For minor, common causes of neck pain:

• Take acetaminophen or ibuprofen.
• Apply heat or ice to the painful area. One good method is to use ice for the first 48 - 72 hours, then use heat after that. Heat may be applied with hot showers, hot compresses, or a heating pad. Be careful not to fall asleep with a heating pad on.
• Perform slow range-of-motion exercises -- up-and-down, side-to-side, and from ear-to-ear -- to gently stretch the neck muscles.
• Have a partner gently massage the sore or painful areas.
• Try sleeping on a firm mattress without a pillow or with a special neck pillow.

• One week of self care hasn't helped.
• You have a fever and headache, and your neck is so stiff that you cannot touch your chin to your chest. THIS MAY BE MENINGITIS -- CALL 911 or get to a hospital.
• You have numbness, tingling, or weakness in your arm or hand.
• Your neck pain was caused by a fall, blow, or injury (if you cannot move your arm or hand, have someone call 911).
• You have swollen glands or a lump in your neck.
• Your pain does not respond to standard doses of over-the-counter pain medication.

Your doctor will perform a physical examination and ask detailed questions about your neck pain, such as:

• Is your pain in the front, back, or side of your neck?
• Are both sides of your neck affected equally?
• When did the pain first develop?
• Is it painful all the time or does pain come and go?
• Can you touch your chin to your chest?
• What makes your neck feel worse? What makes your neck feel better?
• Do you have neck weakness or neck stiffness?
• Do you have any accompanying symptoms like numbness, tingling, or weakness in your arm or hand?
• Do you have swollen glands or a lump in your neck?

• X-rays of the neck
• CT scan of the neck or head
• Blood tests such as a complete blood count or a thyroid test
• A spinal tap for a cerebrospinal fluid analysis if meningitis is suspected
• Occasionally, an MRI of the neck

If the pain is due to muscle spasm or a pinched nerve, your doctor may prescribe a muscle relaxant and possibly a more powerful pain reliever. Prescription drugs are not necessarily better than over-the-counter medications. The doctor may prescribe a neck collar or, if there is nerve damage, refer you to a neurologist or neurosurgeon for consultation.

If meningitis is suspected, you will be sent to an emergency department for further tests, antibiotics, and hospital admission.

If a thyroid condition is considered (due, for example, to a lump in the front of your neck), follow-up care for abnormal blood tests will be needed.

• Use relaxation techniques and regular exercise to prevent unwanted stress and tension to the neck muscles.
• Learn stretching exercises for your neck and upper body. Stretch every day, especially before and after exercise. A physical therapist can help.
• If you tend to get neck pain from exercise, apply ice to your neck after physical activity.
• Use good posture, especially if you sit at a desk all day. Keep your back supported. Adjust your computer monitor to eye level. This prevents you from continually looking up or down.
• If you work at a computer, stretch your neck every hour or so.
• Use a headset when on the telephone, especially if answering or using the phone is a main part of your job.
• When reading or typing from documents at your desk, place them in a holder at eye level.
• Evaluate your sleeping conditions. Make sure your pillow is properly and comfortably supporting your head and neck. You may need a special neck pillow. Make sure your mattress is firm enough.
• Use seat belts and bike helmets to prevent injuries.

Kasch H, Bach FW, Stengaard-Pedersen K, Jensen TS. Development in pain and neurologic complaints after whiplash: A 1-year prospective study. Neurology. 2003; 60: 743 - 749.

Devereaux MW. Neck pain. Prim Care. 2004; 31(1): 19-31.

Phero JC. Pharmacological management of head and neck pain. Otolaryngol Clin North Am. 2003; 36(6): 1171-1185.