July 8, 2021

Neck pain: common causes and when to see a doctor

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A number of factors can contribute to neck pain; here’s how to manage it.

Nobody likes a pain in the neck, but neck issues are a common cause of pain and disability among adults. “Approximately one in four adults report having had at least one episode of significant neck pain in the past year,” explains Dr. Amir Abtahi, an orthopaedic spine surgeon with Vanderbilt Spine Center.

Not only can neck pain have a significant impact on individuals but it is also a common cause of lost work productivity and healthcare expenditures.

Help for neck and back pain

If you’re ready to tackle the root cause of your back and neck pain, this treatment guide can help.

Risk factors

A number of factors can contribute to pain, Abtahi explains, including disc degeneration, occupational factors like sitting at a desk or computer for multiple hours each day, as well as other less-known factors like stress and anxiety. People whose jobs involve lifting (particularly overhead lifting) and/or prolonged periods of time with their necks in awkward positions — such as mechanics, plumbers, electricians or surgeons(!) — may also be at an increased risk of developing neck problems. In many cases, there is no specific history of an injury. Pain may start suddenly and for no apparent reason or can come on more gradually.

Common symptoms

Cervical spine issues may not just cause pain in the neck but may refer to pain in other areas, including the shoulder and shoulder blade (most commonly) or the chest.

Sometimes, other symptoms may indicate the presence of a more serious problem. These “red flag” symptoms include pain radiating down the arm and/or numbness or weakness in the upper extremity. These symptoms may indicate the presence of a pinched nerve in the neck – a condition known as radiculopathy.

Other “red flag” symptoms may include difficulty with hand dexterity, difficulty with standing or walking balance, or issues with bladder incontinence. These symptoms may indicate the presence of spinal cord compression – a serious condition known as myelopathy.

When to see a specialist

Most episodes of neck pain are benign and self-limited. These episodes typically do not require a visit to a spine specialist. Conservative care can be initiated at home and typically includes activity modifications, ice and anti-inflammatory medications.

When pain in your neck fails to improve with initial conservative care, or when “red flag” symptoms are present, a visit to a spine specialist may be warranted. There, X-rays of the neck and sometimes an MRI help determine the underlying cause of a patient’s symptoms, Abtahi said. He usually starts with conservative treatments such as physical therapy and sometimes recommends spinal injections.

Sometimes – when symptoms have not responded to conservative care or when a more serious condition is present, surgery may be recommended.

Recommendations for avoiding and managing neck pain

  • Be aware of occupational risk factors and work to mitigate them. This may include being more aware of your posture at work and potential triggers for neck pain such as awkward neck positions. Sitting with the shoulders slouched forward is a common inciting factor for pain because it forces the neck into hyperextension.
  • Maintain good strength in all muscle groups in the shoulders, upper back and neck. Isometric neck strengthening exercises are one of the best ways to keep pain at bay.
  • At the earliest sign of symptoms, initiate a self-directed conservative care program including neck stretching exercises, ice and anti-inflammatory medications. Common sense activity modifications should be initiated.
  • If symptoms fail to improve, or if “red flag” symptoms develop, consider seeing a spine specialist for further treatment recommendations.

The Vanderbilt Spine Center treats patients from across the Southeast for back pain, sciatica, whiplash and other conditions of the spine, offering a full range of treatments including non-surgical options. If surgery is necessary, the Vanderbilt Spine Center team provides an extraordinary level of experience and expertise for each patient’s needs. Download our treatment guide and schedule an appointment online.

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