Neck problems


The neck is made up of 7 bones which are known as vertebrae. These vertebrae are labelled from C1 to C7, and connect from the base of the skull down to the top of the thoracic spine. The top two vertebrae, C1 and C2, are unique to the rest of the vertebrae. C1 is known as the atlas and serves as a ring or washer that the skull rests upon, this articulates in a pivot joint with the dens or odontoid process of C2.

Each of the vertebrae are connected by facet joints which, along with the muscles in the neck, allow your head to move in different directions. Between each cervical vertebra are small discs made of cartilage, their role is to distribute pressure and force through the spinal column. Nerve roots branch out from the spinal cord through an opening in the side of the spine between each vertebra. These nerve roots join to form nerve trunks that run into your arms. Impulses travel along these nerves, sending sensations such as touch and pain to your brain and messages from your brain to your muscles.

Four arteries carry blood from the heart to the brain. Two of these run inside the bones of your spine and supply the part of the brain that controls balance (the cerebellum). All four arteries connect to your brain.

In this section:


Why do I have neck pain?

There are numerous structures in the neck that can give rise to pain. Neck pain is common in people of all ages and is usually caused by how we use our necks. An understanding of the location of pain, the aggravating movements and the time of onset of the symptoms can help make a diagnosis.

Pain can be present due to damage or on-going irritation of structures in the neck however this is not always the case. As more and more people spend their working day at a computer or sat in an office, the neck and shoulder muscles can become stiff or overused. Other factors such as stress and tiredness can contribute to ongoing neck pain as can osteoarthritis (age-related wear and tear) in the neck. This can, in turn, cause not only muscular pain from the neck into the shoulder but also some stiffness in moving the neck. Pain can be present in the absence of structural damage and can be termed persistent pain.

As there are a number of possible causes of neck pain, a thorough examination by a healthcare professional may be required to determine the most appropriate management pathway.


How can I help myself?

There are a number of things that you can do to help manage your pain before seeking help from a medical professional. Below are some ways that you may wish to try to help manage your neck pain.


I have just injured myself …

In an acute injury the tissues often need time to settle and therefore a period of relative rest may be required. This does not mean that the neck should be immobile but rather activities that aggravate your neck pain such as rapid movements, high impact exercise and sustained postures should be modified or avoided, on a temporary basis.

It may be appropriate to manage your symptoms with appropriate pain relief. You can discuss what medication is most appropriate for you with a pharmacist at your local pharmacy. If these medications do not provide adequate relief then you may need to see a GP to discuss prescription pain medications.


I have had a problem for over 3 months that is not getting better …

If symptoms persist for more than 3 months this still does not mean that there is damage to the structures in the neck. We know that there are a number of reasons as to why pain can persist for longer than three months without structural damage. If this is the case then there are ways to manage the symptoms:

  • Commence gentle exercise – this could be specific for the neck or general cardiovascular exercise. The NHS recommends 150 minutes of moderate aerobic exercise and 2 to 3 days of strengthening exercise per week for people between the ages of 19 and 64 years of age. Muscles and joints need regular movement to remain healthy.

  • Pain medication – Pharmacists at a local pharmacy will be able to advise you on over the counter pain medications that will be most appropriate to you. If these do not provide adequate relief then you may need to speak with a GP to discuss prescription medications.


When should I seek medical attention?

An irritated nerve in your neck can cause arm pain going down into the hand which may be accompanied by pins and needles and numbness. If you notice that your arm feels weak you should see your doctor.

On rare occasions the nerves in your neck can become trapped making it difficult for you to use your hands for tasks such as undoing and doing up buttons or unscrewing jars and can even make you lose your balance when walking, or have difficulties passing urine. If these symptoms occur you should see your doctor.

Sometimes neck pain develops when you are ill with other problems. See your doctor if this is the case.

If neck pain and restriction of activities of daily living continue to be problematic then a review with your local general practitioner may be required to discuss future management options.


What treatments are available?

Often the first line of treatment is through self-help – (see section How can I help myself? For more details)

Medical treatment will vary depending on your symptoms and likely diagnosis. Often your general practitioner will refer you directly to physiotherapy where exercise therapy, manual therapy and taping may be of benefit.

Occasionally a review with an Extended Scope Practitioner or Orthopaedic Consultant is required which may lead to further treatment options such as Injections or surgery.


How do I get help?

If you wish to seek further advice and help in the diagnosis and management of your shoulder pain then you will need to make an appointment to see your GP. Your GP can then make a decision with you about what would be the next steps going forward in managing your pain. At this time your GP may consider sending you for investigations including x-ray, or they may wish to refer you to the Surrey Integrated Musculoskeletal service at Ashford & St Peter’s Hospitals, or to a physiotherapist.


Helpful Links

There are a number of websites that you may find useful regarding taking care of your neck:

Link to website

NHS Choices

NHS Choices was launched in 2007 and is the official website of the National Health Service in England.

Link to website

Arthritis Research UK

Our focus to 2020 is to improve the quality of life of people with arthritis so those seeking help from Arthritis Research UK are able to make informed choices and feel supported so they can say “I am in control, I am independent and I am recognised”.

Link to website

The Chartered Society of Physiotherapy

Founded in 1894, the Chartered Society of Physiotherapy has grown to become the profession’s largest membership organisation.


Other Websites