It is extremely common to suffer an episode of neck pain both acutely, in the short term after an injury or pulled muscle with heavy lifting, for example, or chronically and long term due to degeneration of the tissues or arthritis.We’ve asked one of our expert consultant neurosurgeons Mrs Anne Mitchener to explain just how common neck pain is, whether it can be a sign of something more serious and how it can be diagnosed by a specialist.
How common is it for people to experience pain in the neck?
Most adults suffer neck pain at some time. Fortunately, most cases are benign and self-limiting. Time, simple analgesia or anti-inflammatories will help. Less commonly, if the symptoms persist then physiotherapy may help but the advice of a general practitioner (GP) is also sensible.Similarly, if the advice received from a physiotherapist is to seek an expert opinion, it is important to follow. This is because these practitioners know what signs to look for that may indicate a more serious diagnosis or protracted course. A diagnostic scan or other investigations may be appropriately advised in these circumstances.
What are the possible causes of neck pain?
The neck has many structures of different tissue types that can give rise to pain through injury, inflammation, infection or tumour. I will limit my comments to the cervical or neck spine which includes the skeletal tissues of the neck (vertebral bones, muscles, ligaments, joints).The causes of neck pain are most commonly mild injury such as muscle strain or whiplash. Infectious causes in these tissues are unusual, such as bacterial septic arthritis, tuberculosis or herpetic viral “shingles”.Mechanical poor posture often at work, fibromyalgia, torticollis, which may have an infectious origin, is frequently seen. Degenerate disc disease, cervical spondylosis, spinal stenosis, herniated disc, osteoarthritis and rheumatoid arthritis may give rise to acute or chronic episodes of pain and are relatively commonly diagnosed.Much less common causes include head and neck primary cancers and metastases. A common symptom of meningitis (bacterial or viral) includes stiffness giving rise to neck pain.
Can neck pain be prevented?
Some of the causes of neck pain can be prevented such as those caused by trauma, including poor posture and whiplash. Chair to desk height can be adjusted to reduce neck flexion at work during long hours on a computer screen. Wearing a seatbelt reduces neck injury in car accidents.Chronic inflammatory conditions can often be treated and with the correct amount of exercise and perhaps maintenance medication the symptoms can be controlled and avoided. Cancers (rare forms of neck pain, see below) can be treated early to prevent pain and metastasis.
Can neck pain be the sign of something more serious?
While relatively uncommon, neck pain can be a sign of a more serious condition such as a benign or malignant tumour. I have confined my points to the skeleton or cervical spine here, so the commonest tumours would be metastatic and usually in the bone of the vertebrae from a breast, kidney, lung, lymphoma, myeloma, prostate or thyroid cancer.Primary benign and malignant tumours of the soft tissues of the cervical /neck spine, specifically in this instance of the spinal cord or coverings itself are very rare, for example, meningioma, chordoma, glioma (astrocytoma, ependymoma) or cavernoma. Soft tissue muscle tumours such as sarcoma are also very rare.
Does neck pain heal by itself?
This depends on the cause. If the cause is benign, it may settle with time and requires no intervention. Otherwise, the pain will likely need to be investigated and treated. Depending on the likely cause, blood tests and X-rays, scans or electromyography and nerve conduction tests may be indicated.Physical therapy such as physiotherapy or osteopathy may be the first-line treatment without other investigation. Importantly most conditions are treatable, some need an investigation to make sure of the diagnosis and identify the treatment options.
