Saying someone is a “pain in the neck,” usually means they are annoying or irritating. But anyone who has had neck pain knows it is far worse than simply annoying. Neck pain can be extremely debilitating.

What Causes Our Neck to Hurt?

Each day we subject the neck to repeated stress during daily activities. With time, the repeated stress and small insults to the neck add up, sometimes leading to degenerative problems in the cervical spine; sometimes only leading to discomfort.

Here are some of the factors leading to neck pain:

Muscle strains: Medics call it overuse. When we spend too much time hunched over our smartphone, a book or even a computer, the sitting position triggers muscle strain around the neck area. The longer we sit, the more strain we experience.

Even such minor activities such as gritting your teeth or reading in bed can cause strain on the neck.

Aging: Like other joints, the neck wears down as a person ages often resulting in osteoarthritis. When the cartilage between the bones deteriorates, spurs form which can lead to neck pain.

Trauma and injuries: Auto collisions, which cause whiplash, result in a hurting neck. The head being jerked backward creates strain on the soft tissues in the neck area.

Sports injuries: Rough and tumble games, like football, basketball and soccer often lead to neck strains. This is especially true if an athlete falls.

Diseases: There are some diseases that cause neck pain, including meningitis, cancer, and rheumatoid arthritis.

Common Diagnoses of Neck Pain

  • Disc Herniation: This is one of the more common causes of neck problems. The outer part of the disc tears or splits causing the gel-like substance between the vertebrae to poke out. This disc presses on the nerve resulting in numbness and pain.
  • Disc Bulging: As mentioned above, a gel-filled disc exists between vertebrae acting as a shock absorber. When it’s damaged, it bulges, pushing backwards into one side of the spinal canal causing pain and tingling.
  • Spinal Stenosis: This is an obstruction an compression of the nerves from the spine. It mostly starts to develop as an ailment related to age secondary to the disc dehydrating. With aging, this occurs more frequently. Someone with lower back spinal stenosis will experience unusual weakness in the lower back as well as numbness and pain into the legs and feet. Mid-back spinal stenosis is accompanied by painful ribs, and ache in the internal organs and legs. Spinal stenosis in the neck can cause pain in the arms and hands, numbness, and even weakness in the upper body.
  • Degenerative Disc Disease: This is a common cause of neck pain. A degenerative disc develops when the cushioning disc begins to break down. It may be genetically caused or a result of the aging process.
  • Muscle Sprain and Strain: A muscle becomes strained when it is overstretched. Overuse, fatigue, or improper movement can cause straining in the neck, causing discomfort and inhibiting movement.
  • Tension Headaches: Suboccipital muscles, located at the base of skull can be painful to some people resulting in tension headaches. These muscles aid in the subtle movement of the first and second vertebrae and skull. Eye strain, poor posture, trauma—and even wearing new eye glasses— may make these muscles tense and tender. A pain in the suboccipital muscles normally feels like a band warping the head.

Finding the Reason for Your Pain

To make a correct your neck pain, it is important for you to have an accurate diagnosis. Fortunately, your medical provider has a number of tests and examinations available to help find the problem. Based on your symptoms, your medical provider will figure out the exact cause of the pain, and suggest treatment to manage it.

You will also be asked questions a good number of questions to aid in diagnosing the problem.

Some of the questions which will be asked are: how long you’ve had the neck pain; whether you have been involved in an incident that would have caused neck pain; how the pain feels; what makes it feel better; what makes it feel worst; and whether you have tried to treat it at home.

Based on this information, the medical provider will observe your physical condition, your posture, and note any movement which is causing pain. Your muscle strength and reflexes may be tested to determine if the neck pain is traveling to other parts of your body.

Tests may be performed to find the real source of the pain. These tests could include:

  • X-Ray: They are always the next thing that is done for diagnosis; they can be plain neck X-rays and cervical X-rays. Four sets of x-rays are needed to look at the bone anatomy to find where the wear and tear in the neck is located. The X-ras will also show whether there are any signs of degeneration of discs.
  • CT scan: The imaging procedure gives detailed images of the targeted part of the body.
  • MRI: MRIs have the ability to give more detailed images of the structure of the neck. They do not use radiation, although patients with implants may not use them.

Symptoms to be Aware of

Persistent neck pain of more than six weeks. No improvement of pain treated with exercises or medicine. This could indicate an underlying problem such as:

  • Cancer: Although rare, neck pain may be a warning sign of cancer.
  • Infection: It may also be an infection of the spinal cord or areas near the neck.
  • Broken Bone: You may have broken your bone at some time without realizing it. Neck pain may be an indication that all is not well with one of the bones in the region.
  • Other red flags include: spinal cord injury, or a threat to a blood vessel in the neck region.

Options for Managing the Pain

  • Facet Injections: Medication is injected into the joint space. Response varies depending on the medication used. Medication can give several hours of pain relief. It’s normally delivered over a prolonged period.
  • Epidurals: This involves injecting a steroid into the surrounding areas. It helps in decreasing swelling and inflammation.
  • Painkillers: Medication to ease the pain is often helpful. Your physician may prescribe paracetamol, which should be at full strength, or anti-inflammatory painkillers such as ibuprofen, naproxen, and declofenac. Stronger painkillers such as codeine may be an option, especially if the anti-inflammatory meds do not respond well. Muscle relaxants, such as diazepam, are occasionally be prescribed if the neck muscles are very tense and pain is worsening.
  • Risks: Becoming addicted to opioids, hitting a nerve with needle, or infection.
  • Outcomes: Though painkillers are needed at times, they don’t help everyone.

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Physical Therapy

These are standard procedures for helping an individual get rid of spinal inflammations.

Massage evidence points toward beneficial effects on pain and other symptoms associated with a number of different conditions.

Exercise may help alleviate some pain, although one is advised to be cautious not to cause more harm in the injured areas.

Joint Manipulation: This is increasingly becoming an accepted procedure for treating neck pain. Chiropractic adjustment of the neck is achieved with the patient lying on the back or in a seated position.

Patient Education: Involves giving patients information on how to manage pain, and avoid more pain or complications.


  • Laninectomy: This procedure reduces the pressure on the nerves in the spine. It aims at removing the lamina (the part of the vertebral arch that forms the roof of the spinal canal) giving the spinal cord more space. Other sections which may be removed include part of the vertebra, and the bony protrusion which is attached.
  • Discectomy: Anterior cervical discectomy is done to remove a degenerative disc in the neck.
  • Fusion: This is done to strengthen the spine. Spinal fusion permanently connects two or more vertebrae in your spine, eliminating motion between them.


These last three procedures are only recommended when other non-surgical procedures have failed. Risks associated with these procedures are infection from the environment in which the procedure is done, and after. Although it is rare, it is possible to experience more pain, or even be paralyzed, because of botched surgery.


Although fifty percent of the surgeries are successful, a large percent of them fail. Therefore, caution is required. Surgery should only be done when it’s absolutely necessary, and all other options have failed to solve the problem.

Good Practices for a Pain-Free Neck

How often do you find yourself hunched over the steering wheel of your car? Or your computer or iPhone? Each time you curve over a keyboard, it puts stress on the discs of the back. When our head in a forward position, the muscles and tendons of the neck get overstretched.

To avoid over stretching the neck, keep your head upright on your neck. A strong neck does a good job of holding up your head, all eleven pounds of it. It is also more likely to stay pain free.

Another good practice is to be sure your hips are supported by the chair back, while your feet are flat on the floor. Position your computer at eye level with elbows at 90 degrees when typing. This is good for your body and reduces fatigue.

Periodically do a few gentle neck exercises such as slowly turning the head from side to side.

Finally, understand that sitting for too long is not healthy. If your goal is to be pain-free, counter your sitting with standing and moving.


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About Author: Dr. Scott Gray

Dr. Scott Gray is an internationally recognized and expert physical therapist specializing in sport, athletic, and back and neck injuries. He is the inventor of a revolutionary form of treatment called the GRAY METHOD. This type of treatment unlike others, addresses the CAUSE rather than just your SYMPTOMS with a full body approach. For more information on how to ease or overcome your injury, go to

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