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When should you worry about neck pain?

When should you worry about neck pain?

Woken up with a sore neck? Suffering with neck ache? most of us will experience neck pain at some point. It's hardly surprising - the neck is a miracle of natural engineering, allowing us to twist our heads in all directions while still supporting the weight of our skulls and protecting the vital nerves connecting our brains with the rest of our bodies.

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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.

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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?

Most neck pain doesn't mean there's a serious problem to worry about. However, you should always get your symptoms checked out if:

  • It's connected with numbness, weakness or persistent pins and needles in your arm.

  • You've had any trauma such as a whiplash injury.

  • You feel generally unwell, especially with weight loss or fever.

  • The pain keeps getting worse rather than better.

  • The neck bones - rather than muscles on either side - are very tender.

  • You also develop weakness in your legs or problems with passing urine.

  • You have other medical problems such as a history of a recent accident, cancer or rheumatoid arthritis.

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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.

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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.


  • 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.

Article history

The information on this page is peer reviewed by qualified clinicians.

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