Neck pain

Generally seen in those aged over 65 years as part of the normal ageing process. However, the signs of normal ageing do not predict the presence of symptoms. 

Symptoms:

• Stiffness on neck movements and restriction, particularly on turning or looking upwards
• Pain, particularly at night and difficulty finding a comfortable position
• Difficulty looking over the shoulder when driving
• Grinding, grating or clicking noises from the neck

Many muscles attach to the neck and provide support to the head as well as enabling us to move in a variety of directions. Pain is often felt in the Trapezius muscles, particularly the upper fibres which run from the base of the head and across to the shoulder.

Symptoms:

• Generalised pain, often an aching sensation across the top of the shoulder/s
• Often pain at end-of-range movements e.g. turning the head or tilting the ear across to the shoulder
• Does not radiate down the arm or into the hand/fingers
• Aggravated by prolonged positions e.g. reading

Headaches can sometimes be caused by a problem with the neck, these are called cervicogenic headaches. This can be disc-related or soft tissue. This type of headache is usually, but not always accompanied by neck pain.

Symptoms:

• Reduced range of movement of the neck or pain with movements
• Headache significantly improves/goes away at the same time as neck pain
• One-sided or one-side dominant headaches
• Pain with pressing on the upper neck joints and/or surrounding muscles
• Weakness in the deep neck muscles
• Non-throbbing pain usually begins in the neck

Nerves run from the brain throughout the body, cervical nerve roots named C1-C8 exit the level above the vertebrae named in the neck, except the last one (C8 exits below the C7 vertebra). These cervical nerves then branch out to supply muscles that enable the functioning of the shoulders, arms, hands, and fingers. They also carry sensory fibres to the skin that provide us with sensation.

• Pain in the neck and often radiating down the arm/s and into the fingers, this may also include weakness, pins and needles or numbness
• Pain in neck movements, often worse on turning your head and tilting your head towards the side of the pain
• Often lasts up to 3 months, nerve healing timeframes are much longer than those of bones, muscles and ligaments and sensory symptoms e.g. pins and needles or numbness often persist longer

For most types of general neck pain, the advice is to carry on with your normal daily activities, keep active, and take painkillers to relieve the symptoms.

These steps may help you to manage your pain:

• take regular doses of paracetamol, ibuprofen, or a combination of the two, to control pain – ibuprofen gel can be rubbed onto your neck as an alternative to taking tablets (always follow the instructions that come with the medication)
• try holding a hot water bottle or heat pack to your neck - this can help reduce the pain and any muscle spasms, although some people find cold packs offer better relief
• avoid wearing a neck collar – there’s no evidence to suggest wearing a neck collar will help to heal your neck, and it’s generally better to keep your neck mobile
• avoid driving if you find it difficult to turn your head - this may prevent you from being able to view traffic

You should see your GP if:

• the pain or stiffness doesn’t improve after a few days or weeks
• you can’t control the pain using ordinary painkillers
• you’re worried your neck pain could have a more serious cause

Your GP will examine your neck and ask some questions to help identify any underlying condition. They may also prescribe a stronger painkiller, such as codeine, to take with your usual over-the-counter painkillers.

If you’ve had neck pain or stiffness for a month or more, your GP may be able to refer you to a Physiotherapist. 

If you have had trauma to your head/neck or symptoms such as dizziness, problems speaking or swallowing, drop attacks, nausea, visual disturbance or numbness and loss of balance than contact your GP or call 111.