Neck pain

There are a variety of different reasons for developing neck pain and most of these are not serious. Neck pain often gets better on its own within a few weeks.

Key points

  1. Most neck pain is not serious and will improve over time.
  2. To help you recover more quickly, keep active and continue to move your neck. Keep doing your normal work or daily activities, or return to doing these as soon as you can. It is fine to have some pain while moving.
  3. Keeping still or using a cervical collar is not helpful and can be harmful.
  4. Use heat or ice packs, pain relief medication or massage if these reduce your pain.
  5. Rarely, neck pain is a sign of a more serious problem. You should get it checked right away if you:
  • have flu-like symptoms along with a stiff painful neck and difficulty bending your head forward
  • have severe neck pain after an injury, such as a motor vehicle accident, diving accident or fall
  • lose function in your arm such as weakness or clumsiness or you have persistent loss of feeling
  • have difficulty passing urine.

Call Healthline on 0800 611 116 if you are unsure what you should do.

What are the symptoms of neck pain?

Neck pain refers to pain or stiffness in the neck. You may have limited movement of your neck and moving it may make the pain worse. Sometimes the pain starts in your neck but may spread to your shoulder, arm or your head. You may also feel 'pins and needles' in part of your arm or hand.

What causes neck pain?

There are different reasons for developing neck pain including the following common causes:

Common causes Description
No obvious cause
  • People often have neck pain for no apparent reason. This means there has not been any injury.
  • Pain like this is more common at times of high stress, poor sleep or lower levels of physical activity.
  • When this type of neck pain is combined with movement limitations it is often called an acute wry neck (or torticollis).
Sprains and injuries 
  • Injuries from sports, falls or whiplash can cause neck pain. 
  • This happens when the neck is moved beyond its normal range of motion. 
  • Whiplash is a sudden fast forward and backward movement causing injury to the soft tissues of your neck, most commonly caused by rear-impact car accidents. The pain and stiffness associated with these accidents usually begins 24 to 48 hours after the injury.
Posture-related
  • Sometimes neck pain is related to particular postures.
  • Even though posture does not cause injury, it makes sense to alter painful postures if possible.
  • This might include getting up and moving around more often, sitting more upright or sleeping with one pillow.

Other less common causes of neck pain can be pinched nerves, inflamed lymph nodes, bone disorders, tumours and swelling of your thyroid gland. 

What can I do if I have neck pain?

Most neck pain will get better on its own within a few weeks. In the meantime, here are a few general things you can do.

Keep active

  • Movement and exercise are good natural pain relievers. Keeping active reduces the impact of neck pain on your life. It is okay to feel some pain while moving.
  • Some discomfort with exercise is normal and should be expected. If an exercise makes your pain a lot worse, or you get other symptoms like dizziness, you should seek advice before continuing.
  • At time you may have a flare-up or marked increase in pain (this can happen whether you exercise or not). If this happens, you may be happier reducing the amount you exercise for a couple of days, but try not to stop completely. As the pain eases, try and build back up to the previous level as soon as you can.

Stay at work or get back to work and normal daily activities as soon as you can

Being at work helps you to focus on things other than your neck. Being at work is good for your general health too.

Move your neck

  • Gentle movements (starting as soon as possible) will help to reduce pain and spasm and help you regain full range of motion. Movement also helps healing.
  • Move your head often and gently in all directions, as long as the movement is not forced. Tuck your chin in, bend your head back, turn your head from side to side.
  • See exercises to manage neck pain

Hot or cold compresses

You can try using hot and cold compresses to reduce your pain, whichever one gives you the most relief. Alternating heat and cold may help.

  • Apply ice or cold packs to the painful area for 10–15 minutes every few hours. Wrap a plastic bag of ice (or a bag of frozen vegetables) in a damp cloth or light towel. Never place ice directly on your skin.
  • Apply a moist, warm compress or a warm wheat bag to the painful area for 20–30 minutes several times a day. Keep the compress warm for best effect.

Massage 

When you have neck pain your neck may become stiff. Massage can help you to relax and move your neck more. Massage the area gently by rubbing your neck with your fingers for several minutes.

Medication

Taking pain relief medication such as paracetamol or non-steroidal anti-inflammatories (NSAIDs) can help to ease the pain and keep you active. However, NSAIDs are not suitable for everyone and are usually not recommended on an ongoing basis. Common examples of NSAIDs include ibuprofen, diclofenac and naproxen. Read more about pain relief medication.

Physiotherapy

If symptoms do not improve over a week or so, you may see a physiotherapist to help with advice on specific neck exercises to do at home. 

When should I see my doctor about neck pain?

Most neck pain improves gradually with home treatment. See your doctor if your neck pain is severe, persists for several days without relief, spreads down your arms or legs and is accompanied by headache, numbness, weakness or tingling.

When to seek urgent medical care

Sometimes neck pain is a sign of a more serious problem. You should get it checked right away if you:

  • have flu-like symptoms along with a stiff painful neck and difficulty bending your head forward
  • have severe neck pain after an injury, such as a motor vehicle accident, diving accident or fall
  • lose function in your arm such as weakness or clumsiness or you have persistent loss of feeling
  • have difficulty passing urine.

Call Healthline on 0800 611 116 if you are unsure what you should do.

How can I prevent neck pain?

Neck pain is a normal part of life. The best ways to reduce the likelihood of neck pain or reduce its impact are to do the following:

Learn more

The following links have more information on neck pain. Be aware that websites from other countries may have information that differs from New Zealand recommendations.

Neck pain Ministry of Health, New Zealand
Neck pain Arthritis Research UK
Neck pain Patient Info, UK
Acute neck pain - a guide to help your recovery NHS Trust
Neck pain Mayo Clinic, US

References

  1. Neck pain American College of Rheumatology
  2. Gross A, Forget M, St George K, et al. Patient education for neck pain. Cochrane Database of Systematic Reviews, 2012

Reviewed by

Dr Ben Darlow is a musculoskeletal physiotherapy specialist in private practice in Wellington and a senior lecturer and researcher in the Department of Primary Health Care and General Practice at the University of Otago, Wellington. 
Credits: Health Navigator Editorial Team. Reviewed By: Dr Ben Darlow, Musculoskeletal Physiotherapy Specialist Wellington, Senior Lecturer and researcher, Department of Primary Health Care and General Practice, University of Otago, Wellington (July 2018) Last reviewed: 24 Jul 2018