and keep your neck in a neutral position.

Other prevention tips:

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • What are your main symptoms?
  • How long have you had your symptoms?
  • If you were injured, how and when did the injury occur? How was it treated?
  • What were you doing at the time the neck pain started?
  • Have you recently been in a fight or been slapped, punched, or strangled?
  • Have you had any injuries in the past to the same area? Do you have any continuing problems because of the previous injury?
  • If you have chronic neck pain, has the pain changed significantly?
  • Do you have numbness or weakness in your arms or legs?
  • What activities related to sports, work, or your lifestyle make your symptoms better or worse?
  • Do you think that activities related to your job or hobbies caused your symptoms?
  • What home treatment measures have you tried? Did they help?
  • What nonprescription medicines have you taken? Did they help?
  • Do you have any health risks?

Credits

By Healthwise Staff
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
David Messenger, MD
Last Revised May 16, 2013

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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