Many people are accused of being a pain in the neck. But some people actually have a physical problem in that region of the body, whether they blame it on someone else or not.

Call it a "crick," a bulging disk, a muscle sore spot or a stiff neck, it all means the same thing -- you have pain that indicates there is a problem.

Many people experience neck pain. Many times, the neck muscles are strained or otherwise compromised by poor posture from working on a computer, leaning down over a work table or simply sitting in a chair incorrectly.

Arthritis can be the issue, or neck pain may be a sign that something else is going wrong in the body. Numbness in the hands or arms or shooting pains are a sign that something serious is happening. When you have pain caused by holding your neck rigidly in place for long periods while working or driving, suffer muscle spasms and tightness, or have difficulty moving your head, it may be time to consult a doctor.  

Because the neck is flexible and is attached to the head, which is a heavy part of the body, it can be susceptible to injuries. Here are five issues that may be the cause of neck pain, including:

1. Muscle strains - If there is a project that requires intense concentration, a worker may not move the neck much. This can cause stiffness and strain in the neck muscles. Pain can also originate from awkward sleeping positions, placing the neck in strange positions for reading or simply moving the neck in a direction that causes injury.
2. Worn-out joints - Wear and tear can happen to the joints in the neck. The onset of arthritis can cause deterioration in the cartilage cushions in the neck vertebrae, which eventually leads to bone spurs that can hamper joint motion and cause mild to extreme pain.
   

3. Nerve issues - If a nerve becomes impinged or otherwise squeezed by poor sleep position, an accident, or bone spur development, neck pain can occur.
4. Injuries - The sudden impact of a car collision or the brute force of a tackle in sports often can cause whiplash, causing injuries to the delicate, soft tissues of the neck.
5. Neck diseases - Cancer, meningitis or rheumatoid arthritis are among the diseases that can cause pain and stiffness in the neck region.

A family doctor may issue a referral to a specialist in musculoskeletal conditions, arthritis specialists, neurologists who treat nerve issues, or an orthopedic surgeon who handles bone and joint issues.

The Role of Ergonomics

The United States Occupational Safety & Health Administration lists musculoskeletal disorders as the most common work-related injuries in the country. These injuries include stiff necks, but also cover carpal tunnel syndrome, tendinitis, rotator cuff injuries, back strains and lower back pains workers suffer on the job.

The Occupational Safety & Health Administration agency reports nearly 2 million workers per year have a musculoskeletal disorder, resulting in 600,000 missing work because of the injuries. Most are away from work for about seven days, but some miss months, while others are permanently disabled. The total cost is estimated at up to $18 billion per year in direct costs, with ancillary costs estimated at more than $45 billion.


The Bureau of Labor Statistics reports that the professions with the highest rates of musculoskeletal disorders include transportation, health care, warehousing, wholesale trade, retail and construction. That means nursing assistants, janitors, registered nurses, stock clerks, production workers, retail salespeople, maids and housekeepers, police, and firefighters are most vulnerable to musculoskeletal injuries.

Diagnosis and Treatment

To determine the cause of neck pain, a doctor typically will request imaging tests to get to the cause. These can include:

1. X-rays. These images can examine areas in the neck where nerves may be pinched by bone spurs or other degenerative changes.
2. CT scans - These are X-ray images from different directions that produce detailed cross-sectional views of the neck’s internal structures.
3. MRI - Radio waves and a magnetic field can create highly detailed images of bones and soft tissues, which provide clues to potential impingements.

Beyond imaging, there are other tests that a physician may require. These includes:

1. Electromyography (EMG) -- This test is usually requested if a pinched nerve is suspected. The process involves fine needles inserted into a neck muscle. Tests are then performed to determine whether the nerves function properly.
2. Blood tests -- Blood tests can detect inflammation and infection. These may determine any potential links to neck pain, like those associated with meningitis.

Most neck pain can be controlled and usually goes away within a couple of weeks. Persistent pain may require further tests and treatments.

Doctors usually will prescribe pain medications, muscle relaxants or tricyclic antidepressants for pain relief.

Medications may be combined with some other therapies, including:

1. Physical therapy - Working with a skilled trainer, sufferers may work on neck strengthening to help ease the condition and prevent relapses.
2. Transcutaneous electrical nerve stimulation - Often referred to by its acronym, TENS, this practice uses electrodes on the painful areas to stimulate the muscles and potentially help with impingements.
3. Traction - For serious issues, traction will take weights, pulleys and other balances to stretch the neck gently. This therapy is always performed under the supervision of a medical professional.
4. Immobilization - A soft collar that will help support the neck will take some pressure off the muscles that hold it aloft. However, this is a short-term therapy because not using the neck muscles may cause atrophy.
5. Steroids - A corticosteroid injection into the nerve roots, spinal joints or neck muscles may help with pain. There are also numbing medications that can be injected to help with the aching.
6. Surgery - Usually a last resort, surgery may be used if a nerve impingement is suspected but not relieved by other therapies.

Over-the-counter pain medications like ibuprofen, acetaminophen and naproxen sodium sold under the Tylenol, Aleve and Advil brand names may be used to help with pain.