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Chronic Neck Pain

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(Neck Pain, Chronic)

Definition

Chronic neck pain is pain that occurs over a long period of time. It usually lasts more than three months. The pain can range from mild to severe.
Contact your doctor if you have experienced neck pain over a period of time without relief.
Nerve Pain in Neck
Neck pain
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Causes

Chronic neck pain can be caused by:

Risk Factors

The causes of chronic neck pain are also usually risk factors.

Symptoms

Chronic neck pain may also cause you to have neck stiffness. Pain may be worse when moving your neck. The pain can be any type of pain including burning, sharp, dull, tingling. The pain may spread to other parts of the body such as the shoulders and arms.
Muscles of the Neck
Neck Muscles
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Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may refer you to a specialist. Orthopedists specialize in bones and joints. A neurologist or neurosurgeon specializes in the nerves and spinal cord.
Your doctor may need to see images of your spine. This can be done with:
Your doctor may need to measure how well the nerves and muscles in your neck are working. This can be done using electromyography (EMG) .

Treatment

Talk with your doctor about the best plan for you. Options include the following:

Activity and Exercise

You may be able to decrease your pain by staying active and exercising. Your doctor may also refer you to a physical therapist. A therapist may work on strength exercises and stretching.

Medications

There are many different medicines that may be used the help you manage your neck pain.
  • Nonsteroidal anti-inflammatory drug (NSAID)—to treat the pain and reduce inflammation
  • Acetominophen—to treat pain
  • Certain antidepressant medications—sometimes used for neck pain
  • Certain antiseizure medications
  • Corticosteroid injection —to treat the pain and reduce inflammation caused by disk disease

Other Treatments

There are other treatments that might be helpful for neck pain.
  • Low-level laser therapy— a light source is directed on the painful area
  • Chiropractic care
  • Acupuncture
  • Intermittent traction (pulling on the neck)
  • Massage

Surgery

Most cases of neck pain are treated medically. In some cases surgery is needed. The type of surgery will depend on the cause of pain. For example, if you have a herniated disk in your neck, surgery will remove the disk .

Prevention

To help reduce your chance of getting neck pain, take the following steps:
  • Maintain good posture.
  • Take breaks from activities that do not involve movement such as driving or working at a computer.
  • Avoid sleeping with too many pillows
  • Get plenty of exercise
  • Make sure your desk chair and keyboard are at proper heights.
  • Avoid cradling the phone in your neck.

RESOURCES

American Academy of Family Physicians http://www.familydoctor.org

American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/

American Physical Therapy Association http://www.apta.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org/

Canadian Orthopaedic Foundation http://www.canorth.org/

Canadian Physiotherapy Association http://www.physiotherapy.ca/public

References

Langevin P, Lowcock J, Weber J, Nolan M, Gross AR, Peloso PM, Roberts J, Graham N, Goldsmith CH, Burnie SJ, Haines T; Cervical Overview Group. Botulinum toxin intramuscular injections for neck pain: a systematic review and metaanalysis. J Rheumatol. 2011;38(2):203-214.

Misailidou V, Malliou P, Beneka A, Karagiannidis A, Godolias G. Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools. J Chiropr Med . 2010 Jun;9(2):49-59.

Neck pain. American Academy of Family Physicians website. Available at: http://familydoctor.org/online/famdocen/home/tools/symptom/513.html . Accessed December 6, 2012.

Neck pain. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00231 . Updated November 2009. Accessed December 6, 2012.

Neck pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated November 30, 2012. Accessed December 6, 2012.

What a pain in the neck! American Academy of Physical Medicine and Rehabilitation website. Available at: http://www.aapmr.org/patients/conditions/msk/spine/Pages/Prevent-Neck-Pain.aspx . Accessed December 6, 2012.

12/31/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet. 2009;374:1897-1908.

12/17/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Andersen LL, Christensen KB, Holtermann A, et al. Effect of physical exercise interventions on musculoskeletal pain in all body regions among office workers: a one-year randomized controlled trial. Man Ther. 2010;15(1):100-104.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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