Signs You Should Seek a Doctor for Your Chronic Neck Pain

February 18, 2022

By Joshua Abrams, DO

Have you ever slept in an awkward position and woke up with a neck so stiff you could barely look down to tie your shoes, or spent a day hunched over a desk only to stand up and realize how badly it hurt your neck? If you have, chances are you simply stretched, took some painkillers and hoped for the pain to disappear by morning — or at least by the end of the week.

However, there are times when neck pain is a deeper issue than just poor posture. In these cases, the issue likely won’t go away, and it might even get worse unless you seek medical treatment. Read more to learn about whether your neck pain needs an ice pack and a day of rest or a doctor’s appointment.

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There are many causes of neck pain aside from poor posture and sleeping positions. Injuries, chronic diseases and even traumatic events can cause neck aches and pains. If you’re unsure what’s causing your neck pain or suspect it could be a serious injury or chronic disease, it’s important to seek medical treatment as soon as possible.

Stress or Tension Headaches

Headaches can lead to neck pain, too. These particular headaches usually stem from heightened emotional stress or extended periods of muscle tension. 

Muscle Sprain or Strain

A strained or sprained muscle in the neck is another common cause of neck pain. These strains may occur from sports injuries, awkward sleeping or sitting positions, carrying heavy objects or even sudden movements that place excessive strain on the neck muscles. 

Whiplash Injury

Whiplash is just as the name indicates — an injury that occurs when the head whips violently back and forth or from side to side. This movement stretches the muscles, vertebra, nerves and ligaments in the neck, sometimes leading to neck pain and stiffness. Whiplash can result from any instance of the neck being violently “whipped” around, most commonly from auto accidents. It can also happen with contact sports, such as football. 

Infants and children run a much higher risk of severe injury from whiplash because their heads are large compared to the rest of their bodies and their necks are relatively weak. Due to this weakness, they may suffer whiplash from being shaken too hard. While adults usually heal from whiplash with time and mild treatment, infants and children can experience permanent nerve damage or brain trauma that delays their development. Untreated whiplash in adults may lead to loss of sensation or movement. 

If adults suffer a severe injury that could potentially lead to whiplash, they should seek medical treatment to make sure the whiplash isn’t too severe and evaluate any other injuries. Infants suffering from whiplash require immediate medical treatment because their bodies are so much more delicate. 

Osteoarthritis

Although you may not give it much thought, there’s more to your joints than a single hinge. A durable tissue called cartilage protects the bones in your joints. This cartilage covers the areas where two or more bones meet, preventing them from rubbing together and damaging each other. 

Osteoarthritis is a condition that develops over time and is most often found in the middle-aged to elderly. When the cartilage between the joints wears down over time, becoming thin and damaged, it creates friction between the bones when the joints move. Osteoarthritis can also inflame the synovial membranes. These membranes normally allow for smooth joint movement but become warm, swollen and tender when inflamed. 

Osteoarthritis causes inflammation, pain, stiffness and swelling at the joints. It can affect the elbows, knees and neck. This condition gets worse over time due to the constant friction of moving joints. Treatment is usually tailored to the individual’s medical history and needs, sometimes including anti-inflammatory medication and physical therapy. 

Fibromyalgia

Fibromyalgia is the leading cause of musculoskeletal pain in the U. S. While it’s not yet known what causes fibromyalgia, the symptoms may be triggered by an emotionally or physically traumatic event or come on slowly with no apparent trigger. 

This condition causes chronic, widespread muscle pain, sleep disorders, memory problems, fatigue and tenderness at select parts of the body, including the neck. Fibromyalgia symptoms vary between patients and some symptoms may lie dormant for extended periods of time. Untreated fibromyalgia can lead to severe emotional distress and should be treated as quickly as possible. While there’s currently no known cure, you can manage fibromyalgia with certain medications, such as pain relievers and antidepressants. 

Nerve Compression

Your nerves are responsible for your ability to feel physical sensations, such as temperature, touch and pressure. If a nerve is pinched between bones or other tissues, it can cause sudden, seemingly unexplained pain. Pinched nerves in the neck may come from spinal compression, the degradation of cartilage over time or a slipped spinal disc.  

Both brain and spine tumors can cause stiffness or pain in the neck. There are two types of pain-causing spinal tumors — primary and secondary. Primary spinal tumors originate in the spine and are often benign. Secondary tumors originate in other parts of the body and spread to the spine. These tumors are cancerous.

Tumors, especially malignant ones, must be treated by a professional. If you feel a lump in your neck, consult your doctor as soon as possible to determine if it’s a benign or malignant tumor.

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Overview

Chronic neck pain can be caused by a variety of conditions such as muscle spasms, trauma, deformity, osteoarthritis, inflammatory conditions, spondylosis, stenosis, or pinched nerves. That’s why it’s important to see a doctor who can diagnose the source of your pain and symptoms and help you feel better. Duke spine experts diligently work to provide the greatest relief with the least-invasive interventions. Together, you and your doctor can create a treatment plan that fits your goals and lifestyle.

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About Neck Pain

Content

Neck pain is often caused by problems in the top part of your spine (called the cervical region). Acute pain comes on suddenly and usually heals on its own within days or weeks. Chronic pain lingers for months and can be constant or intermittent.

Many cases of neck pain are minor. However, you should seek immediate medical care if your pain is caused by an injury or is accompanied by any of the following symptoms: 

• Fever
• Severe headaches
• Nausea/vomiting
• Tingling or numbness in the arms or legs
• Shooting arm pain
• Loss of bladder or bowel control
• Loss of balance or frequent falls 
• Weakness or difficulty using your hands

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Nonsurgical Treatments

Content

Conservative options can be very effective in treating neck pain. Surgery may be a last resort if these solutions don’t provide the relief you need.

Physical Therapy
A trained physical therapist guides you in exercises and stretches designed to strengthen your neck, improve your balance and flexibility, and improve range of motion — all benefits that can alleviate your symptoms. Your therapist may suggest cervical traction, which stretches your neck to reduce compression.

Electrical Stimulation
A TENS (transcutaneous electrical nerve stimulator) unit can be used in your doctor’s office or at home. A portable version is small enough to hold in your hand. When you are experiencing pain, you place reusable electrodes on your neck and attach them with wires to the TENS device. Then you turn on the device to deliver mild electricity (it should not hurt) through your skin for 15 to 30 minutes. This stimulates your nerves and stops pain receptors in the brain.

Short-Term Bracing 
In some cases, including with trauma and fractures or instability of the spine, your doctors may recommend wearing a rigid or semi-rigid neck brace for a short time. This stabilizes your spine, allowing it to heal and helping to prevent additional injury.

Chiropractic Care
A skilled chiropractor uses spinal manipulation and other manual methods to help relieve neck pain and other symptoms such as numbness and tingling, loss of strength, or pain in the arms or legs. These hands-on techniques stretch and move the spine to restore mobility to joints restricted by injury or repetitive stress, such as sitting without proper back support. Our chiropractors can also teach you exercises for improving strength and flexibility and incorporating safe movements and proper posture into your daily activities.

Acupuncture
Using fine needles placed strategically in the skin, acupuncture stimulates the central nervous system and releases chemicals that promote healing. We offer this treatment as a complement to your regular treatment plan, not as a substitute.

Medication
Medications include over-the-counter and prescription anti-inflammatory drugs, muscle relaxers, steroids, nerve-pain medicines, and more. Our doctors balance medication recommendations with risks of side effects, dependency, and other unwanted reactions.

Spine Injections
Epidural steroid injections treat inflammation and pain right at the source — your pinched spinal cord or nerve roots. Using X-ray imaging to guide them, doctors numb your skin and place a needle into the epidural space in your spine. You’ll feel pressure during this procedure. The medicine usually begins working within a few days to a week. You’ll be able to return to normal activities the following day. We give these injections in a special, sterile fluoroscopy suite.

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Tests

Content

X-Rays
By taking pictures of bones and joints in your neck, X-rays can help identify fractures, dislocations, bone spurs, instability, or other potential causes of pain. X-rays take about 15 minutes and are virtually painless.

MRI (Magnetic Resonance Imaging)
Magnet waves create the most detailed images of your spine, including your discs, spinal bones, spinal cord, and nerves. Images can help identify disc damage or the source of pressure on your spinal cord and spinal nerves. This test takes about 30 to 60 minutes and is virtually painless.

CT (Computed Tomography)
A series of cross-sectional pictures produce detailed, 3D images of your spine bones. This test takes about 10 minutes and is virtually painless.A series of cross-sectional pictures produce detailed, 3D images of your spine bones. This test takes about 10 minutes and is virtually painless.

Electromyography (EMG)
Electrodes are inserted directly into muscle with a thin needle to record electrical activity. You will feel some discomfort. EMG, which can last from 30 to 90 minutes, measures how well muscles and nerves are working in a certain area of your body — in this case, your neck and arms.

Blood Tests
Rarely, neck stiffness or pain can be a symptom of an infection or another serious condition like meningitis. Blood tests can help identify these issues. 

Diagnostic Injections 
To confirm whether pain is coming from a specific area in your neck, doctors inject numbing medication into that spot. If the pain improves, doctors know more about the source of your pain.

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Why Choose Duke

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Duke Spine Health Program
Duke’s Spine Health Program takes a holistic, patient-centered approach to neck pain. Since research shows that trying conservative treatments lowers your risk of developing chronic pain, we offer the full range of first-line options, including chiropractic care, physical therapy, acupuncture, massage, yoga, mindfulness, and more. With in-person or virtual visit options, we also help you learn about your pain and help you manage it at home. If and when you need it, we won’t hesitate to refer you for more advanced care.

Team of Specialists
Our multidisciplinary team includes physical and occupational therapists, psychologists, a massage therapist, acupuncturists, a chiropractor, physiatrists (physical medicine and rehabilitation doctors) who specialize in conservative spine care, pain management specialists, orthopedic and neurosurgery experts, and others. We work together to ensure you receive comprehensive, thorough care.

Safe, Effective Results
Our spine care team is motivated to constantly improve, so they pay close attention to outcomes and always strive to do better. As members of many national and international groups such as the North American Spine Society, Scoliosis Research Society, and Cervical Spine Research Society, our clinicians stay up-to-date on the latest technologies and advances in treating your spine injury or condition. This results in safer, more effective procedures and fewer complications.  

Improving Care
We’re always looking for ways to advance spine care treatment. In addition to ongoing clinical trials, we also collect information about outcomes that we use for quality improvement.

This page was medically reviewed on 06/07/2022 by

Oren N. Gottfried, MD
| Neurosurgeon

Neck pain – which doctor to contact

Choosing a specialist

Despite the huge list of ailments that can cause neck pain, it is not at all difficult to independently choose a specialist who specializes directly in the treatment of such diseases and differentiate the symptoms of the disease.

Neurologist. So, if the pain in the neck is clearly localized, acute, turning into a migraine, and it is not stopped by painkillers, while visual impairment and fainting are noted, it is obvious that this is the area of ​​​​knowledge of a neurologist. Similar sensations occur with degenerative changes in the cartilage tissue, resulting in damage to the trigeminal nerve, as well as inflammation of the latter as a result of infection or stress.

A vertebrologist is a rather narrow specialist, the existence of which is known to few. The scope of his activities extends to such lesions of the musculoskeletal system as arthritis, intervertebral hernia, spondylitis.

Osteopath — patients with dysfunctions of the spine and joints get an appointment with this specialist, since this specialist is responsible for restoring spinal mobility and normalizing posture. Sometimes an uncomfortable posture in the workplace and physical inactivity provoke stagnation in the upper skeleton and pain occurs, suggestive of serious ailments.

Surgeon. If conservative methods of treatment are ineffective, there is nothing left but surgical intervention. This is, first of all, relevant for all kinds of hernia and neoplasms.

Otolaryngologist – an ENT doctor, as a rule, the last one they decide to turn to with neck pain, believing that it is difficult to confuse a sore throat with something. At the same time, severe inflammation of the tonsils or middle ear can spread to the lymph nodes and the nature of the suffering will not allow the disease to be correctly identified. In such cases, a blood test shows an excessively high content of leukocytes and an ESR of more than 30.

Traumatologist. If pain in the neck appeared after a fall, careless movement, excessively intense training or other injury, you should immediately visit a traumatologist, since even a slight violation of the integrity of the bone and cartilage block or muscle strain is fraught with serious consequences up to death.

Rheumatologist – specializes in the diagnosis and treatment of lesions of bone, cartilage and muscles, often due to heredity. It is no coincidence that a visit to him is often accompanied by a referral to a geneticist.

Orthopedist. Thinning or immobilization of bones requires the help of an orthopedist, who will be able to correctly determine the causes of the disease and select adequate therapy.

Phlebologist. A huge number of the most important vessels are concentrated in the neck, the treatment of diseases of which is carried out by a phlebologist. Thickening of the walls of blood vessels, their clogging or other pathologies can also cause severe pain, reminiscent of muscle spasms. Such conditions are indicated by a change in the color of the skin, a cyanotic complexion and a pronounced capillary network.

Due to the fact that narrow specialists consider the same anatomical and physiological problem from different angles, complex diagnostics involving several doctors is required to maximize the effectiveness of treatment. It should be understood that if unbearable pain in the neck appears, then which doctor treats the disorder that caused it does not matter, since it is important to take urgent measures by contacting any of the available specialists.

How to get rid of neck pain

Once diagnosed, all that is required of the patient is to strictly follow the doctor’s orders. If a specialist insists on the use of bandages and other fixing devices, then this is really necessary. It is impossible to adopt recommendations given by a doctor to another person, since even very similar symptoms may indicate different diseases, and analogy in such matters is unacceptable.

As a rule, therapy consists of three areas:

1. medication, namely the use of non-steroidal anti-inflammatory drugs, special painkillers and vitamin and mineral supplements, the use of warming ointments;
2. physiotherapeutic procedures, including massage, phototherapy and paraffin therapy;
3. exercise therapy, which is prescribed only after the disappearance of acute pain.

Impulse devices, hirudotherapy, acupuncture and a visit to the manual therapy room give excellent results. However, you should not supplement the appointment list yourself, as it is easy to aggravate the situation. Any manipulations with the treatment of the spine and joints should be carried out only after consulting a doctor. In addition to therapeutic methods, there are many ways to cope with pain for a while, which allows you to sleep better, be treated without interrupting work and lead a more fulfilling lifestyle.

Thus, pain syndrome, with the exception of injuries and sprains, is effectively relieved by hot baths and alcohol compresses. It is necessary to purchase an orthopedic pillow for sleeping, which will fix the head in such a way as to relieve the load from the neck and shoulders. It makes sense to use a comfortable chair with a headrest for work, as well as take short walks from time to time, which will improve blood flow and distract from discomfort.

Thinking about which doctor to go to if your neck hurts, you should not hesitate, because any disease is easier to stop at an early stage. In addition, timely treatment is the only way to prevent the transition of the acute form of the disease into a chronic one. In order to prevent diseases of the cervical spine, it is important to follow simple preventive measures, namely, eat well and do gymnastics regularly.

blown out, or is the pain in the neck caused by something else? Treatment of neck pain

Author

Vyacheslav Vladimirovich Korolev

Neurologist of the highest category, doctor of functional diagnostics, vertebroneurologist.

Leading physician

Candidate of Medical Sciences

Neurologist

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Neck pain: what does it look like?

Neck pain

Neck pain is a common symptom. According to medical statistics, every third adult has ever experienced pain in the neck. Right now, one in ten people have neck pain.

As a rule, pain in the neck is constant, aching in nature. Sometimes the pain is accompanied by dizziness, nausea, tinnitus. In some cases, the pain radiates (spreads) to the arms. Simultaneously with pain in the neck, pain in the region of the heart can also be felt, especially with an uncomfortable posture. Even with pain in the neck, there may be complaints of limited mobility of the neck or a crunch in the neck when turning the head.

Why does my neck hurt?

The reasons why the neck can hurt are quite diverse. Most often, neck pain is due to one of the following reasons:

• prolonged exposure to an incorrect posture, such as sleeping in an uncomfortable position, or working in which you have to maintain the same position of the head for a long time. For office workers, the wrong position of the monitor on the desktop quite often causes neck pain;
• prolonged physical activity;
• stress, depression, anxiety;
• injuries and sprains;
• incorrect posture;
• hypothermia of the neck muscles. People still say in this case: “the neck was blown.” A draft – a steady stream of cold air – leads to a local deterioration in blood supply, resulting in aching pain in the neck.
• The most common cause of neck pain is osteochondrosis. This is a group of diseases characterized by a deterioration in the properties of the cartilaginous tissue of the spine, mainly due to age-related changes in the body or traumatic consequences. Cervical osteochondrosis often causes not only pain in the neck, but also headaches. A formidable complication of cervical osteochondrosis is the appearance of intervertebral hernias. A herniated disc is a protrusion of part of the intervertebral disc. In this case, compression of the nerve fibers occurs, which causes increased pain during exercise or in a static position. With an intervertebral hernia of the cervical spine, pain radiates to the arms. Fingertips may be numb.

Neck pain can also be caused by other causes, including some serious diseases that require urgent treatment. For example, neck pain and limitation of head movements are observed in meningitis, vascular, infectious and oncological diseases, injuries of the cervical spine, immune disorders (rheumatoid arthritis, ankylosing spondylitis, arthritis in inflammatory bowel diseases), as well as various diseases of the internal organs.

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Neck hurts: what to do?

Neck pain caused by any mechanical cause may resolve in a few days. If you are sure that the pain in your case is due to the fact that your neck simply blew out or you turned it abruptly, try holding your neck in soft warmth. It is also recommended to ensure a reduction in the static load on the muscles of the neck and a comfortable position of the head during sleep. However, with prolonged or severe pain, you should consult a doctor. Self-medication will be ineffective, because before starting treatment, it is necessary to make a diagnosis. For pain in the neck, it is very important to undergo instrumental research methods, in particular, radiography or, even better, computed tomography of the cervical spine. This will distinguish “banal” osteochondrosis, for example, from tumor diseases.

Which doctor to contact for neck pain

If your neck hurts, you should first of all contact a general practitioner (therapist), who will determine the further direction of the examination.