Neck pain

Overview

• Most neck pain is not serious and will improve over time.
• To help you recover more quickly, keep active and continue to move your neck. Keep doing your normal work or daily activities, or return to doing these as soon as you can. It is fine to have some pain while moving.
• Keeping still or using a cervical collar is not helpful and can be harmful.
• Use heat or ice packs, pain relief medication or massage if these reduce your pain.
• Rarely, neck pain is a sign of a more serious problem. You should get it checked right away if you:
  • have flu-like symptoms along with a stiff painful neck and difficulty bending your head forward
  • have severe neck pain after an injury, such as a motor vehicle accident, diving accident or fall
  • lose function in your arm such as weakness or clumsiness or you have persistent loss of feeling
  • have difficulty passing urine.

Call Healthline on 0800 611 116 if you don't know what you should do.

Symptoms of neck pain

Neck pain refers to pain or stiffness in the neck. You may have limited movement of your neck and moving it may make the pain worse. Sometimes the pain starts in your neck but may spread to your shoulder, arm or your head. You may also feel 'pins and needles' in part of your arm or hand.

There are different reasons for developing neck pain including the following common causes:

Other less common causes of neck pain can be pinched nerves, inflamed lymph nodes, bone disorders, tumours and swelling of your thyroid gland. 

Most neck pain will get better on its own within a few weeks. In the meantime, here are a few general things you can do.

Keep active

• Movement and exercise are good natural pain relievers. Keeping active reduces the impact of neck pain on your life. It is okay to feel some pain while moving.
• Some discomfort with exercise is normal and should be expected. If an exercise makes your pain a lot worse, or you get other symptoms like dizziness, you should seek advice before continuing.
• At time you may have a flare-up or marked increase in pain (this can happen whether you exercise or not). If this happens, you may be happier reducing the amount you exercise for a couple of days, but try not to stop completely. As the pain eases, try and build back up to the previous level as soon as you can.

Stay at work or get back to work and normal daily activities as soon as you can

Being at work helps you to focus on things other than your neck. Being at work is good for your general health too.

Move your neck

• Gentle movements (starting as soon as possible) will help to reduce pain and spasm and help you regain full range of motion. Movement also helps healing.
• Move your head often and gently in all directions, as long as the movement is not forced. Tuck your chin in, bend your head back, turn your head from side to side.
• See exercises to manage neck pain(external link). 

Hot or cold compresses

You can try using hot and cold compresses to reduce your pain, whichever one gives you the most relief. Alternating heat and cold may help.

• Apply ice or cold packs to the painful area for 10–15 minutes every few hours. Wrap a plastic bag of ice (or a bag of frozen vegetables) in a damp cloth or light towel. Never place ice directly on your skin.
• Apply a moist, warm compress or a warm wheat bag to the painful area for 20–30 minutes several times a day. Keep the compress warm for best effect.

Massage 

When you have neck pain your neck may become stiff. Massage can help you to relax and move your neck more. Massage the area gently by rubbing your neck with your fingers for several minutes.

Medication

Taking pain relief medication such as paracetamol or non-steroidal anti-inflammatories (NSAIDs) can help to ease the pain and keep you active. However, NSAIDs are not suitable for everyone and are usually not recommended on an ongoing basis. Common examples of NSAIDs include ibuprofen, diclofenac and naproxen. Read more about pain relief medication.

Physiotherapy

If symptoms do not improve over a week or so, you may see a physiotherapist to help with advice on specific neck exercises to do at home. 

Most neck pain improves gradually with home treatment. See your doctor if your neck pain is severe, persists for several days without relief, spreads down your arms or legs and is accompanied by headache, numbness, weakness or tingling.

Neck pain is a normal part of life. The best ways to reduce the likelihood of neck pain or reduce its impact are to do the following:

• Be physically active. Try and get at least 150 minutes of moderate or intense physical activity a week. Read more about physical activity.
• Sleep well. Read more about sleep and tips for improving it.
• Manage your stress and anxiety levels. Read more about stress and how to manage it.
• Stop smoking. Read more about the benefits of quitting and tips on how to stop smoking.

The following links have more information on neck pain. Be aware that websites from other countries may have information that differs from New Zealand recommendations.

Neck pain(external link) Ministry of Health, NZ
Neck pain(external link) Versus Arthritis, UK 
Neck pain(external link) Patient Info, UK
Acute neck pain - a guide to help your recovery(external link) NHS Trust
Neck pain(external link) Mayo Clinic, US

Pain relief medications
Non-medicine treatments for pain
Ways to describe and document your pain

1. Neck pain(external link) American College of Rheumatology
2. Gross A, Forget M, St George K, et al. Patient education for neck pain(external link). Cochrane Database of Systematic Reviews, 2012

Neck pain – clinical practice guidelines revisions 2017(external link) Journal of Orthopaedic & Sports Physical Therapy, 2017
An approach to neck pain for the family physician(external link) Australian Family Physician, 2013