• Chronic Neck Pain

    (Neck Pain, Chronic)

    Definition

    Chronic neck pain is pain that occurs over a long period of time. It usually lasts more than three months. The pain can range from mild to severe.
    Contact your doctor if you have experienced neck pain over a period of time without relief.
    Nerve Pain in Neck
    Neck pain
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Chronic neck pain can be caused by:

    Risk Factors

    The causes of chronic neck pain are also usually risk factors.

    Symptoms

    Chronic neck pain may also cause you to have neck stiffness. Pain may be worse when moving your neck. The pain can be any type of pain including burning, sharp, dull, tingling. The pain may spread to other parts of the body such as the shoulders and arms.
    Muscles of the Neck
    Neck Muscles
    Copyright © Nucleus Medical Media, Inc.

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may refer you to a specialist. Orthopedists specialize in bones and joints. A neurologist or neurosurgeon specializes in the nerves and spinal cord.
    Your doctor may need to see images of your spine. This can be done with:
    Your doctor May need to measure how well the nerves and muscles in your neck are working. This can be done using electromyography (EMG).

    Treatment

    Talk with your doctor about the best plan for you. Options include the following:

    Activity and Exercise

    You may be able to decrease your pain by staying active and exercising. Your doctor may also refer you to a physical therapist. A therapist may work on strength exercises and stretching.

    Medications

    There are many different medicines that may be used the help you manage your neck pain.
    • Nonsteroidal anti-inflammatory drug (NSAID)—to treat the pain and reduce inflammation
    • Acetominophen—to treat pain
    • Certain antidepressant medications—sometimes used for neck pain
    • Certain antiseizure medications
    • Corticosteroid injection —to treat the pain and reduce inflammation caused by disk disease

    Other Treatments

    There are other treatments that might be helpful for neck pain.
    • Low-level laser therapy— a light source is directed on the painful area
    • Chiropractic care
    • Acupuncture
    • Intermittent traction (pulling on the neck)
    • Massage

    Surgery

    Most cases of neck pain are treated medically. In some cases surgery is needed. The type of surgery will depend on the cause of pain. For example, if you have a herniated disk in your neck, surgery will remove the disk .

    Prevention

    To help reduce your chance of getting neck pain, take the following steps:
    • Maintain good posture.
    • Take breaks from activities that do not involve movement such as driving or working at a computer.
    • Avoid sleeping with too many pillows
    • Get plenty of exercise
    • Make sure your desk chair and keyboard are at proper heights.
    • Avoid cradling the phone in your neck.

    RESOURCES

    American Academy of Family Physicians http://www.familydoctor.org

    American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/

    American Physical Therapy Association http://www.apta.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org/

    Canadian Orthopaedic Foundation http://www.canorth.org/

    Canadian Physiotherapy Association http://www.physiotherapy.ca/public

    References

    Langevin P, Lowcock J, Weber J, Nolan M, Gross AR, Peloso PM, Roberts J, Graham N, Goldsmith CH, Burnie SJ, Haines T; Cervical Overview Group. Botulinum toxin intramuscular injections for neck pain: a systematic review and metaanalysis. J Rheumatol. 2011;38(2):203-214.

    Misailidou V, Malliou P, Beneka A, Karagiannidis A, Godolias G. Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools. J Chiropr Med. 2010 Jun;9(2):49-59.

    Neck pain. American Academy of Family Physicians website. Available at: http://familydoctor.org/online/famdocen/home/tools/symptom/513.html . Accessed December 6, 2012.

    Neck pain. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00231 . Updated November 2009. Accessed December 6, 2012.

    Neck pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated November 30, 2012. Accessed December 6, 2012.

    What a pain in the neck! American Academy of Physical Medicine and Rehabilitation website. Available at: http://www.aapmr.org/patients/conditions/msk/spine/Pages/Prevent-Neck-Pain.aspx. Accessed December 6, 2012.

    12/31/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet. 2009;374:1897-1908.

    12/17/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Andersen LL, Christensen KB, Holtermann A, et al. Effect of physical exercise interventions on musculoskeletal pain in all body regions among office workers: a one-year randomized controlled trial. Man Ther. 2010;15(1):100-104.

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