Diagnosis
To diagnose neck pain, your healthcare professional asks about your symptoms and medical history. This is followed by a physical exam to check for tenderness, numbness and muscle weakness. Your healthcare professional checks how far you can move your head forward, backward and side to side.
Imaging tests
Imaging tests may be ordered to help find the cause of your neck pain. These may include:
- X-rays. X-rays can show areas in the neck where the nerves or spinal cord may be pinched by bone spurs or other changes.
- CT scan. A CT scan takes many X-ray images from different angles to create a detailed picture of the inside of your neck.
- MRI. An MRI uses radio waves and a strong magnet to make detailed images of bones and soft tissues. The soft tissues include the disks, spinal cord and nerves.
It's possible to have X-ray or MRI images show structural issues in the neck without neck pain. Imaging studies are best used with a careful history and a physical exam to diagnose the cause of neck pain.
Other tests
- Electromyography, also called EMG. This test is done to see if a pinched nerve may be causing your pain. A healthcare professional places small needles into muscles to measure how well your nerves are working.
- Blood tests. Sometimes blood tests can show signs of infection or inflammation that may be causing neck pain or making it worse.
More Information
Treatment
Most mild to moderate neck pain gets better within 2 to 3 weeks with simple self-care. Typically, pain medicine you can buy without a prescription and applying ice and heat are enough to ease symptoms.
Medicines
Pain relievers you can buy without a prescription include nonsteroidal anti-inflammatory drugs, also called NSAIDs, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve). You also might consider taking acetaminophen (Tylenol, others). Take these medicines only as directed. Taking too much can cause serious side effects.
If pain relievers you can buy without a prescription don't help, your healthcare professional may suggest prescription NSAIDs or muscle relaxers to relieve pain and stiffness.
Therapies
- Physical therapy. A physical therapist can teach you how to improve your posture and strengthen muscles to help you position your neck in healthy ways. Physical therapy also may include heat, ice or other measures to help ease pain.
- Transcutaneous electrical nerve stimulation, also called TENS. This treatment uses tiny electrical impulses delivered through patches on the skin. These electrical impulses may help lessen some types of pain, but there's little evidence that TENS offers any relief for neck pain.
- Neck collar. A soft foam collar that supports your neck may help lessen pain by taking pressure off the neck. This may be especially helpful if you have arm pain associated with a pinched nerve. However, wearing a neck collar for more than three hours at a time or for more than 1 to 2 weeks, can make symptoms worse.
Surgery or other procedures
- Steroid injections. If other therapies don't ease pain, a healthcare professional may suggest steroid injections. Steroid medicine is injected near nerve roots, into spinal joints or into neck muscles to lessen pain and swelling. A numbing medicine, such as lidocaine, also may be used.
- Dry needling. Dry needling may improve blood flow and help relax the muscle to lessen pain and stiffness. A healthcare professional inserts very thin needles into tight or sore areas of muscle. The needle is called "dry" because no medicine is injected.
- Surgery. Surgery is rarely needed for neck pain. It may be considered if pain is caused by pressure on a nerve or the spinal cord and other treatments don't help.
Alternative therapies
Some people find relief from alternative treatments. Always talk with your healthcare professional before starting a new therapy.
- Acupuncture. Very thin needles are placed in specific spots on the body. Acupuncture typically is considered safe when done by a certified professional using sterile needles. Multiple sessions may be needed for best results.
- Chiropractic care. Performed mainly on the spine, a chiropractic adjustment typically applies quick, controlled movements to adjust the spine. Chiropractic treatments to the neck may provide short-term pain relief. Risks typically are low for most people.
- Massage. During a massage, a trained massage therapist gently presses and kneads the neck and shoulder muscles. This may help lessen tightness and pain, especially for people with long-term neck tension.
- Tai chi, qigong and yoga. These gentle activities combine slow movements, deep breathing and relaxation. They can help lessen neck pain and improve flexibility.
Self-care
Besides taking pain medicine that you can buy without a prescription, you can try these self-care steps:
- Use cold and heat. For the first 48 hours, apply an ice pack wrapped in a thin towel for up to 15 minutes at a time, several times a day. After that, use heat, such as a warm shower, a heating pad on low or a warm compress, to relax muscles.
- Do gentle exercises. Keep your neck moving as the pain begins to ease. Try slow neck rolls and shoulder rolls. Gently tilt, bend and turn your head. Warming up your neck with a heating pad or warm shower before stretching can help.
Preparing for your appointment
If you have neck pain, you'll probably start by seeing your regular healthcare professional. Depending on your symptoms, you may be referred to a specialist such as:
- A doctor who treats muscle and joint issues without surgery, called a physical medicine and rehabilitation specialist.
- A doctor who treats arthritis and other conditions that affect the joints, called a rheumatologist.
- A doctor who treats conditions related to the brain, spine and nerves, called a neurologist.
- A doctor who operates on bones and joints, called an orthopedic surgeon.
What you can do
Before your appointment, be prepared to answer the following questions:
- When did your symptoms start?
- Have you ever hurt your neck? If so, when?
- Do certain neck movements make the pain better or worse?
- What medicines or supplements do you take regularly?
What to expect from your doctor
Your healthcare professional might ask some of the following questions:
- Where exactly is your pain?
- Is the pain dull, sharp or shooting?
- Do you have numbness or weakness?
- Does the pain radiate into your arm?
- Is the pain made worse by straining, coughing or sneezing?
- Do you have other physical issues?