When should you worry about neck pain?

What causes neck pain and stiffness?

Seven bones called vertebrae are connected by spongy shock-absorbing 'discs', with a network of muscles and tough connective tissue supporting them. The spinal cord runs through a canal protected on all sides by bone. Damage or strain to any one of these can cause pain.

What are the symptoms of neck pain?

Pain which often starts in the neck and spreads to one or both shoulders - sometimes further down the arm - or up to the back of your head. Your neck and shoulders may feel stiff. Pins and needles are common and usually not a worrying sign, but these need to be checked out as they suggest a nerve emerging from your spine may be caught or irritated. The pain usually improves after a few days and goes within weeks.

Do I need tests?

As long as you don't have any of the 'red flags' below you're unlikely to need tests and may not even need to see a doctor. X-rays and scans aren't recommended except in special circumstances as they don't change treatment options.

Red flags - when should you worry?

Treating neck pain

Keep moving

When you first get neck pain, it may be very painful to move and you'll need to rest in a neutral postion for a couple of days. After that, as long as you don't have the 'red flags' above, it's important to keep moving your neck to stop it stiffening up - which is why neck collars or braces are not recommended unless your doctor says so.

Turn your head gently in all directions every few hours, trying to increase the range of motion gradually. Avoid prolonged sitting but keep up your normal activities as much as possible.

Medication and self-care

Painkillers such as paracetamol or anti-inflammatory painkillers like ibuprofen - which also comes in a gel from your pharmacist - will help Your doctor may recommend a short course of muscle relaxants if there's a lot of muscle spasm. A heat pad or pack over aching muscles may also help.

Patient picks for Back and spine

Bones, joints and muscles

Video: Neck pain exercises

Neck pain is very common but in most cases is not caused by a serious problem. Pain is more likely to be muscular and the exercises outlined here are recommended to ease symptoms.

by Lilly Sabri

Bones, joints and muscles

Cervical spondylosis

This leaflet is aimed at people who have been told they have cervical spondylosis as a cause of their neck symptoms. Cervical spondylosis is a 'wear and tear' of the vertebrae and discs in the neck. It is a normal part of ageing and does not cause symptoms in many people. However, it is sometimes a cause of neck pain. Symptoms tend to come and go. Treatments include keeping the neck moving, neck exercises and painkillers. In severe cases, the degeneration may cause irritation or pressure on the spinal nerve roots or spinal cord. This can cause arm or leg symptoms (detailed below). In these severe cases, surgery may be an option.

by Dr Doug McKechnie, MRCGP

Wry neck

A wry neck - torticollis - is when the neck gets stuck with your head twisted to one side. It may be due to strain of the muscles or ligaments of the neck, making the muscles go into spasm. Sleeping in a draught or an uncomfortable position may bring it on. It's often very painful in the muscles on one side but usually settles within a few days. In the meantime, painkillers will help.

Avoiding neck pain - dos and don'ts

You cannot always avoid neck pain, but simple day-to-day precautions can reduce your risk of suffering.

Do

• Turn your chair to face your computer directly and adjust your chair so the screen is at eye level.

• Stretch regularly if you're working at a desk or driving long distances.

• Keep your head back over your spine rather than hunched forwards.

• Consider Pilates, yoga or the Alexander technique - many councils have lists of local classes for all ages and abilities.

Do not

• Sleep on your stomach. If possible, sleep on your back.

• Use a very firm or high pillow - it should support the natural curve of your neck.

• Tuck your phone under your chin by hunching your shoulders up.