Most neck pain comes from a strained muscle, a “crick” from sleeping wrong, mild arthritis or overdoing it at a sport, and it usually gets better on its own with simple care. In the video above, family physician Dr. Richard Honaker explains the sign to watch for: numbness, weakness or pain that travels into one or both arms can mean a pinched nerve, and if it doesn’t go away quickly, it’s time to see a doctor.
Neck pain at a glance
| Muscle strain or “crick” | Pinched nerve (cervical radiculopathy) | Possible emergency | |
|---|---|---|---|
| What you feel | Sore, stiff neck that hurts more when you move; muscle spasms; hard to turn your head | Burning or sharp pain from the neck down one arm, with tingling, numbness or weakness | Fever, headache and a neck too stiff to touch chin to chest; chest, arm or jaw pain; pain or weakness after an injury |
| Common causes | Poor posture, sleeping awkwardly, sudden twisting, overdoing it | A herniated (“slipped”) disk or bone spurs from arthritis | Meningitis, heart attack, spinal injury |
| What to do | Home care; see a doctor if it’s not better in about a week | See a doctor, especially if it doesn’t go away quickly | Call 911 or go to the emergency room |
The table is a guide, not a diagnosis. If you’re unsure, check with a doctor.
What Dr. Honaker says in the video
Dr. Honaker says all of us have neck pain at some point, and the most common causes are harmless: a muscle spasm, a little arthritis, a crick in the neck, or having overdone it at a sport. For those, he suggests a heating pad, some massage, and over-the-counter acetaminophen or ibuprofen, and they tend to go away.
The kind of neck pain to watch for, he explains, comes with numbness, weakness or pain going into one arm or both. That points to pinched nerves where they leave the spinal column. If it’s brief and goes away quickly, it’s not a big deal. If it stays for a while, you probably need to be seen, get X-rays and maybe further tests, and start medicine to reduce whatever is pinching the nerve. The cause could be a slipped disk, arthritis or a bone spur. Dr. Honaker notes this matters more as you get older and if you’ve had neck injuries before, so keep track of your symptoms.
Common causes of neck pain
MedlinePlus, from the National Institutes of Health, says most neck pain comes from everyday habits: bending over a desk for an hour or more, poor posture while reading or watching TV, a computer screen set too high or too low, sleeping in an awkward position, or twisting the neck suddenly during exercise. Other causes include:
- Sprains and strains: the American Academy of Orthopaedic Surgeons (AAOS) calls these the most common neck injuries. Car crashes (whiplash) and falls can cause them, and the pain may not start until hours later or the next day.
- Arthritis of the neck (cervical spondylosis): age-related wear on the disks and joints. It affects more than 85% of people over 60, though many have no symptoms.
- Disk problems: disks usually start to wear around age 40, and a disk can bulge or herniate and press on a nerve.
- Less common causes: fractures, infections, tumors and narrowing of the spinal canal (spinal stenosis).
How to treat a stiff neck or “crick” at home
For minor strains, MedlinePlus and the AAOS suggest:
- Ice, then heat. Use ice for the first 2 to 3 days, then heat, such as a warm shower or heating pad, for up to about 20 minutes at a time. Don’t fall asleep on a heating pad or ice pack.
- An over-the-counter pain reliever, such as ibuprofen or acetaminophen. Ask your doctor or pharmacist which is safe for you, and follow the label.
- Gentle massage of the sore area.
- Ease off, but keep moving. Cut back on normal activity for the first few days, but avoid bed rest. Slow up-and-down and side-to-side neck movements can help.
- A firm mattress and a pillow that supports your neck.
- A soft collar only if your doctor suggests it, and only for a few days; wearing one too long can weaken the neck muscles.
Pinched nerve in the neck (cervical radiculopathy)
A pinched nerve happens when a nerve root is squeezed or irritated where it branches off the spinal cord. According to the AAOS, the pain usually starts in the neck and travels down the arm, and it may feel burning or sharp. It can come with tingling, numbness, or weakness in the shoulder, arm or hand, and turning the head or tilting it back can make it worse.
The main causes are a herniated disk, the usual cause in younger people, often after lifting, twisting or a sudden injury, and age-related changes, such as worn disks and bone spurs that narrow the openings the nerves pass through. The good news: most people get better without specific treatment, some within days or weeks and others more slowly.
When the spinal cord is squeezed
Wear and tear can also press on the spinal cord itself (cervical spondylotic myelopathy). The AAOS says this is most common after age 40 and usually develops slowly. Warning signs include clumsy hands (trouble with handwriting or buttons), numbness or weakness in the arms and hands, and trouble walking or keeping your balance. See a doctor promptly if you notice these.
How neck pain is diagnosed
A doctor will ask about your pain and check the strength, feeling and reflexes in your arms and hands. MedlinePlus says tests usually aren’t needed at the first visit unless there are signs of a fracture, infection, tumor or serious nerve problem. Tests may include X-rays of the bones (sprains and strains don’t show up on them), an MRI of the disks, nerves and spinal cord, a CT scan for bone spurs, and nerve tests (EMG) to see whether a nerve in the neck is causing arm symptoms.
Treatment options
Most neck pain is treated without surgery. Depending on the cause, options include:
- physical therapy to ease pain and build strength and flexibility
- medicines, such as anti-inflammatory pain relievers, a muscle relaxer for spasms, or a short course of steroids to calm swelling around a nerve
- steroid injections near the irritated nerve or joint for short-term relief
- surgery, considered when a pinched nerve doesn’t improve after a period of nonsurgical care, or when the spinal cord is compressed
When to see a doctor
MedlinePlus recommends contacting your doctor if:
- your neck pain isn’t better after about a week of self-care
- you have numbness, tingling or weakness in an arm or hand
- the pain started after a fall, a blow or an injury
- over-the-counter pain medicine doesn’t control the pain
- the pain is worse lying down, wakes you at night, or is so bad you can’t get comfortable
- you have trouble swallowing or breathing, or a lump or swollen glands in your neck
- you have trouble walking or keeping your balance
- you lose control of your bladder or bowels (call right away)
Get care right away
Call 911 or go to the emergency room for:
- Fever and headache with a neck so stiff you can’t touch your chin to your chest. MedlinePlus says this can be a sign of meningitis. Bacterial meningitis is an emergency that needs treatment in a hospital right away.
- Possible heart attack symptoms, such as pain, pressure or discomfort in the chest; pain in the arms, shoulders, back, neck or jaw; shortness of breath; heavy sweating for no clear reason; nausea; or sudden light-headedness or dizziness. The National Heart, Lung, and Blood Institute (NHLBI) says to call 911 even if you aren’t sure it’s a heart attack, and not to drive yourself to the hospital.
- Neck pain after a car crash, diving accident or fall, especially with numbness or weakness in the arms or legs, or an arm or hand you can’t move. Don’t move someone with a possible neck injury; let paramedics keep the neck still.
How to prevent neck pain
- Stretch your neck about once an hour when you work at a desk, and keep reading material at eye level.
- Strengthen your upper back, which takes stress off the neck.
- Always wear a seat belt.
Find a doctor
For new neck pain, start with a family physician. For a pinched nerve or pain that doesn’t improve, a spine surgeon or pain management specialist can help. Doctors on Best Docs Network who treat neck pain include:
- Dr. Richard Honaker, family medicine, Dallas-Fort Worth
- Dr. Bryce Benbow, minimally invasive spine surgery, Dallas-Fort Worth
- Dr. Robert Bulger, pain management, Dallas-Fort Worth
More videos on this topic: Head and Neck Pain and Nerve-Related Conditions.
Frequently asked questions
How long does a crick in the neck last?
Mild neck pain from a strained muscle often eases with self-care. MedlinePlus says to see a doctor if it isn’t better after about a week. The AAOS says most neck sprains and strains clear up within 4 to 6 weeks.
Should I use heat or ice on a stiff neck?
MedlinePlus suggests ice for the first 2 to 3 days, then heat. Dr. Honaker recommends a heating pad and massage for a muscle spasm or crick.
What does a pinched nerve in the neck feel like?
Usually a burning or sharp pain that runs from the neck into the arm, sometimes with tingling, numbness or weakness in the arm or hand.
Can a pinched nerve in the neck heal on its own?
Often, yes. Many people improve without specific treatment within days to weeks. If symptoms last, get worse or include weakness, see a doctor.
Do I need an X-ray or MRI for neck pain?
Usually not at first. Dr. Honaker says arm symptoms that don’t go away are a reason for X-rays and possibly more tests.
Sources
- MedlinePlus (National Library of Medicine, NIH): Neck pain
- MedlinePlus: Neck pain or spasms - self care
- MedlinePlus: Cervical spondylosis
- OrthoInfo (American Academy of Orthopaedic Surgeons): Neck Pain
- OrthoInfo: Neck Sprains and Strains
- OrthoInfo: Cervical Radiculopathy (Pinched Nerve)
- OrthoInfo: Cervical Spondylosis (Arthritis of the Neck)
- OrthoInfo: Cervical Spondylotic Myelopathy (Spinal Cord Compression)
- MedlinePlus: Meningitis
- National Heart, Lung, and Blood Institute (NIH): Heart Attack Symptoms
This page is for general information only and is not medical advice. Talk with a qualified health professional about your own situation. If you think you may have a medical emergency, call 911.
