Neck pain or a stiff neck is a common problem and generally nothing to worry about.
The pain and stiffness usually gets better after a few days or weeks, and is rarely a sign of a more serious problem. You can get a painful or stiff neck if you sleep in an awkward position, use a computer for a prolonged period of time, or strain a muscle because of bad posture.
Anxiety and stress can also sometimes cause tension in your neck muscles, which can lead to pain in your neck. You can normally manage your symptoms at home by following the advice below.
Managing neck pain at home
For most of the types of neck pain described above, the advice is generally the same: carry on with your normal daily activities, keep active, and take painkillers to relieve the symptoms. You can also take these steps to manage your pain:
- take regular doses of paracetamol, ibuprofen, or a combination of the two, to control pain – ibuprofen gel can be rubbed on to your neck as an alternative to taking tablets (always follow the instructions that come with the medication)
- try holding a hot water bottle or heat pack to your neck – this can help reduce the pain and any muscle spasms, although some people find cold packs offer better relief
- sleep on a low, firm pillow at night – using too many pillows may force your neck to bend unnaturally
- check your posture – bad posturecan aggravate the pain, and it may have caused it in the first place
- avoid wearing a neck collar – there is no evidence to suggest wearing a neck collar will help to heal your neck, and it's generally better to keep your neck mobile
- avoid driving if you find it difficult to turn your head – this may prevent you being able to view traffic
- if your neck is stiff or twisted, try some neck exercises – gently tense your neck muscles as you tilt your head up and down and from side to side, and as you carefully twist your neck from left to right; these exercises will help strengthen your neck muscles and improve your range of movement
When to see your GP
See your GP if the pain or stiffness does not improve after a few days or weeks, if you cannot control the pain using ordinary painkillers, or if you are worried your neck pain could have a more serious cause. Your GP will examine your neck and ask some questions to help identify any underlying condition. They may also prescribe a stronger painkiller, such as codeine, to take with your usual over-the-counter painkillers.If you have had neck pain or stiffness for a month or more, your GP may be able to refer you to a physiotherapist.
If your symptoms are particularly severe or do not improve, your GP may consider prescribing more powerful medication or referring you to a pain specialist for further treatment.
What causes neck pain and stiffness?
A twisted or locked neck
Some people suddenly wake up one morning to find their neck twisted to one side and stuck in that position. This is known as acute torticollis and is caused by injury to the neck muscles.
The exact cause of acute torticollis is unknown, but it may be caused by bad posture, sleeping without adequate neck support, or carrying heavy unbalanced loads (for example, carrying a heavy bag with one arm). Acute torticollis can take up to a week to get better, but it usually only lasts 24 to 48 hours.
Wear and tear in the neck
Sometimes neck pain is caused by the "wear and tear" that occurs to the bones and joints in your neck. This is a type of arthritis calledcervical spondylosis. Cervical spondylosis occurs naturally with age. It does not always cause symptoms, although in some people the bone changes can cause neck stiffness. Nearby nerves can also be squashed, resulting in pain that radiates from the arms, pins and needles, and numbness in the hands and legs. Most cases will improve with treatment in a few weeks.
Whiplash is a neck injury caused by a sudden movement of the head forwards, backwards or sideways. It often occurs after a sudden impact such as a road traffic accident. The vigorous movement of the head overstretches and damages the tendons and ligaments in the neck. As well as neck pain and stiffness, whiplash can cause tenderness in the neck muscles, reduced and painful neck movements, and headaches.
Neck pain caused by a squashed nerve is known as cervical radiculopathy. It's usually caused by one of the discs between the bones of the upper spine (vertebrae) splitting open and the gel inside bulging outwards on to a nearby nerve. The condition is more common in older people because your spinal discs start to lose their water content as you get older, making them less flexible and more likely to split. The pain can sometimes be controlled with painkillers and by following the advice below, although surgery may be recommended for some people.
More serious causes
Your neck pain may have a more serious cause if it's persistent and getting progressively worse, or you have additional symptoms, such as:
- a lack of co-ordination – you may find fiddly tasks increasingly difficult problems walking
- loss of bladder or bowel control
- a high temperature (fever)
- unexplained weight loss
A serious cause is more likely if you have recently had a significant injury – for example, you were involved in a car accident or had a fall – or you have a history of cancer or conditions that weaken your immune system, such as HIV. See your GP if you are concerned.
Preventing neck pain
You may find the following advice helpful in preventing neck pain:
- make sure you have good posture when sitting and standing
- take regular breaks from your desk, driving or any activity where your neck is held in the same position for a long period of time
- if you often feel stressed, try relaxation techniques to help ease any tension in your neck
avoid sleeping on your front, and make sure your head is in line with your body (not tilted to the side) if you sleep on your side
only use enough pillows (usually only one) to keep your head level with your body
make sure your mattress is relatively firm – a soft mattress could mean your neck is bent while you sleep