Neck pain is common and can originate from various structures. Find out more about the common risk factors, when to consult a doctor and lifestyle changes to manage neck pain.

Introduction

• Neck pain is very common.
• Neck pain commonly originates from various structures such as muscles, tendons, ligaments, bones and joints¹. 
• A healthcare provider can assess and help you understand how to manage your neck pain.

Other possible symptoms 

As neck pain is a symptom and not a medical diagnosis, these are other symptoms that you may feel with neck pain:

• Pain with movement
• Neck stiffness
• Muscle tightness and cramp
• Weakness, numbness or tingling down hands
• Headache (especially over back of head)
• Giddiness

Common risk factors

• Prolonged postural stress
• Poor sleep
• Stress
• Anxiety and depression

When should you consult a doctor?

Consult a doctor urgently if you are experiencing any of the following:

• Persistent pain from an injury
• Left-sided chest pain spreading to arm, shoulder, neck or jaw
• Shortness of breath or cold sweat
• Change in urinary and bowel control
• Worsening headache, numbness, weakness or tingling sensation in any region
• Sudden loss of function (e.g. Difficulty in balancing when walking, unsteady walking)

Consult a doctor early if you are experiencing any of the following:

• Unexplained weight loss
• Fever or night sweat
• Pain which does not improve after rest or pain medication
• Swelling or redness around neck region

How long does recovery take?

• Most neck pain recovers in a few weeks with self-management. For some, it may recur over time
• These can help you return to your regular activities
  • Understand your pain
  • Make appropriate lifestyle changes
  • Set right goals
• Certain neck pain may persist and require regular management (e.g. upper back strengthening exercises)

Why do some people have persistent neck pain?

Chronic pain refers to pain that lasts beyond 3-6 months. They are:

• Usually caused by an initial injury, but remains sensitive and painful even if the region is healed.
• Associated with other factors like stress, poor sleep, anxiety and depression².
• Sometimes may have no specific cause or reason.

Lifestyle changes to prevent / manage Neck Pain

• Refer to leaflet on “Self-help tips to manage pain”.
• Avoid overuse or overstrain of your neck.
  • When in a call, do not tuck the phone between your ear and shoulder when you talk.
  • Do not carry heavy bags with straps over your neck and shoulder.
• Do self-directed stretches and exercises regularly. 

Self-directed stretches and exercise

Frequently Asked Questions

“Do I have neck pain because my neck is degenerating?”

• These age-related changes are common in people as they age, and often not related to symptoms!

“I have neck pain with arm pain/numbness. Do I have a stroke?”

• Most of the arm pain/numbness is not an indication of stroke. 
• Learn to recognise the early signs of a stroke using the “Think F.A.S.T” acronym, so you can seek help quickly if you suspect you or your loved one has a stroke.
• F.A.S.T refers to:
  • Face drooping
  • Arm weakness
  • Speech difficulty
  • Time to call 995

“Should I rest in bed the whole day when I have neck pain.”

• No. Complete rest in bed is not recommended. All rest and activity should be done in moderation. Prolonged inactivity can contribute to neck pain, while exercises done safely can help to reduce stiffness and pain.

“Do I need an X-ray for my neck pain?”

• Unless advised by a doctor to rule out certain specific conditions, imagings such as X-ray or MRI often do not show the cause of your pain³.
• Your doctor will refer you for further investigation if needed.

“Is there an ideal sleep position or pillow type to help support my neck?”

• Try not to sleep on your stomach.
• When buying a pillow, consider your body size, preferred sleeping position, and pillow firmness. When you lay down, your head and neck should be comfortably supported and aligned with your body. If you tend to sleep on your back, choose a slightly higher pillow.

Disclaimer

In most cases, your pain should improve in 6 weeks. See a doctor if your pain worsens or if you have any of the symptoms stated in the “When should you consult a doctor” section above.

Support networks / Useful links

• SGH Physiotherapy YouTube: physiotherapy management of neck pain  https://www.youtube.com/watch?v=y3hXtQ6zs-s
• https://www.versusarthritis.org/media/23110/neck-pain-information-booklet.pdf

Acknowledgements

One-Rehab Musculoskeletal Workgroup (Jan 2023 - Dec 2023)

Musculoskeletal Physiotherapists from Public Healthcare Institutions 

References

1. Bogduk, N. (2011). The anatomy and pathophysiology of neck pain. Physical Medicine and Rehabilitation Clinics, 22(3), 367-382.
2. Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J., ... & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC musculoskeletal disorders, 23(1), 1-13.
3. Farrell, S. F., Smith, A. D., Hancock, M. J., Webb, A. L., & Sterling, M. (2019). Cervical spine findings on MRI in people with neck pain compared with pain‐free controls: A systematic review and meta‐analysis. Journal of Magnetic Resonance Imaging, 49(6), 1638-1654.