Neck pain can signal a more serious underlying problem if it is severe, lasts longer than a week, or is accompanied by other symptoms. The neck is made up of a combination of supporting structures including vertebrae, cervical discs, ligaments and muscles. Muscles and ligaments help support and move the head.
Inflammation, injury, or a problem with any of these structures can cause neck pain. Although most causes are mild, such as sleeping in an awkward position, some cases of neck pain may indicate a serious underlying problem. This article reviews ways to identify severe neck pain, when to see a doctor, possible causes, and potential treatments and management options.
How to identify if neck pain is severe
Neck pain usually begins in the neck and can radiate to one or both arms. Several diseases and disorders can affect the tissues of the neck, which include muscles, nerves, bones, joints, and ligaments.
Pain can be subjective, but a person may consider neck pain serious if:
over-the-counter medications do not help improve it
there is no improvement after 1 week
pain occurs after a blow to the head or injury
the person feels numbness, tingling, or weakness in the arms or hands
the pain manifests as intense stiffness
the pain spreads down one arm
neck pain is accompanied by fever or headache
the pain is accompanied by weakness in the legs or loss of coordination in the legs or arms.
Severe neck pain may be a sign of an underlying condition or injury.
When should you seek medical help?
A person should contact emergency services or a doctor after a neck or head injury. Here are some possible causes:
whiplash in a car accident
impact during a contact sport
falling from a ladder or other height
any blunt object trauma
A person should also consider contacting a doctor if they experience additional symptoms, the pain lasts longer than a week, or does not go away with over-the-counter medications.
A doctor may refer a person to a neurosurgeon if they experience persistent pain, tingling or numbness in their limbs, or other symptoms in addition to their neck pain.
Possible causes of severe neck pain
Several underlying conditions, as well as blunt object trauma, can lead to severe neck pain. Some common causes include:
Cervical stenosis: This is often due to degeneration that results in narrowing of the spinal canal and compression of the spinal cord.
Cervical myofascial pain: This is pain in the muscles and connective tissue, often caused by overuse or trauma to the neck.
Heart attack: Pain from a heart attack can occur in the jaw, neck, or other parts of the upper body.
Angina pectoris: Heart muscle pain due to lack of oxygen can spread to the neck in some cases.
Meningitis: Inflammation and swelling of the spinal cord can occur in the neck area, causing stiffness and pain in this area.
Arthritis: Different types of arthritis, including rheumatoid arthritis and osteoarthritis, can manifest in the neck, causing stiffness and pain.
Fibromyalgia: This disease can cause pain throughout the body, including in the neck.
Herniated disc: This is the weakening of a spinal disc that encroaches on the spinal cord or nerve roots. In some cases, this can cause pain in the neck.
Treatment and Support Options
Treatment for neck pain can vary depending on the exact underlying cause. These can be conservative or more aggressive treatments, depending on the person’s needs.
Non-surgical treatment options can often help relieve a person’s pain and swelling. Here are some common examples:
prescription medication to help reduce pain and swelling
wearing a cervical collar
cessation or reduction of activities
the use of injections, such as corticosteroids
neuromodulation using spinal cord stimulators.
Conservative treatments can last about 6 to 8 weeks. A person should seek immediate medical attention if they experience numbness or weakness in their legs or arms during this time.
In some cases, surgery may be needed to relieve neck pain. Surgery may be an appropriate option for a person if they:
has reduced function due to pain
conservative therapy does not help
has difficulty walking or keeping balance
has progressive neurological symptoms involving the arms or legs.
Surgical options may include, but are not limited to, spinal fusions and artificial disc replacement.
If another underlying condition is affecting the neck, the person will likely need additional medications and therapies to treat the underlying cause.
Neck pain can be due to a variety of benign reasons, as well as more serious causes, such as illness or injury. Severe neck pain usually requires medical treatment. A person should see a doctor if the pain lasts for more than a week, over-the-counter medications don’t help, or if they have other symptoms, such as weakness or tingling in the limbs. Treatments can vary depending on the underlying condition affecting the neck. They can be conservative, consisting of drugs and braces, or more aggressive, such as surgery. A person will also need to treat any underlying conditions in addition to their pain. Further treatment may require the support of specialists or other professionals.