Neck Pain - Newcastle Hospitals NHS Foundation Trust

Neck pain or ache commonly occurs in the area between the base of the skull and the tip of the shoulder. Symptoms can spread into the top of the arm or down to the hand if the nerves or other local sensitive structures are involved.

Most neck pain does not have a serious cause. Neck pain can occur after an injury (e.g. whiplash) but can also occur without any trauma.

Neck pain can be improved by:

Keeping active within your tolerance.
Improving general fitness; cardiovascular, muscular and flexibility.
Breaking up prolonged static postures by moving more.

Your neck is surrounded by strong muscles which both support your head and allow it to move freely.

Occasionally, some people with neck pain may develop signs and symptoms that could indicate a more serious problem. If you develop any of the following warning signs, or if there is a new onset or worsening of your usual arm symptoms, you should see your GP urgently:

Difficulty speaking, slurring words or issues swallowing.
Pins and needles in both arms and legs.
Shooting pains in arms or legs like electric shocks.
A band of pain around the chest or chest tightness.
Clumsiness in hands and fingers causing difficulty with tasks such as fastening buttons, tying laces or counting out coins.
Balance problems including difficulty with walking, going up stairs or recent falls.
Difficulty passing urine or incontinence.

If these symptoms develop rapidly, within hours or days you should seek help immediately at A and E.

If you suddenly develop stiffness in your neck and both shoulders, you should see your GP.

What can I do to help my symptoms?

Acute neck pain normally settles within a few weeks. In some cases, nerve irritation occurs, meaning symptoms can last a little longer but should start to improve within six weeks.

Pain relief

Simple analgesia such as paracetamol and an anti-inflammatory such as Ibuprofen can be very effective in the management of neck pain. You can obtain advice regarding medication from your local pharmacist or GP but remember to read the packet; and do not take over the recommended dosage.

Cold or hot packs

A cold or hot pack can also be helpful in offering symptomatic relief but must not be directly applied to the skin or to areas of skin that have poor sensation or are numb. A layer of protection (e.g. towel) should be used to cover the cold or hot pack so that it is not in direct contact with the skin.

Do not use ice or heat if you have circulatory problems, such as Raynaud’s disease, history of cold induced hypertension, peripheral vascular disease, allergy to cold (urticaria, joint pain) or sickle cell anaemia. If your skin is usually numb over the injured area, please speak to your physiotherapist or GP before using a hot or cold pack / ice.

Ice must be used correctly otherwise ice burns can occur. Please see the instructions below:

Start by wetting a cloth under a cold tap and then wring the cloth out until it is just damp.
Place the damp cloth over affected area and then place either a plastic bag of crushed ice or a packet of frozen peas on top of the cloth. (The ice should be in small pieces in order to mould better to the area and help prevent ice burns).
Leave the ice pack and cloth in place for approximately 10-15 minutes and repeat 3 to 4 times a day.

It is normal for your skin to go slightly red or pink. Remove the ice if extreme redness/pain, blistering or an increase in swelling occurs. If this does occur, please call NHS Direct for further advice.

Posture

Research has suggested certain “bad” postures do not necessarily cause neck pain and that changing your posture regularly can be more effective for maintaining movement and flexibility in your neck rather than trying to maintain “good posture”.

Relaxation

Learning to relax your muscles is very useful if your neck pain is made worse by stress. The links below provide advice on how to manage stress and tension:

Advice on how to manage stress and tension using breathing exercises

Headspace is an app which provides meditations, sleep and movement exercises to help you de-stress.

Staff need to use their NHS email as a verification code will be sent (please check your junk folder if this does not go into your inbox). Newcastle OHS have various resources for further advice on staff wellbeing on the trust website.

Sleeping hygiene

Sleep is key for recovery and overall health, so finding a position that is most comfortable for you and allows you to get the best sleep that you can is recommended. However, sometimes you may feel more comfortable if your spine rests in a neutral position when sleeping. In these cases, your pillows should be placed so that your nose, chin, chest bone (sternum), and stomach button are in line, rather than off to one side. This prevents the neck leaning to one side.

Exercise

With any neck condition the aim is to keep your neck moving as normally as possible. This initially will feel like the last thing you want to do, but you will not damage your neck by moving it gently!

It is good to continue your normal activities as able, this may involve a period of decreased or modified activity.

Our recommendation is to move your neck within a tolerable range and perform tasks that you can comfortably tolerate. As symptoms improve, look to gradually return to normal activities as able, as this will help your recovery.

Moving your neck side to side and turning from left to right can help to keep your neck mobile if this is done little and often; even a few of these exercises done regularly (e.g. hourly) can help better manage symptoms throughout the day.

What about work?

Stay active at work or return to work as soon as possible; if necessary, with temporarily modified duties. This helps you keep your ‘work fitness’ and prevents your body getting weak, which can prolong your pain.

Remember: you do not have to be pain free to return to or remain at work.

Maintaining all normal activities including work improves your chance of recovery by keeping you moving.

Working in discomfort is unlikely to lead to any long-term problems and can reduce the risk of re-injury’. It also helps to regain any strength that has been lost in the early stages when the pain stopped you moving normally. The more time spent away from work, the greater the risk to your long-term quality of life.

You may not be able to return to your full duties straight away. It may take a short period of adjustment before you resume full duties. Often people are concerned about heavy jobs or jobs that require staying in the same position for a long time. You can discuss this with your manager and a short period of modified duties may be possible.

What should I do if I am still experiencing problems?

If you are unable to agree on restricted roles with you manager or you are still having problems (despite following this advice): your Occupational Health team can help. The Occupational Health team can advise you on how to bridge the gap to help you return to normal activities. You can also gain access to the Occupational Health physiotherapy team by:

Self referral

The Occupational Health can assist in the management of musculoskeletal problems that affect your ability to work. Staff are able to self refer to physiotherapy via Occupational Health.

Management referral

If you feel your symptoms are having a significant effect on your ability to carry out your role, discuss this with your manager and request a referral to the Occupational Health Service.

For more information on neck pain or how to stay active, why not try:

1 minute body check