Why is the neck such a pain in the neck?


Neck pain can range from simple discomfort to severe pain preventing you from moving your head and neck or pain running down your arms or back. This can be due to a previous or recent injury, poor posture or repetitive strain. In many cases, some form of trauma is the first insult resulting in pain in the neck. In other cases, very low level repetitive trauma such as poor posture or poor breathing habits can lead to pain or continued irritation (of the structures of your neck) leading to wear and tear on the muscles and joints and you find yourself continuously having neck discomfort. Then, like the other areas of your body, your tissue is no longer able to manage the loads placed on it. You then suddenly turn your head, get pushed by a friend or try and lift something in the gym and then, your neck is stiff and painful. And, this neck pain can fluctuate from mild to severe, and, once an episode of neck pain occurs, many people will find it becomes a persistent or recurrent condition, unless you do something about it.

Who gets neck pain and what are the causes?

Neck pain is very common. More than 50% of the world population will develop a bout of neck pain at some time in their life. It is estimated that in industrial nations like Canada, USA and Europe, approximately 20% of adults aged 45-75 years of age will be suffering from some sort of neck pain – right now! Neck pain that limits activity occurs in approximately 10% of the general adult population per year and 10% of people will find their neck pain disabling.

There are usually multiple factors that contribute to an individual’s neck pain, including overall physical and mental health, work and daily activities. Stress plays a critical role for chronic neck pain. This is due to poor breathing habits that come about due to stress (you become a neck rather than belly breather) and the postures people assume when they are stressed further compounds the issues that incorrect breathing techniques create. Of course, neck strength and stability both play important roles especially when considering the re-occurrence of neck pain.

When asking the questions: What causes neck pain? The answer is, it depends. It often depends on the type of neck pain someone is experiencing and if there has been trauma involved in the onset of the pain (which I find there always is, regardless of how trivial someone believes their trauma to be).

Most neck pain, however, is not the result of a serious injury or disease and is mechanical in nature, therefore can be rectified.

Types of Neck Pain

  • 'Mechanical' neck pain is the most common type. This is sometimes called 'simple' or 'non-specific' neck pain. Some of the causes of this pain include minor injuries to the muscles (often the fascia) or ligaments in the neck. Bad posture is also a common cause, which puts continuous strain on the muscles, ligaments and joints leading to slow degeneration. For example, neck pain is more common in people who spend much of their working day at a desk with a 'bent-forward' posture.  To find out more about Mechanical Neck Pain, click here.

  • A whiplash injury is most commonly due to rapid flexion and extension to the head and neck and is experienced primarily in motor vehicle accidents, regardless of how slow someone is driving. That being said, there is a lot more involved with Whiplash Associated Disorders (WAD) and the resulting neck pain, click here to learn more about Whiplash.

  • Acute (sudden onset) primary torticollis. This is sometimes called 'wry neck'. A torticollis is when the head becomes twisted to one side and it is very painful to return it to the forward-looking position. Most cases are thought to be due to a minor injury or poor posture while sleeping, which causes one or more muscles on one side of the neck to go into 'spasm'. The pain and spasm usually ease and clear away over a few days without any treatment. However, if it persists, you may want to have someone look at it, as there are some relatively simple therapies that can help for this.

  • Cervical Spondylosis is used to describe degenerative osteoarthritis of the cervical spine. It is due to 'wear and tear' of the spinal bones (vertebrae) and the 'discs' between the vertebrae. Patients often experience pain at end ranges with this condition and may result in radiculopathy. In these patients, it is important to prevent further degeneration. Keeping the neck mobile and strong are the most important component for long term success.

  • Cervical radiculopathy is when the root of a nerve is pressed on or is injured as it comes out from the spinal cord in the neck (cervical) region. This causes symptoms such as numbness, pins and needles, and weakness in parts of an arm supplied by the nerve in addition to neck pain. The common causes are cervical spondylosis and a disc problem. Various less common disorders can cause a cervical radiculopathy.

  • More serious and rarer causes include: rheumatoid arthritis, bone disorders, cancers, and serious injuries that damage the vertebrae, spinal cord or nerves in the neck.

What are some common symptoms associated with neck pain?

  • The pain may spread down an arm to a hand or fingers. This is due to irritation of a nerve going to the arm from the spinal cord in the neck. Often neck pain is associated with other symptoms such as cervical radiculopathy that may be aggravated during times of excessive fatigue or stress. If you are curious to know if you are experiencing mechanical neck pain or cervical radiculopathy, feel free to contact us.

  • Restricted motion and pain in the neck that may spread to the base of the skull and/or shoulders are the main symptoms experienced with mechanical neck pain.

  • Movement of the neck often feels restricted and makes the pain worse

What is the outlook (prognosis) for neck pain?

  • The outlook is usually good in most cases of acute (sudden onset) neck pain.

  • Symptoms commonly begin to improve after a few days. But, the time it takes for symptoms to decrease varies based on the person and history of the condition. If symptoms are still present after three (3) days, it is recommended that you have it looked at by a health care professional. If you would like an evaluation of your condition, contact us at your convenience.

  • Chronic and persistent neck pain occurs in some individuals. Chronic neck pain will result in the pain coming and going with some exacerbation ("flare-up") during times of stress. Often these "flare-ups" are due to poor postures or weakness. In these situations, it may be best for you to engage in some form of active rehabilitation program.

How can I tell if the pain is due to a more serious cause?

A thorough assessment and examination is used to determine what type of neck pain you have is mechanical neck pain or a more serious cause. The following are the sort of symptoms that may indicate a more serious problem.

  • If the pain becomes progressively worse with or without treatment.

  • If you start having numbness or tingling of the arm or if you start to feel weakness or clumsiness of a hand or arm, or persistent numbness. As mentioned, some numbness and pins and needles may occur with mechanical neck pain, but this is very mild and is not associated with weakness.

  • If you feel ill with other symptoms such as weight loss, fever, etc.

  • If the neck bones (vertebrae) are tender, which may indicate a bone or joint issue.

If you are experiencing any of the above symptoms, do not wait, have your neck looked at IMMEDIATELY.  What are the some treatments for neck pain?

The aim of therapy is to create optimal and pain-free neck movement. 

Treatment may vary and you should go back to see a health care professional

  • If the pain becomes worse.

  • If the pain persists beyond 3-5 weeks.

  • If you start experiencing numbness, weakness, or pins and needles in one or both of your arm and hand, or if pain travels along your back.

What about driving?

In order for you to drive safely, (i.e. ride a bicycle or motorcycle) you must be able to turn your head quickly. Therefore, I recommend that you do not drive until you are able to move your head freely and you are free of pain. If you would like some help with your neck pain, feel free to contact us at your convenience.