Globally, neck pain is estimated to affect 203 million people, making it one of the most common musculoskeletal pains worldwide. It often stems from a combination of factors, such as muscle strain, poor posture, and degenerative disc conditions. This pain can limit movement, disrupt daily life, and, in severe cases, impact overall health.
While some turn to pain medications or consider surgical options for relief, these approaches may carry risks and side effects. Fortunately, many cases of neck pain can be managed through alternative options that focus on supporting the body’s natural healing processes. Interventional orthobiologics offer an alternative path to recovery, reducing reliance on medications or surgery.
Where In The Neck Does It Hurt?
The neck is a common term that refers to the cervical spine. This is a complex structure located at the top of the spinal column, composed of bones, muscles, nerves, and soft tissues. These components work together to support the head, provide stability, and ensure flexibility and range of motion.
The main components of the cervical spine are:
- Cervical vertebrae: The neck area of the spine is composed of seven stacked bones (C1-C7), which support the head and protect the spinal cord.
- Intervertebral discs: Between each pair of vertebrae, soft discs of cartilage help absorb impact and shock. They also prevent bones from friction damage.
- Muscles: More than 20 muscles allow neck movement. They extend from the bottom of the skull to the collarbone, shoulder blades, and jaw.
- Ligaments and tendons. Strong bands of connective tissues, called tendons and ligaments, attach bones to muscles and to other bones, providing stability.
- Nerves: Nerve roots from the spinal cord extend through the neck, controlling sensation and movement.
- Facet joints: Facet joints are small joints located between vertebrae, which guide neck movement.
Pain can affect different regions of the neck. Depending on where symptoms are localized, neck pain can have different causes.
Nape
Neck pain is most commonly felt at the nape, the back of the neck. This section of the spine houses many important structures, including the trapezius muscles and part of the cervical spine.
Pain here typically feels like a dull ache or stiffness. It tends to worsen after prolonged sitting or sleeping in an awkward position. Accompanying symptoms may include muscle tightness, reduced range of motion, and tension headaches.
Common causes are muscle strain from poor posture or overuse, and in some cases, issues like facet joint inflammation or herniated discs.
Side of Neck Pain
Neck pain can occur on either side due to the mirrored anatomy of the neck. In most cases, this pain results from muscle tension, poor posture, or an awkward sleeping position.
Other common causes include radiculopathy, where a pinched nerve leads to pain, numbness, or tingling that may radiate to the shoulder, arm, or hand. Torticollis, or wryneck, can cause a twisted or stiff neck due to muscle spasms or nerve irritation.
Cervical disc degeneration, a common age-related condition, may lead to stiffness, pain, and nerve compression. Spinal canal narrowing can irritate nearby nerves, resulting in sharp pain, tingling, or weakness. Addressing posture, muscle health, and spinal alignment can help alleviate discomfort, regardless of which side of the neck is affected.
Types Of Neck Pain
The type of neck pain felt may vary depending on what structures are affected. The two main types of neck pain are:
- Axial pain: Axial pain is typically felt in the neck, possibly extending to the shoulders. Patients can typically point to the source of the pain.
- Radicular vs Referred pain: This refers to a type of pain caused by nerve irritation or damage. In the neck, it can happen due to the narrowing of the spinal canal or disc herniation, which can compress nearby nerves. This type of pain radiates along the nerve pathways, from the back of the head to the arms and hands. Symptoms may include numbness, tingling, reduced muscle strength, and altered reflexes.
Depending on the type of neck pain, specific accompanying symptoms include the following:
- Pain often is worsened by holding the neck in one position: If the pain worsens when holding the neck in a single position, it may be because that position is straining muscles and ligaments, or compressing nerves.
- Muscle spasm: Sudden, involuntary muscle contractions can occur when a nerve transmitting motor signals is compressed or affected. Spasms can be caused by muscle tension or response to injury or strain.
- Reduced range of neck motion: Inflamed muscles and joints or discs affected by degeneration, like osteoarthritis and disc herniation, can restrict movement. Restricted neck movement can make it difficult to turn or tilt the head.
- Headache: Neck pain often radiates to the head due to shared nerve pathways, leading to tension headaches. A 2023 study shows that 73% to 90% of people experiencing migraines or tension headaches also suffer from neck pain.
- General soreness: Overused or strained muscles can occur due to excessive activity, poor posture, or inadequate sleeping position. Soreness can cause a dull ache that can spread from the neck to the shoulders and head.
- Facet joint pain: Facet joints between vertebrae can become inflamed or misaligned, causing localized pain and stiffness.
- Nerve pain: Compression or irritation of cervical nerves can cause sharp, radiating pain, often with tingling or numbness in the arms or shoulders.
Common Causes Of Neck Pain
Neck pain is sometimes caused by benign conditions, like muscle strains. However, sometimes, it can indicate more serious or degenerative underlying conditions.
Muscle Strains
Muscle strain in the neck often results from poor posture or repetitive habits. Over time, it can cause tense muscles and misalignments in the spine. Unevenly distributed pressure can cause the wear and tear of cervical discs, contributing to pain and reduced mobility.
Common posture problems leading to muscle strain include:
- Bad posture, such as hunching over a desk or slouching while using a phone, places undue stress on neck muscles.
- Sitting for extended periods with shoulders rounded and head forward disrupts the natural alignment of the spine, leading to muscle fatigue and strain.
- Activities like prolonged computer work or texting can contribute to this condition. A 2024 study found a strong correlation between prolonged mobile phone usage and chronic neck pain.
Worn Joints
Facet joints are small joints located between and behind vertebrae. They are responsible for stabilizing the spine and enabling movement. Cervical facet joints facilitate the head’s range of motion, including rotation and tilting.
Over time, these joints can wear down, especially in older adults, due to cartilage loss or degeneration. Worn joints often cause stiffness, aching, and a grinding sensation when moving the neck.
Injury
Neck injuries, such as whiplash from car accidents or falls, can overstretched ligaments and tendons, causing tears. This type of neck injury can also strain muscles, cause broken bones, and compress nerves.
These injuries often result in immediate pain, muscle stiffness, and difficulty moving the head. Additionally, if not properly treated, trauma-related injuries increase the risk of long-term neck issues, such as chronic pain caused by misalignments.
Injuries can lead to the acceleration of spinal degeneration, such as degenerative disc disease and facet arthritis. Injuries to your neck damage multiple structures in your neck, such as ligaments that hold your bones together, facet joint injuries, intervertebral disc injuries, and bone injuries. The trauma creates an unstable neck, leading to muscles trying to protect the spine, causing spasms and stiffness.
Diseases
Neck pain may sometimes stem from certain diseases, such as:
- Meningitis: This is an infection of the protective membranes around the brain and spinal cord. As well as other symptoms, meningitis can cause sudden neck stiffness and fever. While rare, this condition requires urgent medical attention. A 2023 study found that 41% of cases of bacterial meningitis present the classic triad of symptoms: fever, neck stiffness, and altered mental status.
- Cervical spine infections: These are bacterial or fungal infections affecting the vertebrae and discs in the neck. They can cause severe neck pain and inflammation.
- Tumors: Tumors may also cause neck pain if they press on nerves or other structures in the neck area.
Arthritis
Arthritis is an umbrella term for several inflammatory diseases, including osteoarthritis and rheumatoid arthritis. These conditions cause ongoing inflammation and the breakdown of important neck structures.
This leads to changes in the intervertebral discs, cervical joints, and bones. Over time, arthritis can result in neck pain, stiffness, and limited motion, particularly during flare-ups or as the conditions progress.
Degenerative Cervical Discs
Degenerative disc disease occurs when the discs between cervical vertebrae lose hydration and elasticity, which reduces their ability to absorb shock and prevent friction during movement.
This degeneration often develops with age or due to repeated stress on the neck. As discs wear down, they can press on nerves or reduce flexibility, leading to chronic pain, stiffness, and restricted movement in the neck. A 2021 review reports that nearly a third of individuals over the age of 65 show signs of spine degeneration.
Herniated Cervical Discs
A herniated cervical disc occurs when the outer layer of a spinal disc tears. This causes the inner material to bulge out and press against nearby nerves. This condition typically results from trauma, aging, or intense physical strain.
When a herniated disc compresses nearby structures, like nerve roots in the neck, it can cause sharp, radiating pain, numbness, or tingling in the shoulders, arms, and hands.
Diagnosis And Examination
Since neck pain can stem from a combination of factors, physicians use several tools to diagnose it:
- Medical history: A review of health history helps identify potential causes, such as past injuries or existing medical conditions.
- Physical examination: During a physical examination, the physician will assess areas causing pain, range of motion, and signs of muscle weakness or nerve damage.
- Imaging tests (X-ray, MRI, CT scan): Imaging tests aid physicians in assessing the structural integrity of the neck. X-rays are used to diagnose bone problems, like breakages, while MRIs and CT scans provide detailed views of soft tissues, like discs, tendons, and nerves.
- Nerve conduction studies (NCS): These tests are carried out if nerve impairment is suspected. They measure nerve function to evaluate the presence of nerve damage or compression.
- Blood tests: Blood tests, such as the ones for the rheumatoid factor, can help rule out infections or systemic diseases like arthritis.
Types Of Treatment
Treatment options for neck pain range from conservative therapies to more advanced interventions. Many cases respond well to non-surgical treatments, while surgery may be considered as a last resort for severe pain.
- Medications: Pain relief medications include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or, in some cases, prescription drugs. However, long-term use can lead to side effects, including stomach ulcers, kidney disease, and an increased risk of heart attack and stroke.
- Physical therapy: Exercises improve strength, flexibility, and posture, reducing strain on the neck. Common therapies used include:
- Transcutaneous electrical nerve stimulation (TENS): Utilizes electrical impulses to stimulate nerves and relax muscles, which can temporarily improve pain.
- Traction: This is a gentle technique that involves manipulating and mildly pulling the neck to relieve pressure.
- Short-term immobilization: Immobilization or bracing may involve the use of a soft collar to limit neck movement, prevent further injury, and promote healing.
- Chiropractic care: Manual adjustments can help with problems like misaligned vertebrae.
- Steroid injections: Corticosteroids are injected around inflamed nerves or joints to reduce pain and inflammation, often providing temporary relief. However, 2015 research suggests that prolonged use of steroid injections or high doses can have negative effects, like accelerating the breakdown of cartilage.
- Surgery: Surgery is suggested in severe cases where other treatments fail, especially in cases involving nerve compression or disc issues. Types of neck surgeries include:
- Discectomy involves removing a herniated disc that is pressing on a nerve to prevent further irritation and damage.
- Laminectomy involves the removal of part of a vertebra to relieve pressure on the spinal cord. It may be used in the event of spinal stenosis to correct the narrowing of the spinal canal and relieve pressure on the spinal cord.
- Fusion surgery aims to fuse together two or more vertebrae by removing the intervertebral disc. This can reduce pain and inflammation and stabilize the spine in the case of conditions like spinal degeneration and arthritis.
Surgical interventions may sometimes be considered when neck pain is chronic or causing disability. However, surgery comes with risks like infection, blood clots, and failures requiring further surgical intervention.
Additionally, invasive treatments involve lengthy and painful rehabilitation periods, especially when the spine or neck is affected. It is important to consider all treatment options before undergoing surgery.
- Orthobiologics
Defined as biologics from you that contain healing properties that help tendons and ligaments repair and work as an anti-inflammatory in arthritic joints (joint preservation).- PRP or Platelet-Rich Plasma: A high concentration of platelets isolated from a peripheral blood draw that contains a high concentration of growth factors that accelerate the repair process.
- BMC or Bone Marrow Concentrate: A high bone marrow aspirate concentration that contains isolated repair cell concentrate.
These offer an alternative treatment option to traditional orthopedic care (like steroids or surgery). They can address the underlying cause of all your symptoms using the PRP or BMC to treat all the injured areas, such as:
- Facet joints
- Spinal ligaments and Facet Capsules
- Around the irritated nerves
- Sometimes even directly into the damaged discs
Evidence comparing these to some traditional treatments shows they outperform and give more significant pain relief for longer.
Home Remedies
For minor neck pain, at-home remedies can provide relief, ease muscle tension, and improve mobility. Methods include:
- Over-the-counter (OTC) medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can reduce pain and inflammation temporarily.
- Warm and cold therapy: Warm compresses and cold packs help ease sore muscles and reduce inflammation. Icing is sometimes used as part of the RICE (rest, ice, compression, and elevation) method, a common way of treating injuries at home. However, recent research highlights that this method reduces blood supply to the injured site, which can slow down the healing process.
- Neck massage: Gentle massage around the neck area relaxes tense muscles and improves blood circulation, which may stimulate healing and alleviate pain.
- Neck stretches: Simple stretches help release tension, increase flexibility, and improve range of motion.
- Light aerobic exercises: Activities like walking or cycling improve blood flow and reduce stress or tension. Additionally, physical activity helps with muscle conditioning. Stronger muscles can improve posture and provide a support structure for neck components susceptible to injury or degeneration, like bones and ligaments.
When To Take This Seriously
Mild neck pain often has a benign cause and can be managed at home with activity modification, stretches, and rest. However, some signs associated with pain may be cause for concern and require proper diagnosis. These include:
- Numbness: Loss of sensation in the neck, arms, or hands may indicate nerve compression or spinal cord involvement.
- Persistent pins and needles in the arm: Tingling sensations, called paresthesia, is a symptom associated with nerve irritation or damage.
- General fatigue: Feeling unusually tired while experiencing neck pain and other symptoms, like a fever, can point to a systemic condition or infection.
- Experienced trauma: Neck pain following a fall, accident, or injury requires prompt attention to rule out fractures or tissue damage.
- Pain is getting worse: Worsening pain can indicate that the underlying cause of symptoms isn’t addressed or is progressing. This may be the case of arthritis or degenerative spine conditions.
- Developing weakness in the lower body: Weakness or loss of coordination in the legs may indicate spinal cord compression. This condition requires immediate medical care to prevent lasting damage or disability.
- Urine problems: Difficulty controlling bladder function can be a sign of severe nerve involvement. This sign should not be overlooked, as it represents a medical emergency.
- Other medical problems: Additional symptoms like fever or unexplained weight loss could point to infections or more serious health issues that require medical assistance.
How To Keep Your Neck Muscles Safe
Simple lifestyle adjustments can minimize the risk of developing chronic pain:
- Good posture is vital: Poor posture is a common contributor to neck pain, especially from activities like looking down at screens. Maintaining a neutral spine, with the head aligned over the shoulders, helps reduce strain on the neck.
- Incorporate ergonomics: Ergonomic adjustments at home and work can help prevent neck strain. Ensure screens are eye-level, use supportive chairs, and adjust desks to promote proper posture.
- Good sleeping position: The neck should be supported and aligned with the spine during sleep to prevent imbalances and muscle tension. Using a supportive pillow and avoiding sleeping on the stomach can help maintain a healthy neck posture overnight.
Taking proactive steps to protect the neck can reduce discomfort and prevent issues from developing. However, if you already suffer from neck pain, it is important to get an adequate diagnosis and look at all the treatment options available.