What causes neck pain?

Matthew F. McCarty, MD

The most common cause of neck pain is muscular pain and spasm. This can be brought on through whiplash events which tear away small insertions of muscles from bone. Other underlying causes can include osteoarthritis of the spine, degenerative disc disease, herniated intervertebral discs and even pain generated from the disc itself. Sometimes these conditions can cause inflammation of the spinal cord and its nerve roots. Less often tumors of the spinal cord, bone or soft tissue structures can be sources generating pain.

Dr. Michael Roizen, MD
Internal Medicine
Neck pain may come from a spasm, or when your neck muscles tense up. It's  fancy medical name is torticollis, or wryneck. Here your sternocleidomastoid, trapezius, or scalenus muscles (the neck ones) are in spasm, leaving your head more tilted to the side than one of Harry Potter’s owls. It can happen on one side or both sides of your neck and can last for varying amounts of times. The most common cause is trauma. If you develop torticollis, nonsteroidal anti-inflammatory analgesics such as ibuprofen (Advil, Motrin) and naproxen (Aleve) can help, but not acetaminophen (Tylenol), which treats pain but does not get rid of inflammation.
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Brian Yee
Physical Medicine & Rehabilitation
There are many causes of neck pain. Many times the joints in the neck wear out due to poor postures or a traumatic injury such as a car accident or sports injury. Patients often assume that their pain after such injuries will go away over time. However, what happens is that the neck joints continue to be irritated and potential arthritic changes can occur.

Other sources of neck pain should be considered as well. This includes trigger points in the such neck muscles as the sternocleidomastoid that commonly cause referred pain to the neck, as well as headaches. The nerves of the neck can also cause neck pain, as well as symptoms in the arm. Muscle stability of the neck is also important especially the smaller muscles that are closest to the spine. The longus colli muscle lays on front of the neck vertebrae and is designed to provide proper stability especially in prolonged positions such as sitting. The joints above and below the neck vertebrae can also cause increased stress to the neck. If the jaw does not work correctly it can cause the neck muscles and joints to work harder to compensate. Likewise, poor postures in the mid-back or thoracic spine can alter the way the neck is used and can cause undue stress at the neck to compensate for poor postures.
Samuel K. Cho, MD
Orthopedic Surgery

Neck pain (or cervicalgia) is a common problem, with about two-thirds of the population having neck pain at some point in their lives. Neck pain can be caused by a host of spinal conditions. It can arise from muscle tightness in both the neck and upper back/shoulder, or pinching of the nerves as they come out of the spine and travel down the arms. Disruption of the joint in the neck can generate pain as well.

Causes of neck pain: Neck pain may come from any of the structures in the neck (blood vessels, nerves, airway, esophagus, muscles, and bones) or be referred from other parts of the body.

Some of the major and severe causes of neck pain include:

  • Carotid artery dissection
  • Referred pain from acute coronary syndrome (heart attack)
  • Infections
  • Spondylosis (arthritis of the spine)
  • Cervical stenosis (narrowing of the spinal canal)
  • Disc herniation

The more common and less serious causes include:

  • Stress: either emotional or physical
  • Prolonged postures: many people fall asleep on sofas and chairs and wake up with sore necks
  • Minor injuries and falls
  • Over-use: muscular strain
  • Referred pain: mostly from upper back problems
  • Whiplash
The most common cause of neck pain comes from pain and inflammation in the muscles and other soft tissues around the neck. This can happen gradually or suddenly and is most common along with osteoarthritis in the neck. The pain can be severe and limiting. The important thing is to check with your doctor to be sure there are no other serious causes of the neck pain. Osteoarthritis, rheumatoid arthritis, disk disease, or other medical illness might be present and may need early treatment to be successful.

If your neck pain hurts when you cough, or travels down one or both arms; if you notice weakness in the muscles of your arms; or if the pain awakens you at night, then you should make an appointment with your doctor as soon as possible for further evaluation.
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Rick Olderman
Physical Therapy

From a musculoskeletal point of view, neck pain results from three potential problems:

  • Poor shoulder function. Muscles attach from the shoulder blade to the cervical spine and base of the skull. When shoulder function is less than optimal, stress is delivered to the neck via these muscles.
  • Thoracic spine shape. The shape of the upper trunk (thoracic spine) is different in everyone. Some people have excessive curvature while others have diminished curvature. This affects how the shoulder blades rest and move on the trunk and therefore their function. This also influences the third potential problem.
  • Cervical spine shape and movement strategies. Some people's cervical spine is more or less curved than others. This influences how they move their head which can create stress at the cervical spine.
Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
Your muscles are responsible for neck pain. There are three common reasons for muscles spasms that cause neck pain:
  • A heavy purse can pull your muscles out of whack. To avoid neck pain, make sure your purse weighs no more than 3 to 5 pounds.
  • Pressure from daily stress makes muscles tight and more likely to spasm. One of the most popular places you hold tension is in your neck, as well as your jaw and lower back.
  • Poor posture can misalign the muscles in your spine and cause spasms. So stand up tall as if a string is pulling you up from the top of your head.

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Akash Bajaj, MD

Neck pain can be the result of a variety of causes, ranging from overuse injuries and whiplash to diseases such as rheumatoid arthritis and meningitis. Overuse, such as too many hours hunched over a computer, often triggers muscle strains. Neck muscles, particularly those in the back of your neck, become fatigued and eventually strained. When you overuse your neck muscles repeatedly, chronic pain can develop. Even such minor things as reading in bed can strain neck muscles. Just like all the other joints in your body, your neck joints tend to experience wear and tear with age, which can cause osteoarthritis in your neck. A variety of problems in your neck's vertebrae can reduce the amount of space available for nerves to branch out from the spinal cord. A few examples are stiffened discs, herniated discs and bone spurs. Car accidents, such as rear-end collisions, often result in whiplash injuries, which occur when the head is jerked forward and then backward, stretching the soft tissues of the neck beyond their limits. In addition, neck pain may be caused by diseases, such as rheumatoid arthritis and meningitis.


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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.