Table: Some Causes and Features of Neck Pain - Merck Manuals Consumer Version

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Some Causes and Features of Neck Pain

Some Causes and Features of Neck Pain

Cause	Common Features*	Tests
More common but less serious causes
Sprains and strains	Pain that Usually occurs off to one side of the spine Worsens with movement and lessens with rest	A doctor's examination
Muscle spasms	Constant pain and stiffness, causing difficulty or pain when the head is turned one way or the other (sometimes both ways) No symptoms of nervous system malfunction (neurologic symptoms)	A doctor's examination
Osteoarthritis (without compression of the spinal nerve root)	Pain that Is sometimes constant Worsens with motion Often in people with arthritis in the joints of fingers, hips, and/or knees	A doctor's examination Sometimes neck x-rays
Cervical spondylosis (with compression of the spinal nerve root)	Pain that Often extends down the arm, sometimes to the hand Usually occurs in the arm more than in the neck itself Sometimes weakness and/or numbness in the arms	MRI of the neck
A herniated disk (typically with compression of the spinal nerve root)	Same as for cervical spondylosis, above except neck pain can be as severe or more severe than the arm pain	MRI of the neck
Fibromyalgia	Aching and stiffness in many areas of the body (not just the neck) Sore areas that are tender to the touch Often poor sleep Most common among women aged 20 to 50	A doctor's examination
Less common but more serious causes
A tear in the lining of a neck artery	Usually constant head, neck, or facial pain Usually neurologic symptoms such as loss of balance or taste, confusion, weakness of an arm and leg on the same side of the body, and difficulty swallowing, speaking, and/or seeing	MRA (an MRI with injection of dye to allow doctors to see the arteries in the neck) Angiography
A tumor in the spine	Progressively worsening, constant pain (even at night), regardless of position or movement Sometimes night sweats or weight loss	MRI or CT Sometimes biopsy
Infection of bone or nearby tissues	Progressively worsening, constant pain (even at night) regardless of position or movement Sometimes night sweats, fever, and/or weight loss	MRI Usually culture of a sample of infected tissue
Meningitis	Severe headache Neck pain that worsens when the head is bent forward, but not when rotated side-to-side Usually fever, lethargy, and/or confusion	A spinal tap (lumbar puncture) and analysis of spinal fluid
A heart attack or angina	Sudden and sometimes recurring sweating, difficulty breathing, and/or chest discomfort Usually risk factors for heart disease Usually also pain in the chest	Electrocardiography, blood tests to measure substances called cardiac markers to check for heart damage, and/or imaging tests such as cardiac catheterization or stress testing
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. CT = computed tomography; MRA = magnetic resonance angiography; MRI = magnetic resonance imaging.