Why Does Your Neck Hurt? 5 Neck Pain Causes

Muscle strain in your neck happens as a result of injury or inflammation to muscles, joints, nerves, or other structures in the spine. For example, a strained ligament or "pinched" nerve can lead to neck pain.

Most of the time, these neck pain causes are easily treated. It's still important to see your healthcare provider for a proper evaluation and not try to self-diagnose your neck pain.

This article presents five common neck pain causes and their treatment, along with common symptoms to help identify them. It offers a few lifestyle changes that may reduce the muscle strain to your neck.

Common Neck Injuries
Verywell / Hugo Lin

Sprain or Strain

A neck sprain is a tear of the ligaments that connect the vertebrae in your neck. A neck strain is a pulled muscle in the neck, or similar injury to a tendon. These two types of neck injuries share symptoms and are generally treated similarly.

Ligaments are bands of tissue that connect bone to bone, whereas a tendon is a band of tissue that connects muscle to bone.

A sudden neck movement, like from a car accident or fall, is usually the culprit behind a neck strain or sprain. However, everyday habits such as poor posture or awkward sleeping positions can also cause these two types of neck injuries.

Symptoms

Symptoms of a neck strain or sprain may include:

  • Neck pain with movement
  • Neck stiffness, sometimes described as a "crick in the neck"
  • Muscle spasms and pain in the upper shoulder
  • Reduced neck flexibility

Be sure to seek medical attention right away if your neck pain is severe, or is associated with a headache or neurological symptoms like numbness, tingling, or weakness in the arms or hands.

Diagnosis

A neck strain or sprain can usually be diagnosed with a medical history and physical examination alone. Imaging tests are really only used to rule out alternative diagnoses.

Treatment

The pain and inflammation of a neck strain or sprain can generally be eased with ice and taking a nonsteroidal anti-inflammatory drug (NSAID). Other home remedies and lifestyle changes to try include:

  • Massaging a pulled neck muscle for pain relief
  • Doing exercises to strengthen the head and neck
  • Changing your sleep routine to ensure enough rest
  • Using fewer pillows to better align your neck when you sleep
  • Moving around more often to limit the impacts of poor posture
  • If you have eyeglasses, making sure your vision care is current
  • Improving ergonomics while at your desk or working on laptop

In some cases, your healthcare provider may recommend wearing a soft collar for a short period of time and/or physical therapy.

How Long Does It Take for a Neck Strain to Heal?

Most neck strains or sprains will heal in a matter of days or weeks. After an injury or surgery, special exercises can help to strengthen the spine. This conditioning typically lasts for four to six weeks, but may vary based on your healthcare provider's recommendation.

Degenerative Disc Disease

Cervical degenerative disc disease refers to "wear and tear" changes to your neck that occur in the cervical spine discs as a normal part of aging.

Symptoms

Cervical degenerative disc disease causes no symptoms in many cases. However, if symptoms are present, they usually include neck pain and stiffness that may get worse with movement.

Spinal degenerative changes progress with aging, notably with narrowing of the space between the discs and bone spur formation. This means that compression of spinal nerve roots may occur.

This compression, called cervical radiculopathy, may cause symptoms of numbness, tingling, and weakness in the arms and hands.

If the spinal cord becomes compressed as a result of degenerative changes, a person may develop other difficulties because of cervical myelopathy. These problems include:

  • Trouble walking
  • Balance problems
  • Bladder or bowel dysfunction

Diagnosis

In addition to a medical history and physical examination, imaging tests are sometimes performed to confirm a diagnosis of cervical degenerative disc disease. Some of these tests may include:

  • X-ray
  • Magnetic resonance imaging (MRI)
  • Myelogram
  • Electromyography (EMG)

Treatment

Treatment of cervical degenerative disc disease depends on the severity of the symptoms, as well as whether any neurologic symptoms are present.

Typically, treatment with NSAIDs, ice, heat therapy, and physical therapy are recommended initially. Steroid injections can also offer short-term relief.

With severe and/or persistent cases of degenerative disc disease, especially for nerve root or spinal cord involvement, surgery to alleviate the pressure is performed.

Osteoarthritis

Cervical osteoarthritis, sometimes called cervical facet joint syndrome, occurs when the protective cartilage that lines each facet joint in the neck begins to break down. This condition is a normal part of aging but can be accelerated by a neck injury, or by being overweight or obese.

Cervical osteoarthritis often accompanies cervical degenerative disc disease.

Symptoms

Symptoms of cervical osteoarthritis include neck stiffness and achy pain that is often localized to one spot. Less commonly, the pain may spread to the shoulder or back of the head. The neck pain from cervical osteoarthritis tends to improve with rest.

As with cervical degenerative disc disease, if the "wear and tear" changes within the facet joint cause nerve root or spinal cord compression, symptoms of radiculopathy and myelopathy, respectively, may develop.

Diagnosis

Besides a medical history and physical examination, a computed tomography (CT) scan or MRI test can reveal the classic findings of cervical osteoarthritis such as narrowing of the facet joint space, bone erosions, and bone spur formation.

Keep in mind that facet joint changes seen on an imaging test do not necessarily correlate with the presence or severity of a person's neck pain.

Sometimes, a cervical facet injection is performed. This is a procedure where a healthcare provider injects a steroid and/or a numbing agent into the facet joint. Any relief of pain can then help to establish the diagnosis.

Treatment

The treatment of cervical osteoarthritis entails the following therapies:

  • Rest and activity modification
  • Ice and/or heat therapy
  • Engaging in moderate exercise
  • Over-the-counter pain medications, such as Tylenol (acetaminophen)
  • Physical therapy

Surgery may be an option for patients who have severe pain despite the above-mentioned conservative therapies, or if symptoms of radiculopathy or myelopathy are present.

Herniated Disc

A herniated disc occurs when the soft, rubbery substance that is normally contained to the inside of the disc (called the nucleus pulposus) escapes, and pinches or compresses on a nerve root.

Tears in the tough outer fibers of the disc, called annular tears, may lead to a herniation. Annular tears may be brought on by either repeated or sudden, forceful stress to the spinal joint.

Symptoms

People with a herniated disc report symptoms of nerve root compression (radiculopathy) described as a burning or electric shock sensation that moves down one arm, along with numbness and/or weakness.

Diagnosis

A herniated disc can often be diagnosed by a medical history and physical examination. To confirm a diagnosis, your healthcare provider may recommend an MRI test.

Treatment

Treatment of a herniated disc generally includes:

  • Slowing down certain physical activities, like lifting
  • Taking an anti-inflammatory medication like an NSAID
  • Applying ice to the neck several times a day for 15 to 20 minutes
  • Physical therapy
  • Cervical traction

Much less commonly, surgery to remove the herniated disc (called a cervical diskectomy) is performed.

Whiplash Injury

Whiplash injury is a neck injury that results from a sudden movement in which the head is thrown first into hyperextension and then quickly forward into flexion. It's most often due to car accidents, often as a result of being rear-ended, but less commonly may be caused by sports injuries or falls.

Whiplash injury is not technically a medical diagnosis, but rather an episode that can lead to any number of diagnoses, usually a neck strain or sprain. Sometimes, a whiplash injury damages joints or discs, which in turn may irritate spinal nerve roots or, very rarely, the spinal cord.

Symptoms

Depending on the exact nature of the injury, symptoms may include:

  • Neck pain and stiffness
  • Headache
  • Shoulder or back pain
  • Numbness and tingling that radiates down the shoulder, arm, hand, and/or fingers
  • Dizziness
  • Fatigue
  • Sleeping problems
  • Vision problems, such as blurry vision or sensitivity to light

The symptoms of a whiplash injury may be felt right after the injury or be delayed for up to several days.

Diagnosis

The diagnosis of whiplash injury requires a comprehensive approach including a medical history, physical exam, and imaging tests, such as X-rays or MRIs of the neck.

Whiplash injuries are graded, based on the symptoms and signs they cause.

  • Grade 1: Causes neck pain or stiffness with no abnormalities noticed on physical exam
  • Grade 2: Causes neck pain or stiffness with abnormal physical exam signs, like neck tenderness or a reduced range of motion
  • Grade 3: Causes neck pain or stiffness, with weakness, reduced reflexes, or other signs of nerve damage
  • Grade 4: Causes neck pain or stiffness with a neck fracture or dislocation

Grade 4 strains are the most serious of all and require immediate medical attention.

Treatment

The treatment of whiplash depends on the grade of the injury and associated neck damage. That said, in most cases, a combination of treatments is used.

Common therapies used to treat a mild whiplash injury include:

  • Rest
  • Ice therapy followed by heat therapy a few days later
  • Taking over-the-counter pain medication, like Tylenol or Motrin (ibuprofen)

For more severe or persistent cases, your healthcare provider may prescribe pain medications, such as a muscle relaxant or opioid. Your healthcare provider may also recommend physical therapy or an epidural injection if there is nerve inflammation from a herniated disc because of the whiplash injury.

A Word From Verywell

Your neck is a flexible, yet susceptible-to-injury structure that is also vulnerable to the normal effects of aging. See a healthcare provider for neck pain. Once diagnosed, you can hopefully move forward with a treatment plan that gives you back your comfort and quality of life.

Frequently Asked Questions

  • How do I know if my neck pain is serious?

    Neck pain accompanied by fever, headache, shortness of breath, or nausea and vomiting may indicate a serious condition, like meningitis or a heart attack. Seek immediate medical attention if this occurs, as well as if you have neck pain due to an injury.

  • Should you massage a pulled neck muscle?

    There is evidence that massage can benefit people with neck pain. It's safe to massage a pulled neck muscle, so long as you don't cause more pain when doing so. For chronic pain, consider a massage therapist. If new neck pain does not resolve, contact your healthcare provider.

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.