This article was medically reviewed by Michelle Mielke, P.h.D., a doctor of epidemiology and member of the Prevention Medical Review Board, in October 2022.
Sometimes moving your head just doesn't feel right. Whether you slept on the wrong pillow or sat in a hunched position for too long, neck pain causes can be obvious—but sometimes the reason for your hurting neck is more mysterious.
While lots of cases of neck pain will be diagnosed as simply stress and structural discomfort, some causes warrant serious concern. But how do we know what's just a body ache and when to see a doctor?
We spoke to experts in neck pain management, Medhat Mikhael, M.D., medical director of the MemorialCare Orange Coast Medical Center's Spine Health Center, and Neel Anand, M.D., professor of orthopedic surgery and director of spine trauma at Cedars-Sinai Spine Center in LA, to explain everything your neck pain could likely be, treatment options, and when to see a specialist.
What is neck pain?
Neck pain is mainly described as discomfort in the neck area, says Dr. Mikahel. He explains that it's discomfort when moving the neck in each direction and "sometimes the pain can be referred to the shoulders and shoulder blades and down your arms."
Common causes of neck pain
Stress
The most common and simple causes of neck pain are exactly what you think they would be: stress-related. "Stress and overworking can lead your neck muscles to tighten or spasm and can also lead to the shoulder muscles tightening," says Dr. Mikhael. He adds that this stress can trigger the nerves in the back of the head and cause headaches, which explains why sometimes our migraines come with neck pain too.
Misalignment
Staying in a hotel and sleeping on a different pillow or mattress than we are used to, or driving or working for long hours in the same neck position can all be reasons we feel neck pain. These situations can lead to muscle tightness and spasming and pressure on the nerves in your neck, leading to pain.
Degenerative changes
Most discomfort in the neck can also be attributed to degenerative changes, says Dr. Anand. The alignment of our vertebrae can change as we age, and it's perfectly normal. But sometimes, that means that you feel some pressure on your spinal nerves, and can feel something a little off in your neck.
Dr. Mikhael explains that as we age, our vertebral discs deteriorate and flatten, creating pressure on our nerves from time to time. With this, "ligaments near our spinal cord can thicken over time because of arthritic changes, and this combination of our discs deteriorating and our ligaments thickening creates a narrowing of the spinal canal and puts pressure on the spinal cord," he explains.
While these are perfectly normal, natural changes that happen to our necks over time, trauma, such as a fall, sports injury, or car accident, can also lead to herniated discs and neck pain.
Less common causes of neck pain
A pinched nerve
When it comes to more chronic and serious concerns of neck pain, what pain specialists and neurologists will look for is radicular pain, says Dr. Mikhael. Radicular pain is a type of pain that radiates from beyond your neck, from your back and hip into your legs through the spine. This kind of pain occurs when the spinal nerve gets compressed (pinched) or inflamed.
Compressed Spinal Cord/Myelopathy
If in addition to neck discomfort, you're feeling shooting pain down your shoulders and arms, occasional bouts of tingling or numbness in your hands or arms, or pain or weakness in your legs, you may be dealing with something more serious. In the neck area of the cervical spine, the spinal canal is vitally important to maintain, says Dr. Mikhael. He warns that you do not want any pressure or tightness on the cord and you absolutely want to avoid any damage to the cord.
If part of the cord is compressed and may begin to cut off, it can lead to neurological damage, such as myelopathy, an injury to the spinal cord caused by severe compression that may be a result of disc degeneration, disc herniation, autoimmune disorders, or other trauma. "If you start to feel weakness in the arms or legs, you may require surgery to release the pressure on the spinal cord so as to not suffer any long-term damage," says Dr. Mikhael.
How to treat neck pain
Neck discomfort with no other symptoms, such as radicular pain, usually does not require a specialist. "If you start feeling neck pain, and maybe pain in your arms and shoulders as well, take it easy. If the pain goes away, it was likely just an acute episode of neck discomfort," says Dr. Mikhael. According to the experts, here are some ways you can get relief for your unambiguous neck pain:
- Rest and relaxation
- Take anti-inflammatories (ibuprofen) as needed
- Massage therapy
- Temporary use of muscle relaxants, as prescribed by a doctor
If you know the cause of your neck pain and it's not serious, it will likely improve with time.
When should you see a doctor about neck pain?
If your neck pain isn't getting better with time and you find yourself having to take pain medications every day, or if you start feeling any pain or weakness down your arms and legs, it's time to get examined by a specialist. Please note that similar weakness symptoms in your arms and legs could indicate a heart attack or other more serious issues, so seek urgent medical attention whether or not you suspect a pinched nerve is the cause.
"If symptoms persist after rest, painkillers, massage therapy, muscle relaxants, etc. and the pain is severe and progressing, get examined by a neurologist, and soon," advises Dr. Mikhael. He explains that in order to find the cause of your pain, your doctor will likely order imaging, such as x-rays and MRIs, to make sure there is nothing that requires an intervention, surgical or otherwise.
"Treatment can be very variable, and not every neck pain needs a neck surgeon," says Dr. Mikhael. However, you shouldn't ignore persistent and progressive pain stemming from your neck or back. And importantly, if you are experiencing arm or leg weakness or find yourself losing balance but without neck pain, you should still see a medical professional.
Madeleine, Prevention's assistant editor, has a history with health writing from her experience as an editorial assistant at WebMD, and from her personal research at university. She graduated from the University of Michigan with a degree in biopsychology, cognition, and neuroscience—and she helps strategize for success across Prevention's social media platforms.
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