Pain in the Neck: What to Do and When to See a Doctor

Neck pain has spurred many health-related headlines recently — from a report in Canada that 75 percent of military helicopters pilots suffer pain in the cervical spine to the ongoing problem with smartphones and “text neck” in the U.S. and elsewhere.

Whether you’re a pilot encumbered by heavily equipped helmets or the average office worker hunched over a computer station for hours a day, the question that invariably comes up is: When should I see a doctor about the pain or stiffness in my neck?

The neck — or cervical spine — is a complex network of nerves, bones, joints, and muscles. It is designed for strength, stability, and nerve communication. It consists of seven bones (C1-C7 vertebrae), which are separated from one another by discs. These discs allow the spine to move freely and act as shock absorbers during activity. But the neck is also meant to be kept at its “normal or neutral position,” says Jobyna Whiting, M.D., neurosurgeon with the Baptist Health Neuroscience Center.

Anytime lower your head to look at your smartphone, you’re applying a considerable amount of pressure on your cervical spine. Research has confirmed that a head bent 45 degrees forward — a typical position while one is texting — can exert a force on the spine of nearly 50 pounds. In the case of military pilots, the weight comes from helmets loaded with electronic displays, communications systems and night-vision goggles. Either way the result will likely be neck pain, either temporary or chronic.

Causes of Neck Pain
In addition to work-related strain, which is common with construction workers and other jobs requiring lifting or awkward postures, over doing it at the gym can cause sudden or prolonged neck pain. So can going a little too far with weekend activities, whether it’s a touch football game or a home improvement project. Waking up with a stiff neck is one of the most common complaints, which can be related to an awkward sleeping position.

“The first thing to do is to recognize that neck pain is probably nothing dangerous,” says Dr. Whiting. “The second thing is to try to avoid that (the activity or position that caused the neck pain). Try to fix whatever the sleeping situation is, or whatever has caused this pain.  As long as you’re not having strange other symptoms like tingling or numbness in your hands or fingers, and as long as the pain doesn’t go on for a prolonged period of time, then you’re probably going to be fine and it will resolve itself.”

However, if the pain continues for more than three or four days, or if it is progressing even after you’ve stopped the activity, then it’s probably time to call your doctor, she adds.

Simple steps can be taken to alleviate the neck pain at home, which have proven effective after stopping the activity or position that caused the discomfort.

Ice vs. Heat: Which is Better?
Dr. Whiting says that one of the most common questions she gets is which is better for neck pain: ice or heat?

“It’s something I hear about all the time. The easy answer is: whichever one makes you feel better,” she says. “But when we’re talking about muscle spasms, heat typically works better because what we’re trying to do is loosen up that muscle, and if you apply heat to the muscle, it will relax it in a way that ice won’t. Ice, however, will help with inflammation.”

Taking over-the-counter ibuprofen, naproxen or similar drugs for pain, which are described as “nonsteroidal anti-inflammatory drugs” or NSAIDs, can also help ease neck pain or strain.

“Before you start taking over-the-counter medications, check with your doctor to make sure it won’t interfere with any other medications you might be taking or any other underlying health condition,” says Dr. Whiting. “But, in general, NSAIDs work to calm down inflammation or swelling. And they work very well.

Text Neck
One simple solution for many people with neck pain could be to improve their posture and raise their smartphones higher when texting or browsing apps. An estimated 80 percent of the U.S. population carry a smartphone with them. And they spend two to four hours a day with their heads dropped down — that’s about 700 to 1,400 hours a year in this position.

“Those numbers sound staggering, but we’re all guilty of it,” says Dr. Whiting. “The thing about the cell phone is having that position where you’re looking down at your phone. It is not a neutral neck position at all. Your neck really isn’t supposed to be in that same position, constantly hour after hour. And it’s a real problem because it’s unrealistic to ask people to give up their phones or jobs that may require poor neck posture.”

Her advice for all smartphone users:  “Just raise your head closer to the neutral position and actually lift your phone. It may not be particularly convenient, but it will make a difference if ‘text neck’ is starting to hurt and bother you.”