Features June 2010 Issue

Easy Ways to Prevent–and Treat–Neck Pain

When your neck gives you the fits, complicated interventions are rarely needed.

As many as 80 percent of adults experience acute neck pain at some point in their lives. But although that pain can be distressing or disabling for a few days, "many people get better quickly, without complex treatment, often without any treatment at all," says Daniel Mazanec, MD, associate director of Cleveland Clinic’s Center for Spine Health.


Pinpointing the problem

The neck, or cervical spine, is made up of seven bony vertebrae that run from the base of the skull to just below the shoulder blades. Seven shock-absorbing discs, muscles, and ligaments hold these vertebrae in place. The spinal cord, which sends nerve impulses to all parts of the body, runs through an opening in the cervical vertebrae and continues down the spine; it also sends nerve impulses down the arms. Therefore, a problem in the neck can cause pain in the neck itself, in the upper back, or in the shoulders and arms.

To help pinpoint the source of the pain, your doctor will take your medical history and do a physical exam. "An X-ray is not always necessary, but most of the time it’s done," Dr. Mazanec says. "In most cases, it’s not necessary to do a magnetic resonance imaging (MRI) test, unless a fracture, infection, or malignancy is suspected," he explains. The hazard of getting an MRI lies in the number of false positives. "With an MRI, you see a tremendous number of things—and most of those are benign and unrelated to pain. The danger is that your doctor might say, ‘Well, I see something on the MRI so you have to have surgery on your neck,’ when in fact nothing is wrong.


Common causes

Most often, a careful look at how you perform daily activities will reveal the cause of your neck pain—namely, poor posture and/or poor body mechanics. "Bending over a desk for prolonged periods, lifting and carrying things incorrectly, hunching over while reading a book or watching television, sleeping in an awkward position—all these activities can create soft tissue abnormalities that affect the muscles, nerves, and ligaments in the neck," Dr. Mazanec explains. "If you’re stressed and your muscles are tight, an injury can occur simply by turning your head in the wrong direction."

The neck is also susceptible to the wear and tear of osteoarthritis or degenerative discs; however, that alone generally does not account for the pain. "There’s usually an additional muscular strain or soft-tissue injury involved," Dr. Mazanec says.

Less frequently, neck pain may result from a fall; an injury such as whiplash from an automobile accident; fibromyalgia, a generalized soft-tissue pain disorder that most often affects the neck and upper back; or, rarely, meningitis, a potentially fatal inflammation of the membranes that cover the brain and spinal cord.

Simple solutions

Neck pain related to soft-tissue abnormalities typically lasts from two to four weeks. "Simple treatments are surprisingly effective," says Dr. Mazanec. These include icing the painful area to reduce pain and inflammation, doing exercises to improve neck movement and flexibility (see Easy Exercises to Combat Neck Pain, below), and taking over-the-counter pain relievers, if needed.

"Some people find wearing a soft cervical collar is helpful at night or while riding in a car. That’s acceptable for the short term—no more than a week," says Dr. Mazanec. Similarly, a muscle relaxant may be used in the first week to help relieve pain; after that, "it can make you sleepy and isn’t helpful."


Preventive steps

To help prevent neck pain, "sitting posture is very important," Dr. Mazanec says. Your feet should be flat on the floor, with knees bent at 90 degrees, thighs parallel to the floor. Keep your computer monitor at eye level, and your keyboard and/or mouse at a comfortable level—your wrists should be straight—and at a comfortable distance, so you don’t have to lean forward. Take breaks at least once an hour; stand up and stretch for a minute or two. "These are ways to avoid the chronic muscle strain in the neck and upper back that occurs when you’re hunched over."

Other strategies include placing a foam neck roll into your pillow case and sleeping on your back; acupuncture, which has been shown to relieve muscle tension; and massage therapy, which also has been shown to relieve tight muscles. Steer clear of chiropractic or osteopathic manipulation. "Any attempt to move the joints in the neck is a bad idea," Dr. Mazanec warns. "Such techniques have been associated, albeit rarely, with serious vascular injuries. Manipulation may be helpful for the lower spine, but not the neck."