Neck pain is common and is rarely caused by a serious problem. Pain from the neck area sometimes also affects the shoulders and one or both arms. You may have stiffness, limited movement and tender areas to touch in your neck and surrounding muscles. You may also get pins and needles, or you may get headaches.

General neck pain is often referred to as ‘mechanical neck pain’ or ‘non-specific neck pain’. It affects most of us at some point during our lives. Neck pain often resolves within 2 months. However, around half of people with neck pain continue to have low grade symptoms or recurrent symptoms for more than a year. In most cases no specific cause can be found, which is why x-ray and scans are really not helpful in helping us manage and treat neck pain.  Having neck pain does not mean that your neck is damaged.

Arm pain or pins and needles associated with neck pain can be unpleasant and very uncomfortable, but do not usually mean there is any serious problem. The symptoms are generally caused by irritation or inflammation of a nerve, not compression. Symptoms can settle quite quickly, as inflammation naturally resolves. The good news is that most people see a big improvement in their symptoms after 4-6 months, and 9 out of 10 people with these symptoms get completely better without any specialist treatment.

Regular activity and movement will help the recovery process, and will help to stop your muscles getting weak and your neck getting stiff.  Here are some ways you can help your neck problem:

Keep moving.  Staying active and keeping fit will help your body’s ability to cope with pain and carry out daily physical tasks. If you find a particular activity aggravates your neck pain, try to spend less time doing it or do it less often for a while. Over time, you will be able to build up the amount you can do.

Exercises are important for recovery and managing your neck problem, so try to do some regular neck exercises.  If the pain seems worse at first with certain exercises, reduce how many or how often you do the exercises for a short period. The body will adapt to them, and you will be able to build from there. General cardiovascular exercise, like walking, is also very important.  The research tells us that improving the strength of your neck and shoulders can also help reduce mechanical neck pain so don’t be afraid to do exercises to get a bit stronger!

Changing your position regularly will help you feel more comfortable: Try to take regular breaks and vary tasks where possible. Even though we have been told for years about the ‘right’ posture, the research tells us that there is no ‘right’ posture and certain postures are not a cause of neck pain. However, moving regularly and changing positions is very important.

Sleep, diet and general health. Look after yourself! Sleep is an essential part of feeling well and happy. If we are tired the pain can feel much worse and harder to manage Eating healthy food can also help us to recover and reduce the likelihood of developing other general health problems in the long term (such as diabetes and heart/lung conditions) that can make future recovery from episodes of pain much harder.

Stay positive. Your attitudes and beliefs about your pain play a very important role in helping you manage it successfully. Remember, pain is a normal part of healing and does not mean that damage is being caused.

Look after your mental health.  It is important to be aware that pain can often have an impact on your mood. Pain can also be made worse by additional stress, low mood and anxiety. If you are feeling low, anxious or stressed you may find some useful information in our section on MSK Health and Wellbeing. Otherwise mention it to your GP or healthcare professional who will be able to advise you. 

What about pain relief?

Ask your GP or pharmacist about using pain relieving medications while the symptoms are settling to help you stay active.

Using gentle heat or ice can also help to reduce pain levels

Try relaxation techniques if you feel stressed or anxious

A supportive pillow may help provide comfort at night. Using a rolled towel for further support in the hollow of the neck may also help. You may find the Good sleep guide helpful.

Do I need to see a therapist?

Often neck pain resolves on its own.  Physiotherapists can help by giving advice and coaching so that you know how to help your recovery. Advice will be focused on your specific problems and increasing general activity. Specific exercises can improve strength and flexibility.

An irritated nerve in your neck can cause severe arm pain and may be accompanied by pins and needles and numbness. On some rare occasions the nerves in your neck may become trapped or compressed.

If you have any of the following symptoms you should seek advice from a healthcare professional:

• Weakness in your arm or hand
• Difficultly using your hands for tasks such as undoing buttons or picking up small items such as coins
• Loss of balance when walking
• Pins and needles and numbness, increasing in arms and or legs
• Dizziness
• Double vision
• Trouble swallowing food
• Fainting/blackouts

Whiplash is the term used to describe a neck injury caused by a sudden movement of the head. The sudden, vigorous movement of the head can injure the soft tissues and bones resulting in pain, stiffness and a temporary loss of movement in the neck. It may result from a motor vehicle collision, but it can also occur during other activities or mishaps

The most common symptoms of whiplash are:

• Neck pain which may spread to the shoulder or arm (88-100% of people).
• Headache (54-66% of people).

Other signs and symptoms of whiplash may include:

• Reduced neck movements
• Muscle spasm
• Stiffness
• Deafness
• Nausea
• Fatigue, dizziness, or numbness and or pins and needles (less common)
• Memory loss
• Jaw pain
• Tinnitus – noises in the ear such as buzzing, ringing

Symptoms of pain can be very severe. Pain can affect the joints and soft tissues (muscles and ligaments), but scans or x-rays do not usually show any damage. It can sometimes take a number of months for the symptoms of whiplash to disappear completely. Some people still have some neck pain and stiffness for a long time after the injury. 50% of people have fully recovered within a year, and many recover much quicker.

What can I do to help my whiplash injury?

Whiplash injuries usually improves gradually during the first 2 to 3 months. During this time, it is important to stay active. Regular gentle activity and movement will help the healing process, and will help to stop your muscles getting weak and your neck getting stiff. Return to usual activity as quickly as possible. Restriction of activity may delay your recovery. Long periods of rest and the use of soft collars are not recommended.

Although your symptoms are very unpleasant and may increase with certain activities, they are a normal response to being injured. You may want to ask your GP or pharmacist about using pain relieving medications while the symptoms are settling so that you can stay active.

You may be referred for physiotherapy. The treatments which are recommended for neck pain are exercises to stretch and strengthen. These exercises are safe and will not cause you harm. Other treatments may include ‘hands on’ treatments if needed, and advice/coaching on how you can help your recovery.

Psychological effects of Whiplash Associated Disorder

Some people become afraid of movement and activity when they have pain. Reduced activity might not only lead to weakness and deconditioning over time, but can also affect your mood. Low mood or high levels of anxiety about your symptoms and recovery may increase the risk of long-term pain.

These are very important reasons for you to stay active, keep your normal daily routine going, and stay at work/ return to work as soon as possible. You need to take responsibility for keeping your neck moving, finding ways that you can stay active and gradually returning to normal activities to help your recovery. Healthcare clinicians such as your GP and physiotherapist can help to guide you.