Ever wake up with a crick in your neck so severe that you could barely turn your head? Neck pain, which affects up to half of U.S. adults each year, is one of the most common reasons for doctor visits. Yet the pain is often overtreated with imaging tests, drugs, injections and surgery, which don’t help much in the long term. Here’s what you need to know.
The strain of holding up your 10-to-12-pound head year after year makes your neck vulnerable to injury. Pain can occur after sleeping in the wrong position, cradling a phone too long, spending hours hunched over a computer or simply carrying a heavy suitcase. Other common causes are arthritis, cancer and rear-end car collisions that cause whiplash.
When neck pain strikes, your first inclination may be to ask your doctor for an X-ray, a CT scan or an MRI. But in most cases, mild neck pain clears up in two to three weeks with or without an imaging test, says Zacharia Isaac, division chief for spine care and pain management at the Spaulding Rehabilitation Hospital in Boston. So those tests usually aren’t necessary, Isaac says, though “they do drive up health-care costs tremendously.”
In addition, X-rays and CT scans expose you to potentially cancer-causing radiation. The risk is small, but it’s best to avoid radiation when possible. Although MRIs don’t pose that risk, they do find disk abnormalities in more than 80 percent of people older than 60. They’re usually unrelated to the pain, but finding them often leads to follow-up tests and treatment.
You should have an imaging test if you have moderate pain that lasts more than six weeks or you have any of the following: a history of cancer; fever, chills or unexplained weight loss; numbness or loss of strength in your arms or hands; or a recent infection. Go to an emergency room if your pain stems from a recent fall or car crash.
Exercises can be even more effective than prescription drugs, studies show. Also consider:
Over-the-counter medicine. Acetaminophen (Tylenol and generic), ibuprofen (Advil and generic) and naproxen (Aleve and generic) work better than prescription muscle relaxants, research suggests.
Heat. Apply it for 10 to 15 minutes periodically for the first day or so, using a heating pad, a hot towel or an electric blanket, or by taking a warm bath or shower.
Sleeping right. Lie on your back with one or more pillows under your knees and another small pillow under your neck. If neck pain keeps you from sleeping, a cervical collar can help keep your neck aligned. But using it during the day may weaken your neck muscles.
Physical therapy. It can help when pain is persistent. One to three sessions may be as effective as five, studies show. If you try it, discuss with your therapist how to improve your posture when talking on the phone or using a computer.
“Talk” therapy. A cognitive-
behavioral therapist can teach you some of the relaxation and stress-reduction techniques that have been shown to provide short-term relief for neck pain.
Acupuncture. A study published in the Annals of Internal Medicine last year found that acupuncture substantially eased neck pain for people with chronic symptoms.
Spinal manipulation, or chiropractic care, can help ease lower-back pain, but it hasn’t been shown to be all that effective for neck pain. And in rare cases, it can trigger potentially deadly strokes.
Cervical traction (when a physical therapist pulls your neck) doesn’t help reduce discomfort, studies have shown.
Injections. Repeated injections of corticosteroids can weaken your neck muscles. And Botox injections are no more effective than placebo injections.
Surgery won’t help if the pain is only in your neck or is caused by arthritis. If pain radiates down your arms, surgery may provide some relief, though physical therapy seems to be as effective after two years.
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