Neck pain

Acute neck pain is very common and usually harmless. One third of adults experience neck pain once a year on average. What are the causes and what can provide relief?

At a glance

  • It is estimated that one third of all adults experience neck pain once a year.
  • The incidence of neck pain is higher in women than in men.
  • Acute neck pain usually resolves within one to two weeks.
  • Some people experience recurring neck pain after certain activities that cause strain on their neck, e.g., work or intensive sports or exercise.
  • If the pain is localized, especially in the area of the cervical (neck) vertebrae, this is referred to as axial pain.
  • On the other hand, pain that extends along nerve pathways is known as radicular pain.

Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.

Neck pain: woman massaging her neck with her left hand.

What is acute neck pain?

Acute neck pain is very common. When it occurs, it is usually not cause for concern. In many cases, it is due to muscle tension. Muscle tension may be caused, for example, by sitting in a draft, spending a long time sitting at a computer, or sleeping in a position that doesn’t support the spine. In many cases, however, the precise cause remains unclear. Acute neck pain normally resolves within one to two weeks. Some people experience recurring neck pain after certain activities that cause strain on their neck, e.g., work or intensive sports or exercise.

If the pain lasts longer than 3 months, it is referred to as chronic neck pain. Chronic neck pain is frequently related to emotional strain and mental stress.

Important: Many people with neck pain worry that the pain may worsen or that they may injure themselves if they remain active. In most cases, there’s no need to worry about this happening unless there are any indications that more serious problems are present.

In fact, it is usually important to try to keep moving and going about one’s daily life as normal despite the neck pain. Neck pain can be avoided by means of targeted training of the neck muscles.

What are the symptoms of acute neck pain?

There are, essentially, two different types of neck pain:

  • Axial pain is localized in one specific area, especially around the cervical vertebrae (i.e., the spinal vertebrae in the neck). Occasionally, however, it may extend as far as the shoulders.
  • Radicular pain radiates along the nerve pathways, e.g., into the back of the head or the arm. This type of pain is usually triggered by irritated nerves, e.g., if a disk in the cervical spine (the portion of the spine within the neck) presses on a nerve. This may also affect the arm’s reflexes and muscle strength, or lead to a tingling sensation.

It is only in very rare cases that neck pain indicates a serious condition or needs to be treated as an emergency. However, a doctor should be consulted immediately in the case of:

  • a prior accident
  • a stiff neck
  • loss of bladder or bowel control
  • headache, accompanied by nausea, vomiting, dizziness or sensitivity to light
  • a persistently severe level of pain, both while moving and at rest
  • unexplained loss of weight, fever, or chills
  • nerve disturbances or signs of paralysis, such as tingling sensations or difficulty moving an arm or finger 

A doctor should also be consulted if

  • a tingling sensation persists for an extended period
  • the hands or legs frequently become numb (“pins and needles”)
  • the legs are weakened
  • difficulties with balance occur when walking

What causes acute neck pain?

Neck pain may be caused by weak neck muscles and poor posture, wear and tear on the cervical spine or a slipped disc, lumbar spinal stenosis (narrowing of the spinal canal) or a whiplash injury.

There are many possible causes of neck pain. These include:

  • Weak neck muscles and excessive strain: For example, sitting at a desk for an extended period can cause pain and stiffness in the neck or shoulders, and sometimes also headaches.
  • Wear and tear on the spine: The spine is subjected to normal wear and tear over the course of a lifetime. As a result, the spinal disks become thinner. Small bony projections may also occur on the edges of the vertebral bodies (i.e., the main parts of the vertebrae).
  • Whiplash: This type of injury can occur, for example, as a result of a car accident involving a rear-end collision.
  • Narrowing of the vertebral canal or a slipped disk: If the vertebral canal becomes narrower, it may cause neck pain that radiates into the shoulders or arm. The same symptom can occur as a result of a bulging or herniated (ruptured) spinal disk that presses on a nerve root.

A slipped disk can cause neck pain but does not always do so.

Neck pain may also occur as an accompanying symptom of inflammatory diseases of the spine, mandibular joint problems, or severe headache.

Often, it is not easy to pinpoint the precise cause of neck pain. One reason for this is that the bones, ligaments, and nerves in the cervical spine are located so close together that it is frequently unclear where exactly the pain has originated.

How common is acute neck pain?

Neck pain is very common. It is estimated that one third of all adults experience neck pain on average once a year. Neck pain is more common in women than in men. In most cases, neck pain is harmless and resolves by itself after a short period. However, some people experience recurring neck pain.

In general, older people are at greater risk of suffering more long-term neck pain. In addition, people with back pain or a slipped disk tend to experience more persistent neck pain.

The length of time that neck pain may persist after a whiplash injury depends, for example, on the force of the impact. Individuals who are psychologically affected by an accident or are very worried about its consequences often suffer more severe pain for longer periods.

How is neck pain diagnosed?

The doctor will begin by asking for some background information, such as whether the patient has had a prior accident, where exactly the pain is located, and whether any specific stresses or strains could have a role to play.

Next, a physical examination serves to rule out any serious causes. The doctor palpates (feels) the front and back of the neck, and checks reflexes and head mobility. Muscle strength in the arms and shoulders is also examined.

Important: With neck pain, an x-ray, CT (computed tomography) scan, or MRI (magnetic resonance imaging) scan is usually only required if the patient presents with symptoms of a serious condition or if the doctor suspects that the pain has a specific cause.

If these indications are not present, x-rays or other imaging techniques are not normally useful. For one thing, the images won’t allow any reliable conclusions to be drawn. After all, many people have visible signs of wear and tear on their cervical spines but don’t have any symptoms. Meanwhile, there are often no changes or very slight changes to be seen in people experiencing neck pain.

How is acute neck pain treated?

Most treatments for neck pain have not been studied in sufficient detail for their effectiveness to be evaluated. Heat can always be applied to the painful area, e.g., using a hot water bottle or heated pillow, to see if it relieves the pain. Other options include stretching and strengthening exercises, massages, or painkilling medication.

For more detailed information, e.g., about what can be done to relieve non-specific neck pain, visit gesundheitsinformation.de.

Important: Surgery is only considered if the doctor detects a specific cause of the pain that could possibly be relieved by this type of procedure.

Surgery is not normally beneficial if the pain is caused by a slipped disk, as this issue usually resolves by itself. In addition, surgery in the area of the cervical spine is associated with risks. Therefore, it is important to weigh up the benefits and drawbacks of any procedure before making a decision.

For severe, chronic neck pain, patients may benefit from pain management therapy. This type of treatment is offered by doctors or psychotherapists specializing in this area. Pain management therapy can help sufferers to deal with their pain so that they find it easier to manage everyday life.

In cooperation with the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen) (IQWiG). As at:

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