Neck Pain

The neck, or cervical spine, is made up of vertebrae, ligaments and muscles. It is the most flexible part of your spine. However, because it is not as well protected as the rest of the spine, it's also easy to injure.

Causes of Neck Pain

Neck pain can be caused by injury or by problems that affect the muscles, ligaments, nerves, bones and joints. Medical conditions such as osteoarthritis and rheumatoid arthritis are examples. These are other causes of neck pain:

• Degenerative joint disease (DJD). Between each bone (vertebra) of the spine is a cartilage disk filled with a gelatin-like substance that provides cushioning. As we age, these disks become thinner, losing some of their capacity to absorb shock. The joints of the neck may also become inflamed as a result of arthritis or bone spurs, or a disk may herniate (push outward) from its normal space and place pressure on the nerves. DJD usually occurs in people over age 40. It often causes painful muscle spasms in the neck and upper back, a dull aching in one arm, or numbness and tingling in the arm or fingers. A direct blow can also make disks bulge or break, causing problems similar to those of disk degeneration. Any persistent pain numbness, or tingling should be evaluated by a doctor.

• A bad night's rest. How you sleep at night can affect your neck during the day. A soft mattress, pillows that force your neck into awkward angles and uncomfortable sleeping positions may be to blame if you wake up with a sore neck. But the tossing and turning of a bad night's rest may be less to blame than waking suddenly from a sound sleep. A sudden jerk of the neck upon awakening can leave neck muscles tight and sore.

• Body mechanics. Poor sitting and standing posture -- slumped shoulders, a "drooping" head, slouching or rounding of the lower back -- can cause neck pain. However, bad body mechanics are more than poor posture. Repeated tasks, such as holding the phone with your shoulder or always carrying a heavy briefcase or shoulder bag on the same side of your body, can cause muscle stiffness or imbalance. Workstations can also force you into poor positions.

• Stress. The neck and upper-back muscles are often among the first to become tense when you are under emotional stress. Whenever these muscles remain tight for a long time, they may ache, become sore and even cause headaches.

• Neck sprains and strains. The term whiplash is often used to refer to neck sprains and strains that result when the neck is forced suddenly forward, backward, or both -- such as from a rear-end collision. Contact sports, a fall or a sudden twist can cause similar injuries. Pain from neck sprains and strains may spread into the shoulders, upper back and arms, and sometimes as far as the legs. Pain may remain for six weeks or longer but generally improves with normal activity. In some cases, physical therapy or special exercises may help.

Self-Care Steps for Neck Pain

Even if your neck pain is caused by an injury or a worsening condition, self-care can often provide relief.

• If your neck or upper-back muscles feel tight and sore, especially from stress, ask a friend to massage the area for a few minutes.

• Ice a sore neck for 10 to 15 minutes several times a day to relieve pain and inflammation. A bag of frozen peas or corn makes a great cold pack for the neck. Ice can be good for relieving pain even long after an injury, especially if muscle spasms are present. Switching between heat and ice may also work.

• A warm shower, heating pad or moist warm towel can help loosen sore, tight muscles. Wait 48 hours before applying heat. Then apply heat for 20 minutes three times a day.

• Take a pain medication. If pain persists, your doctor may prescribe other medication. When pain is at its worst, rest. Lie flat on your back for an hour or so, with a fairly flat pillow supporting your head. (Extended bed rest, however, can make neck problems worse by allowing muscles to weaken from lack of use.)

• Stretch! Reduce stiffness and soreness and gain motion and strength by moving your neck often.

Preventive Care for Neck Pain

Neck pain can often be prevented with a few adjustments to the way you work and rest:

• If you often wake up with a sore neck, consider sleeping in a different position, getting a new mattress and box spring, or putting a 3/4-inch plywood board between the mattress and box spring for extra support.

• If you sleep on your side, choose a pillow that allows your head to rest comfortably centered between your shoulders. If you sleep on your back, choose a pillow that doesn't push your chin toward your chest. A special cervical-support pillow or a rolled towel pinned around your neck can also help you position your spine correctly. Avoid sleeping on your stomach.

• If daily stress makes your neck and upper-back muscles tense, take time out to relax. Your spine naturally curves in at the neck, out at the upper back, and in again at the lower back. An easy way to improve your posture is to focus on keeping the natural curve at the lower back. When you do this, the rest of the spine tends to pull into place, straightening your shoulders and head as well. However, be sure that your effort to straighten up doesn't cause your neck or abdomen to stick out.

• Improve your work area. If you spend a lot of time on the phone, use a telephone headset. Keep your briefcase or purse as light as possible, and routinely switch carrying sides. When either is packed full, try to distribute the weight evenly on each side of your body by splitting the contents into two bags or briefcases. Hold reading materials and place computer screens at eye level; don't bend over your work. Type with your elbows, hips and knees at a 90-degree angle, and make sure you have good lower-back support.

Responding to a Neck Injury

Severe trauma to the neck may cause a fracture, creating risk for permanent paralysis. If you suspect possible neck or other spinal injuries from a severe blow or other trauma, keep the injured person still. Do not move the person without a backboard or cervical collar and the help and direction of a trained paramedic or other medical professional.