This Health Alert is intended for readers interested in learning about the prevention, diagnosis, and management of back pain.
Neck pain can result from a variety of causes, including muscle strain, worn joints, disk disorders, and injuries. Sometimes self-care measures are not enough and you need medical attention -- sooner rather than later to prevent long-term disability. This advice and other guidance comes from The Bone and Joint Decade 2000- 2010 Task Force on Neck Pain and Its Associated Disorders, an international group of doctors and other experts specializing in musculoskeletal disorders who reviewed the literature on neck pain. Here's what they found.
There is no single therapy that's right for everyone, and you may need to try a variety of treatments or combinations of therapies to find what works and what doesn't. The goal is to help you regain function and get back to your daily activities.
One option is neck exercises, which can help reduce pain by increasing the strength of your neck muscles. A new study published in Arthritis Care & Research showed that neck and shoulder strengthening exercises done three times a week for 20 minutes a session helped relieve chronic neck muscle pain. Your doctor or a physical therapist can recommend specific strengthening exercises and teach you how to safely perform them at home.
Your doctor can also prescribe stronger pain medicine, such as prescription nonsteroidal antiinflammatory medications (Naprosyn, Celebrex), opioid analgesics (Darvon, Ultram), muscle relaxants (Flexeril), or tricyclic antidepressants (Norpramin). Other safe and potentially effective treatments worth considering are chiropractic manipulation, massage, and acupuncture.
If your neck pain is accompanied by pain, weakness, or numbness in your fingers, arms, or legs, see your doctor as soon as possible. This type of pain is caused by what is commonly known as a pinched nerve. To make the diagnosis, your doctor will do a physical examination and will need to order an x-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI) study to confirm that you have a neurological (nerve) problem.
Recommended treatments for a pinched nerve, according to the Task Force, include corticosteroid medications injected close to the nerve roots or small neck joints or into the muscles of the neck. Lidocaine also can be injected into the neck to numb the pain. Your doctor may also recommend traction, which uses weights and pulleys to gently stretch the neck and keep it immobilized. Surgery is rarely needed for this type of neck pain, but it may be an option if you have nerve root or spinal cord compression. Studies show that surgery can substantially relieve this type of pain and discomfort within six to 12 weeks.
