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  • Writer's pictureDr. Harold Pierre

How to Fix Chronic Neck Pain Fast

Updated: Jan 11


Neck pain, also called cervicalgia, comes in two flavors - acute neck pain and chronic neck pain. With rest, acute neck pain fades within a few days and sometimes over weeks to months. But chronic neck pain persists over three months. It implies an underlying condition requiring treatment.


The neck enables complex mobility. With seven vertebrae, stacked discs, a web of nerves and blood vessels, and multiple muscles, it pivots and supports the head. Damage anywhere along this intricate matrix contribute to neck pain. Pinched nerves, inflamed joints, muscle knots all overproduce pain signals. Neck pain treatment requires identifying the exact pain generator.


What Is Chronic Neck Pain?


Chronic neck pain is persistent pain in the neck that lasts for more than 3 months. It may start suddenly after an injury, or come on gradually over time. The neck pain may range from mild to severe, and may spread to areas like the head, shoulders, arms, or upper back. Axial neck pain refers to pain that is centered in the cervical spine and neck region. Radicular pain refers to the pain that spreads to other areas. Chronic neck pain can negatively impact quality of life, sleep, mood, and everyday activities. Identifying the underlying cause is important for finding effective treatments.


How Common Is Neck Pain?


Neck pain is remarkably common worldwide, though it appears more prevalent in developed Western nations compared to less developed countries.

  • Epidemiological studies estimate the global point prevalence of neck pain ranges from 5.9% to 38.7%.

  • However, studies show that 60% of the Dutch population experiences chronic neck pain each year.

  • Up to 71% of adult Americans had nagging neck pain of any duration within the past 12 months.

  • Up to 70% of people with chronic neck pain also experience back pain. The reverse is also true - back pain commonly coincides with neck pain.

  • The estimated 1-year prevalence is much lower in developing African nations like Nigeria and Botswana.

  • The cause of this discrepancy likely involves:

  • Lifestyle factors

  • Workplace ergonomics

  • Obesity rates

  • Access to healthcare

What Are Some Common Causes of Neck Pain


Woman emphasizing chronic neck pain copy

The modern epidemic of chronic neck pain correlates with the rise in the use of handheld devices like smartphones and tablets. Using these gadgets for hours at a time can cause pain by putting some strain on the neck muscles and spine. This poor "tech posture" can lead to painful muscle knots and joint stiffness over time. One study found office workers suffer more neck and shoulder pain after just 90 minutes of being hunched over the computer. Taking regular breaks and consciously maintaining an upright posture when using devices helps prevent tech-related neck pain. Ergonomic equipment like stands that raise screen height also reduces strain on the neck. So in summary, staring down at your phone may feel comfortable, but it can cause some serious neck issues. Being aware of your posture and taking breaks allows you to keep enjoying your devices pain-free!


Why Is My Neck Hurting So Badly?


There are many potential causes of chronic neck pain. Some of the most common include:

  • Herniated discs: The vertebrae are cushioned by discs that can herniate or rupture, putting pressure on nearby nerves called nerve roots. This often causes radiating pain down the arm (referred pain). This type of pain is often referred to as radicular pain or radiculopathy.

  • Spinal stenosis: Narrowing of the spinal canal places pressure on (compress) the spinal cord and nerves. This is more common in older adults.

  • Osteoarthritis: The breakdown of cartilage and bone causes stiffness and pain in the neck joints (facets).

  • Degenerative disc disease: Discs lose hydration and height over time. This can lead to pinched nerves.

  • Whiplash: Car accidents or falls can cause the neck to hyperextend and result in ligament or muscle strains.

  • Poor posture: Bad posture puts extra strain on the neck. For example, hunching over a desk or looking down at phones frequently.

  • Muscle strain: Overuse of neck muscles can cause painful spasms and tightness.

  • Sleeping on your stomach: This can irritate the facet joints in the neck, lead to muscle tension, stiffness, and pinched nerves.

What all of these have in common is inflammation. Inflammation leads to neck pain and treating inflammation relieves neck pain.


Anatomy Of The Neck


The neck contains a beautiful system of interconnected bones, nerves, muscles, ligaments, and tendons. Understanding the anatomy of the neck structures can help identify causes of neck pain.


Cervical Spine

The seven layered vertebrae that make up the neck is called the cervical spine. These bones protect the spinal cord and allow movement of the head. The first vertebra (C1) connects to the skull at the atlantooccipital joint. The second vertebra (C2) forms a pivot point that allows the head to turn left and right.


Discs

Between each vertebra is a disc composed of a soft inner gel-like nucleus surrounded by a tougher exterior. These discs cushion the vertebrae and prevent them from rubbing together.


Nerves

The spinal cord runs through the hollow center of the vertebrae, extending from the brainstem to the lower back. Nerves branch out through openings on both sides of the cervical spine to connect with muscles and sensory receptors.


Muscles and Ligaments

Layers of neck muscles surround the spine and allow the head to move in different directions. Ligaments connect the vertebrae together and provide stability.


Symptoms of Chronic Neck Pain

  • Aching, stiffness, or soreness in the neck

  • Sharp, shooting pains that radiate down the arms or shoulders

  • Numbness or tingling in the arms or hands

  • Headaches originating at the base of the skull

  • Reduced range of motion when turning or bending the neck

  • Muscle spasms in the neck and shoulders

  • Grinding or popping sounds when moving the neck

Diagnosing the Cause of Chronic Neck Pain


Doctors start with questions - pain quality, neck motions that spark or ease it, associated numbness. Next comes a meticulous hands-on exam. Imaging like x-rays, CT or MRI scans confirm suspected structural abnormalities like disc herniations, arthritis or bone spurs. Only then can customized treatment start - medications, physical therapy, injections, surgery, or likely multi-modal therapy. Chronic neck pain is a challenge. Correct diagnosis and appropriate care offer the path ahead.


Treatment Options for Chronic Neck Pain

doctor massaging patient neck relieve neck pain copy

There are a variety of possible treatments depending on the cause and severity of neck pain. Most people experience relief by combining approaches like:


Medications


Relieving chronic neck pain begins simply - with NSAIDs to calm inflammation, muscle relaxants to untie knots, and nerve medications like antidepressants or anticonvulsants. Over-the-counter NSAIDs treat straightforward muscle or joint irritation. Muscle relaxants ease spasms but cause sedation. Tricyclic antidepressants (TCAs) seem to stabilize nerves and enhance natural pain relief. Anticonvulsants may reduce abnormal nerve firing.

Physical Therapy


I will be the first to admit that I often overlook physical therapy for my patients and go straight to injections. Physical therapy uses stretching, massage, heat/ice therapy, ultrasound, and special exercises to improve mobility and strengthen the neck. This helps provide relief and correct posture issues.

  • Multiple clinical trials and systematic reviews have found strong evidence that physical therapy exercises help reduce pain and improve function in chronic nonspecific neck pain. Benefits can last for months after finishing therapy.

  • For cervical radiculopathy from a herniated disc, studies show physical therapy focused on traction, mobilization, strengthening, and posture correction significantly improves symptoms compared to alternatives like cervical collars.

  • In patients with whiplash-associated disorders, combining physical therapy with advice and education appears more effective than advice alone in decreasing pain and disability.

  • For neck pain with muscle spasm, therapies like massage, ultrasound, heat, and gentle stretches provide symptom relief, especially when combined with medications.

  • Physical therapy programs aimed at correcting poor posture, strengthening neck muscles, and increasing range of motion are beneficial for preventing recurrence of neck pain.

So in summary, substantial research indicates physical therapy offers an effective treatment approach for various common causes of long-term neck pain, both on its own and together with other therapies. A customized exercise program designed by a physical therapist offers a low-risk way to manage neck pain.


Injections


Corticosteroid injections into inflamed joints or soft tissue may provide pain relief. Trigger point injections can release knotted muscle tissue in the neck region. Some cases benefit from injected anesthetics or anti-inflammatories.


Treating Facet Joint Pain


Some cases of chronic neck pain are caused by injured or arthritic facet joints. These are small joints that connect the vertebrae and allow movement.


Medial Branch Blocks


To determine if facet joint pain is the culprit, a doctor may inject an anesthetic called a medial branch block.

  • This numbs nerves that go to the painful joint.

  • If numbing the nerves relieves pain, it indicates the facet joint is likely the source.

Radiofrequency Ablation


Radiofrequency ablation (RFA) can then provide longer-term pain relief typically 6 - 18 months.

  • This procedure uses heat generated by radio waves to disable the medial branch nerves.

  • This stops them from transmitting pain signals from the arthritic facet joint to the brain.

Medial branch blocks and radiofrequency ablation are minimally invasive procedures that can provide lasting relief for neck pain stemming from facet joint issues. They are performed by specially trained pain medicine doctors.

  • The risks are low.

  • Some patients experience significant pain relief for months to years following treatment.

Surgery


Certain conditions that fail nonsurgical options may require surgery. Surgery may be considered for issues like herniated discs putting pressure on nerves. Procedures like discectomy, foraminotomy, or fusion can decompress pinched nerves. However, it is best to avoid surgery. Improvement after surgery is not guaranteed.


Lifestyle Modifications


Making adjustments in certain daily habits and workplace ergonomics can significantly reduce persistent neck pain:

  • Use good posture when sitting, standing, or lying down

  • Take frequent breaks when performing repetitive tasks

  • Neck and back pain often occur together. Target physical therapy to treat both

  • Sleep on your back or side

  • Limit neck strain from activities like bending over phones or laptops

  • Use pillows to properly support the head and neck during sleep

  • Increase physical activity and strength training for the neck

  • Apply ice or heat packs to painful areas

  • Quit smoking, which can contribute to disc degeneration causing neck pain

  • Lose weight to reduce stress on the neck

With some patience and commitment, most people find their neck pain improving and quality of life restored.


1. Cohen, S. P. (2015). Epidemiology, diagnosis, and treatment of neck pain. Mayo Clinic Proceedings, 90(2), 284-299. https://doi.org/10.1016/j.mayocp.2014.09.008


2. Cohen, S. P., & Hooten, W. M. (2017). Advances in the diagnosis and management of neck pain. BMJ, 358, j3221. https://doi.org/10.1136/bmj.j3221


3. Magnus, W., Viswanath, O., Viswanathan, V. K., & Mesfin, F. B. (2023). Cervical Radiculopathy. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK441828/


About the author:

Dr. Harold Pierre is a board-certified anesthesiologist and addiction medicine specialist with over 20 years of experience. He is board-certified by the American Board of Anesthesiology and the American Board of Preventive Medicine.


This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician or another qualified medical professional. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.




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