• Reference Number: HEY1039/2025
• Departments:
• Last Updated: 30 June 2025

Introduction

This leaflet has been produced to give you general information about your injury. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and your doctor but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What causes neck pain?

Neck pain is common even without an accident or injury and is rarely due to any serious disease. Your neck is strong. Like the rest of your spine, your neck is made of solid bony blocks known as vertebrae which are joined by discs to give it strength and flexibility.  It is reinforced by strong ligaments and surrounded by large and powerful muscles that protect it. Most simple neck strains do not cause lasting damage.

Symptoms

Pain and stiffness

Pain may be in the middle of your neck or to one side or the other. The pain may travel to your shoulder or shoulder blade or to the upper chest.  Stiffness is often worse after prolonged rest or sitting in the same position for a long time.

Numbness and tingling

If there is irritation of a nerve you may have numbness and / or pins and needles down your arm, sometimes all the way down to your fingers. The nerve can be affected in this way for a variety of reasons. Most nerve symptoms will improve within 12 months of onset.

Clicking / grating

You may hear or feel clicking or grating as you move your head – this is known as crepitus. It is caused by bony surfaces moving against each other or by ligaments moving over bone.  Other joints often make these sounds, but they often seem louder in the neck because they are happening closer to the ears. This is quite common and can sound alarming but is not serious.

Causes

There are a number of possible causes for the symptoms most of which will resolve on their own if you follow the advice in this leaflet.

Non-specific neck pain

Many people develop a stiff and painful neck for no obvious reason; it may happen after a minor twisting injury.  This type of neck pain is thought to be caused by spasm in the muscles supporting the neck and will usually disappear after a few days or weeks.

Whiplash

Whiplash injuries are most commonly seen as a result of a car accident, which in itself can certainly be frightening. Patients often present to the Emergency Department after even a minor whiplash as it can be very painful.  The facts below show this is not usually the case:

• Permanent injury is rare. The long-term outlook is good.
• Most whiplash injuries are not serious. There is usually no damage to the bones, discs or nerves in the spine
• There is often a delay of a day or two after the accident before you feel any pain or stiffness. This is a good sign that there is nothing serious and usually caused by muscle spasm where your body naturally tries to protect you from experiencing pain.
• Whiplash causes neck pain but can also cause back pain. Again, there is rarely a serious injury to the back.
• Headaches are common in whiplash injuries caused by the tension in the neck. Other symptoms such as arm or jaw pain or dizziness are also common but usually improve along with the neck pain.
• Most of these injuries improve within a few days or weeks, at least enough to get on with your life. Aches and pains can sometimes persist or recur for quite a long time after a whiplash injury.
• What you do in the early stages is very important – following the advice in this leaflet is really important to help you recover.

Cervical spondylosis

Spondylosis is a term used to describe osteoarthritis of the spine and is quite a normal finding as we age. Many people with cervical spondylosis don’t have any symptoms, and it often doesn’t cause serious problems. When symptoms do occur, they can usually be managed with simple treatments like pain relief, gentle exercise, and physiotherapy.

Tension

Most muscles relax when not in use, but the muscles in the back of your neck have to stay active to keep your head upright. When you’re stressed or anxious, you might tense these muscles even more, which can lead to neck pain and tension headaches.

Tension headaches are very common and can feel like pain at the back of your head, behind your eyes, at the sides of your head, or around your ears. They’re sometimes mistaken for migraines.

The clinician may not have been able to give a clear diagnosis or pinpoint exactly where the pain is coming from – and while that can feel frustrating, it also means there’s nothing serious going on.

How is it diagnosed?

In most cases, an X-ray or scan is not needed to find out what’s causing your neck pain. These tests often show normal age-related changes in the spine, which are common and not usually the cause of pain.

However, in very rare cases, there may be something more serious or underlying that requires further investigation. An emergency scan may be arranged for you if experience any of the following:

• Pain that is getting much worse despite following the advice in this leaflet
• Lack of co-ordination – for example trouble with tasks like buttoning a shirt
• Heaviness or weakness in your arms or legs
• Pins and needles in an arm as well as pain
• Problems walking
• Loss of bladder or bowel control

If you do develop any of the symptoms listed above, we recommend you attend or return to the Emergency Department immediately for further assessment.

How long will the pain last?

The complex structure of your neck means that even a mild sprain to any of the structures can cause a lot of pain and discomfort.

The spine is one of the strongest structures in the body and in time this pain will improve – much like a sprained ankle.

What can affect neck pain?

There are many things that can affect how much neck pain you feel and how long it lasts. Often, it’s a mix of different factors, such as:

• Physical factors – like avoiding movement and trying to protect your neck too much
• Emotional or mental health factors – such as being afraid your neck is badly damaged, worrying you won’t get better, feeling low or stressed
• General health and lifestyle – for example, feeling run down, being overweight, not getting enough exercise, poor sleep
• Social factors – like problems at home or work, low job satisfaction, or stressful events such as illness or a bereavement

These things can all increase how strongly you feel pain. But the more you understand what’s affecting your pain, the more you can take control of it and find ways to reduce it.

The advice in the rest of this leaflet will help you recover and stop your neck pain from becoming a long-term issue.

What pain relief medication can I take?

You should not hesitate to use pain relief medication if you need to ease the pain. If you are unsure what medication is best for you to take, we advise that you speak with a pharmacist.

Although pain relief medication helps to ease the pain you experience, they do not necessarily speed up your recovery. It is advised they are used together with other measures, such as exercise, in the short term only as they can have side effects.

Exercise and rest

Why getting moving early matters

What you do in the first few days of neck pain really makes a difference. If you rest too much or avoid activity for more than a day or two, it can actually make things worse.

Long rest can lead to more pain, slower recovery, and being off work for longer. This is because your neck muscles get weaker when they’re not used, which makes them tire more easily and more likely to get strained again.

Your neck is made to move – and keeping it moving helps it heal. The sooner you start doing your normal daily activities, the quicker you’re likely to feel better. If you’re working, it’s usually best to stay at work if you can, even if you need to make some short-term changes to your duties. People who stay active generally recover faster and cope better with neck pain.

Managing symptoms in the early days

Using a warm pack or cold compress for 5–10 minutes at a time can help reduce pain and muscle tension. It’s up to you which one you prefer. Just be careful not to burn or damage your skin:

• Don’t use very hot water
• If using ice, wrap it in something like a damp tea towel
• Check your skin often
• Stop straight away if the area turns white, blue, blotchy, or becomes very painful, numb, or tingly

Staying active helps long term

Exercise like walking, swimming, going to the gym, or playing sport is one of the best ways to reduce pain and stop it coming back. Regular activity helps by:

• Making your bones stronger
• Strengthening your muscles
• Keeping your body flexible
• Boosting your overall fitness
• Improving your mood
• Releasing natural chemicals that ease pain

There’s no single “best” type of exercise – the most important thing is to find something you enjoy and can stick with.

Start gently and build up gradually, both in time and effort. It’s normal to feel a bit sore at first, but with regular movement, this will usually ease over time

Sleep

The importance of sleep in easing pain has become increasingly clear in recent years. Sleep reduces stress and improves your overall feeling of wellbeing; making you less at risk to the triggers of pain and helping you cope if it does occur.

Aim for a regular routine, as far as possible. There is no recommended position for sleep or particular type of mattress or number of pillows – do what is most comfortable for you.

Posture

There is no strong evidence that posture causes neck pain or that there is one “correct” way to sit or stand. What matters most is finding positions that feel comfortable and natural for you. This is usually a relaxed, supported posture that lets your muscles rest. Try not to stay in one position for too long – regularly changing your posture throughout the day can help reduce stiffness and discomfort.

Is surgery an option?

Only a very small number of people with neck pain will ever need surgery.

In some less common cases, neck problems can cause pressure on the nerves or spinal cord. This may lead to symptoms such as severe pain, weakness, pins and needles, or numbness. In these situations, surgery may be helpful.

When to seek further help?

If your neck pain does not settle after 6 – 8 weeks, you should refer yourself to a physiotherapist if you have not already done so.  Physiotherapists provide expert advice, guidance and treatment for neck pain. This is to help reduce your risk of experiencing future episodes, while improving your overall health and wellbeing.

Hull GP patients call tel: 01482 300003

East Riding GP patients call tel: 01377 208300 (open Monday – Friday 09.00am -13.00pm, excluding bank holiday) or self-refer online at www.chcpmsk.org.uk

If you live outside of the Hull area, please seek a referral from your doctor.

If the physiotherapist has any concerns following their assessment of your neck they will refer you on to the appropriate care provider to address your needs.

Your feedback matters to us…

To ensure we deliver a safe and quality service and to help us understand the experience you have of the care you receive from our staff we would value your thoughts about the service you received.

You may be contacted as part of our quality assurance programme which is where we visit our teams and staff and talk to them about the care they provide to our patients or at any time during or after you have needed our services.

To collect this feedback, we would contact you using the registered telephone number we hold in your care record. This feedback will be strictly anonymous and whilst we will share the feedback as part of the process, we will not share any details which may identify you.

We will never ask you any personal questions about your health during these telephone calls.

If you do not wish to speak to us, please say this when we call, we do not want you to feel pressured.