Dr Melanie:
Neck pain
Two-thirds of us suffer at some time, but most episodes are preventable
Our necks contain seven bony vertebrae which gently curve forwards and support our heads. They’re linked to each other, the skull, and the lower spine by shockabsorbing jelly-like discs, complex tiny joints, strong gristly ligaments and powerful muscles that provide stability while allowing us to bend and turn our heads. The spinal cord runs down a bony tunnel and sends out nerves beneath each vertebra – these relay our brains’ instructions to our muscles, and bring back information about touch, pain, position and other sensations.
The causes
Our heads weigh around 10lb but looking down at our mobiles can quadruple the strain on our necks. And poor posture, carrying heavy weights, sleeping badly, twists, turns or sudden jerks (whiplash) can strain or sprain soft tissues, producing a dull ache, stiffness, and/or agonising pain when we move – spasm from an acute wry neck (torticollis) may temporarily twist it to one side. Most non-specific neck pains only last a few days or weeks, but around 10% may become chronic, depending on what the underlying cause is.
Neck pain often spreads to the shoulders, upper back or over the top of the head. Constant or worsening pain may mean a trapped nerve – especially if it goes down the arm and is linked to finger tingling, numbness or weakness. Pain can also be caused by bony conditions, including cervical spondylosis (arthritis of the neck),
bone-thinning osteoporosis, and, rarely cancer; or be ‘referred’ – eg from a chest or heart problem.
The tests
Seek medical advice if pain lasts more than a few days or is linked to trapped-nerve symptoms, night pain, weight loss or sweats – urgently if it follows severe trauma, you have osteoporosis, or your legs/arms/bladder or bowel control are affected. You may need an X-ray to look for bony damage or an MR scan to examine the nerves, discs and other soft tissues. You may also need blood tests or checks on other body areas.
The treatment
Simple neck strain can be treated with painkillers and heat (eg hot-water bottle). Try to identify the cause and avoid driving or lifting until your neck easily moves. As soon as you can, gently move your neck (visit nhs.uk for exercises). Your GP may refer you for physiotherapy, and surgery is occasionally needed for slipped discs or trapped nerves. Some people find acupuncture or chiropractic helpful – choose a qualified practitioner.