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Understanding Neck Pain: Causes and Care

Poor posture, whether induced by prolonged computer usage or a slouched position at a workbench, can strain the delicate neck muscles. Neck pain is the discomfort originating in the neck region, often accompanied by radiating pain down either one or both arms. This pain can stem from various disorders or diseases affecting neck tissues, bones, nerves, joints, muscles, or ligaments.

Neck pain manifests as radicular neck pain, shooting into adjacent areas like shoulders or arms, or axial neck pain, primarily felt in the neck. It may be acute, lasting from a few days to six weeks, or chronic, persisting for over three months. Left unaddressed, neck pain can significantly impede daily activities and diminish overall quality of life.

Thankfully, the majority of neck pain cases are non-threatening and respond well to conservative treatments, such as prescribed pain management, targeted exercises, and effective stress management techniques. However, in rare instances, neck pain could signal a more serious underlying condition. Seeking prompt medical attention from a spine specialist is crucial if experiencing neck pain accompanied by numbness or weakness in the arms or hands or if the pain radiates into the shoulder or down an arm.

Neck Pain Risk Factors: The Contributors

The risk factors for neck pain parallel those seen in various musculoskeletal conditions, sharing commonalities such as genetic predisposition, psychopathological aspects (e.g., anxiety, depression, somatisation, inadequate coping mechanisms), tobacco use, sedentary lifestyle, and sleep disturbances. However, neck pain possesses its distinct set of risk factors:

Age – risk increase with advancing age
Heavy lifting and twisting – both sudden and chronic
Poor physical fitness/conditioning
Poor postural habits
History of trauma
Psychiatric history (chronic LBP)

While specific occupations like computer and office workers, healthcare professionals, and manual labourers have been identified in research as having a heightened incidence of neck pain, the primary culprits within the workplace are often linked to low job satisfaction and a perception of an unfavourable work environment.

Neck Pain: Causes and Warning Signs


Neck pain may result from abnormalities in any of the soft tissue components due to injury (a sprain) as well as in bones and disks of the spine by prolonged wear and tear. Rarely, infection or tumors may cause neck pain. Pain in the jaw, head or shoulders may also spread to the neck and cause pain. Conversely, in some people, problems in the neck can also make other parts of the body hurt, such as the head, upper back, shoulders or arms.
The important spinal conditions responsible for neck pain are listed below:

A woman rubbing her neck due to neck pain.
  • Muscle strains – Excessive use without much change in posture, such as many hours of hunching over your computer or mobile phone, often causes muscle strains. Even simple activities, such as reading in bed or gritting your teeth, can strain neck muscles.
  • Nerve compression – Herniated disks (Slipped disc) or bony spurs in the bones of your neck can press on the nerves branching out from the spinal cord. It can also lead to radiating pain in the arm if it starts impinging on the nerve and in severe cases it can cause nerve damage as well (Numbness/ weakness).
  • Spinal stenosis develops when the spinal canal or a nerve passageway abnormally narrows. This is a result of several degenerative changes in the ligaments, disc and the facet joints. In severe cases, this may even lead to weakness of hands or legs due to compression of the spinal cord.
  • Spinal arthritis, also called spinal osteoarthritis (Worn joints), is a common degenerative spine problem. Just like the other joints in your body, your neck joints tend to wear down with age. Osteoarthritis causes the cushions (cartilage) between your bones (vertebrae) to deteriorate. Your body then forms bone spurs that affect joint motion and cause pain. It is age related and affects the spine's facet joints and sacroiliac joints.
  • Injuries. High velocity motor-vehicle accidents often lead to whiplash injury, which occurs when the head is jerked backward and then forward, straining the soft tissues of the neck
  • Bony fractures (burst or compression types) are often caused by some type of trauma (eg, fall). In elderly patients, it can also be caused spontaneously or even with minor events. This type of pain may not go away, even after weeks.
  • Osteomyelitis is a bacterial infection that can develop in one of the spine's bones. Infection can also spread to the discs or the nerves in some cases
  • Spinal tumors are an abnormal growth of cells (a mass) and are diagnosed as benign (non-cancerous) or malignant (cancer). It can affect the vertebral bone, covering of the nerves (Dura) or the nerves themselves.
  • Other diseases - Certain conditions, such as rheumatoid arthritis, meningitis or ankylosing spondylitis, can cause neck pain

Warning Signs

Presence of these symptoms should alert to a more serious underlying cause and a prompt consultation with your doctor is recommended in such cases
  • Arm pain > Neck pain
  • Neurological deficits (weakness/ numbness)
  • Bladder or bowel dysfunction
  • Sudden severe pain not subsiding in 2 days
  • Mild to moderate pain not subsiding in 1 week
  • Any pain > 6 weeks (on and off)
  • Post-traumatic pain
  • Pain even on lying down
  • Age > 60 yr
  • Associated symptoms fever, weight loss, h/o cancer, immunosuppression or steroid use
Rapid onset of neck pain and stiffness, especially overnight, accompanied by challenges in raising both arms above the head, may be indicative of polymyalgia rheumatica (PMR). PMR is an inflammatory muscle condition that tends to affect individuals predominantly aged 65 and above. If you identify with these symptoms, seeking prompt medical attention is imperative for timely evaluation and diagnosis by a healthcare professional.
The image shows a man appearing unhappy with his neck pain.

Neck Pain Diagnosis: The Spine 360 Approach

The diagnosis of neck pain is a meticulous process overseen by a neurosurgeon, involving a thorough review of the patient's medical history, a detailed assessment of symptoms, a comprehensive physical examination, and, when warranted, the evaluation of diagnostic studies. In this methodical approach, priority lies in ruling out severe underlying causes of neck pain, such as spinal cord compression, myelopathy, infections, or malignancies. Key diagnostic tests may be pivotal in this investigative journey. They include:

Non-Surgical Treatment Methods for Managing Mild to Moderate Neck Pain

In cases of mild to moderate neck pain, which are the most common, timely self-care measures often yield positive outcomes within a span of two to three weeks. Simple remedies such as pain relievers and the application of heat can prove effective in providing relief.

Bed rest – either relative rest or absolute rest based on the severity of pain - You may benefit from a cervical collar which stabilizes your neck.
Local application of ice packs followed 24-48 hours later by heat. In the initial phase ice reduces swelling, pain and spasms. Once acute pain subsides, switching over to heat (hot water bag application) reduces spasm and warmth relaxes the muscles.
Over the counter analgesics – (Paracetamol or Diclofenac) (It is strongly recommended to consult a doctor before self medication)

Surgical Methods: Treatment for Severe Neck Pain

When conservative treatments fall short in providing relief from neck pain, surgery becomes a consideration. Patients may be suitable candidates for surgical intervention when:

  • Conservative therapies fail to alleviate the pain adequately.
  • Persistent pain hampers the patient's daily functioning.
  • Patient experiences worsening neurological symptoms involving the arms and legs.
  • Patient faces challenges in maintaining balance or walking due to neck pain.
  • Except for neck pain, the patient is in good general health.

There are various surgical procedures available, each tailored to the specifics of the individual case. These may include:

For those seeking expert care for neck pain, Spine360 specialises in neck pain treatments, including slip disk surgery of the neck. Neck pain can be due to innocuous factors but can also represent some serious underlying disease in the cervical spine. Do not neglect your neck pain. Get it treated before it can hurt your spinal cord or nerves.

A happy doctor with a stethoscope.

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