What is neck pain?

• Pain in the neck can be due to injury, a mechanical or muscular problem, a trapped nerve caused by a bulge in one of the discs between the vertebrae, or from arthritis of the neck

• It can range from very mild discomfort to severe, burning pain

• If the pain is 'acute' - sudden and intense - it is called a crick in the neck, facet syndrome, muscular rheumatism, or simply acute pain in the neck

• If the pain has lasted more than three months, it is termed 'chronic neck pain'

• Neck pain is a very common condition and is more frequently seen in women than men

• Most people will experience pain in the neck at some point in their life

What causes neck pain?

Many things can trigger neck pain. These include:

• Trauma or injury

• Worry and stress

• Falling asleep in an awkward position

• Prolonged use of a computer keyboard

The underlying problem could be slipped disc, brittle bones (osteoporosis), deformed natural curvature of the spine (scoliosis), trapezitis, and, very rarely, structural damage due to tumours or infection.

Finally, road traffic accidents involving whiplash injury may result in acute or chronic neck pain which takes several months to improve.

What does neck pain feel like?

• General pain located in the neck area as well as stiffness in the neck muscles

• The pain may radiate down to the shoulder or between the shoulder blades

• It may also radiate out into the arm, the hand, or up into the head, causing a one-sided or double-sided headache

• The muscles in the neck are tense, sore and feel hard to the touch

• Acute pain can give rise to abnormal neck posture in which the head is forced to turn to one side; this condition is known as torticollis

• The pain at the base of the skull may be accompanied by a feeling of weakness in the shoulders and arms

• There may be a prickly or tingling sensation in the arms and fingers

Danger signals associated with neck pain

In some cases, neck pain may be a symptom of meningitis. Therefore, if any of the the following symptoms occur, dial 999 or seek medical attention urgently:

• A rash develops that does not fade when you press it with a glass tumbler or a finger

• The patient feels ill or is running a fever as well as feeling neck pain

• It is so painful to bend the neck forward that the patient can't put their chin on their chest

• Light hurts the eyes

• Neck pain is accompanied by severe headache or continuous vomiting

• Neck pain is accompanied by severe pain in the back

In some cases, neck pain can be a symptom of head injury or disc trouble in the neck. If any of the following symptoms occur, dial 999 or seek medical attention urgently:

• Neck pain is the result of a recent head injury and the person is becoming drowsy, confused or is vomiting

• Neck pain is accompanied by headache

• If there is pain behind one eye

• Vision, hearing, taste or balance are affected

• Severe vomiting

• The muscle power in arms or legs is reduced

What can you do yourself?

Stay as active as possible. Try to go to work and keep up your normal everyday activities - bed rest is not necessary. If you are given a neck-collar, try not to use this for more than one or two days.

Remember that neck pain is rarely caused by a serious illness and will often disappear within a week.

If you have had pains in the neck for a longer period, it is a good idea to consult your GP or a physical therapist such as a chiropractor or physiotherapist.

How does the doctor or chiropractor make a diagnosis?

In most cases, a neck problem can be diagnosed by carrying out a thorough examination which may include all or some of the following:

• Testing the movement of the neck

• Testing for trapped nerves

• Examination of the muscles

• Examination of the movement of the joints of the spine, neck and hands

• X-rays, scans or blood tests may be necessary to make a precise diagnosis

How is neck pain treated?

Acute pain at the base of the skull may well disappear without treatment.

For short-term problems, manual treatment (chiropractic or physiotherapy) and pain-relieving medicine are recommended.

With longer-term pain (i.e. three months or more) there is the following choice of treatment:

• Chiropractic treatment

• Intensive muscle training

• Physiotherapy

What medication is given?

Medicine used in the treatment of mild muscle pain includes nonsteroidal anti-inflammatory drugs (NSAIDs). These are generally effective in those who can tolerate them. However, they may cause side effects in patients with a past medical history of indigestion and/or asthma. Consult your doctor or pharmacist if you think this might apply to you.

Exercise

People with weak neck muscles are more prone to neck problems and in such cases, an exercise programme to strengthen the neck is a good idea.

Future prospects

This depends on the underlying cause of the pain. The prognosis is generally good provided the patient remains active and obtains the correct treatment without delay.