What causes neck pain?
There are many causes of neck pain, both acute and chronic. If your pain suddenly occurs and lasts less than three months it is considered acute. Acute neck pain is commonly caused by facet syndrome, acute muscle strain, or a traumatic injury like whiplash.
If your pain persists more than three months, it is termed chronic neck pain. This pain can be from multiple sources, but most often occurs from facet joint irritation, discs, ligaments, and muscular sources.
These causes of neck pain are as varied as the people who experience it. Let’s look at each cause in more detail.
Muscle strain and misuse
Overuse of the muscles and falling asleep in awkward positions for extended periods of time often produces muscle strains. The neck muscles located in the back of the neck become tense. When the neck muscles are continuously or frequently strained, a chronic pain syndrome can develop.
Muscles and ligaments in the neck may also become strained and irritated during strenuous lifting and excessive use. This can cause local nerve irritation. Myofascial (muscle-related) and ligament injury accounts for the majority of neck pain cases.
This is one of the most common causes of neck pain and one of the most common reasons for surgery. Disc disease may be acute, resulting from trauma, or more commonly, chronic degeneration.
Degenerative disc disease is a process that occurs from the thinning and dehydration of the discs over time. The intervertebral discs between the vertebrae are designed to be soft and provide support. Over time or with trauma, the discs can collapse backwards through ligaments and cause irritation to adjacent nerves or even spinal cord compression.
Degenerative disc changes also occur as a person ages. Discs can decay or herniate, producing local nerve root irritation or compression of the spinal cord.
Nerve compression or injury
The first through the third cervical nerves that exit from your cervical vertebrae provide sensory information to your head and face.
When these nerves become compressed or inflamed, they can cause pain and other sensory deficits in specific regions of the head and face. When the greater and lesser occipital nerves are involved, this can cause significant radiating pain to the face and head.
Other nerves located lower in the cervical spine combine to form a large plexus of nerves that provides motor and sensory support to the upper extremities. In addition to neck pain, injury to these nerves can cause weakness, pain, loss of feeling, or other symptoms in the arms.
Whiplash is a well-known cause of neck pain. It often occurs after motor vehicle accidents, especially in rear-end collisions.
This hyperextension of the neck can result in:
- Stretching of the soft tissues of the neck
- Local inflammation
- Muscle tension
- Ligament strain
When ligaments and tendons become inflamed or damaged, they can cause persistent pain that intensifies with particular movements.
Cervical spondylosis (neck arthritis)
In addition to neck muscle strains and nerve compression, the neck facet joints are also commonly involved in painful neck conditions. Cervical spondylosis is caused by degenerative changes of the cervical vertebrae and adjacent facet joints.
The symptoms typically begin around the age of 40, but can occur earlier with trauma. As arthritis progresses, pain typically worsens, especially when extending the head backwards.
Osteoporosis in the cervical spine
Osteoporosis is a thinning of bones that is common in women as they enter menopause.
This thinning can cause neck pain due to fracture, or it may lead to disc herniation or nerve compression.
Another frequent cause of neck pain is spinal stenosis, the narrowing of the central spinal canal. This narrowing can compress the spinal cord and surrounding nerves roots. It can cause:
- Cramping pain
- Shooting pain
- Numbness in the legs, back, neck, shoulders, or arms
The symptoms of spinal stenosis typically depend on the area of the spine that is affected. In cervical spinal stenosis, the upper extremities and shoulders are most commonly affected.
Oropharyngeal cancers and other causes
In rare cases, cancer of the oral cavity and neck may also lead to neck pain.
Metastatic tumors (cancer spread from another organ system) are the most common type of malignant lesions of the spine. An estimated 5-10% of patients with a primary cancer suffer spinal metastases. Breast, lung, prostate, and renal cell carcinomas are the most common tumors that metastasize to the spine. Myeloma, lymphoma, and gastrointestinal carcinoma can also invade the vertebral column, causing pain in the neck.
Less common causes of neck pain include vertebral compression fractures, spinal cord disorders, tumors, and infection.