Neck Pain Causes

In order to effectively treat neck pain, it is important to understand the underlying medical condition causing it. This page focuses on various neck pain causes and risk factors, and how the causes of acute (short-term) pain and chronic (long-term) pain tend to be different.

Common Acute Neck Pain Causes

The most common causes of neck pain—muscle/tendon strains and ligament sprains—heal within a few days or weeks. Many cases of strains and sprains result from overuse or overextension, such as from:

• Poor posture. Long periods of time spent slouching or hunched over a computer screen can lead to forward head posture, which places extra stress on the neck. Repeatedly looking straight down at a phone or tablet may also cause pain, sometimes called text neck.

  Watch Text Neck Symptoms and Causes Video

• Sleeping in an awkward position. If the head is held at a bad angle or twists wrong during the night, a stiff neck might be present in the morning.
• Repetitive motions. Turning the head in a repetitive manner, such as side to side while dancing or swimming, may lead to overuse of the neck’s muscles, tendons, and ligaments.
• Trauma. Examples include any type of fall or impact, such as a sports collision or whiplash from an auto accident.

  Watch Whiplash Video

Sometimes a muscle strain or spasm is not just a soft tissue injury. In some cases, a problem in the cervical spine could be causing a neck muscle to spasm in response.

Watch Neck Strains and Sprains Video

Common Chronic Neck Pain Causes

When neck pain lasts or keeps coming back over a period of several months, it is typically due to spinal degeneration from wear-and-tear over time (also called cervical spondylosis).

• Cervical degenerative disc disease. All discs gradually lose hydration and the ability to cushion the spine’s vertebrae over time. If a disc degenerates enough, for some people it can lead to pain in various ways, such as a herniated disc, pinched nerve, or changes in the facet joints that can cause osteoarthritis.

  Watch Cervical Degenerative Disc Disease Video

• Cervical osteoarthritis. When the cartilage in a cervical facet joint wears down enough, it can lead to cervical osteoarthritis. Cervical osteoarthritis is one of the most common causes of chronic neck pain.

  Watch Cervical Facet Osteoarthritis Video

• Cervical herniated disc. When an intervertebral disc’s protective outer layer (annulus fibrosus) partially or completely tears, some of the jelly-like inner layer (nucleus pulposus) may leak and cause inflammation and pain.

  Watch Cervical Herniated Disc Video

As spinal degeneration progresses, there is an increased risk for a narrowing of the foramen (cervical foraminal stenosis) and/or the spinal canal (cervical central stenosis). If the nerve root and/or spinal cord becomes impinged, pain, tingling, numbness, and/or weakness may radiate into the arms or legs.

Watch Cervical Spinal Stenosis Video

Other Neck Pain Causes

Other causes of neck pain could include:

• Emotional stress. Stress, anxiety, and low social support have all been linked as potential causes or contributors to neck pain.¹Halderman S, Carroll L, Cassidy DJ, Schubert J, Nygren A. The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Eur Spine J. 2008; 17(Suppl 1): 5. doi: 10.1007/s00586-008-0619-8.^,2Kim R, Wiest C, Clark K, Cook C, Horn M. Identifying risk factors for first-episode neck pain: A systematic review. Musculoskelet Sci Pract. 2018 Feb; 33: 77-83. doi: 10.1016/j.msksp.2017.11.007.
• Infection. If part of the cervical spine becomes infected, inflammation could cause neck pain. One example is meningitis.
• Myofascial pain syndrome. This chronic condition has trigger points, which result from achy muscles and surrounding connective tissues, typically in the upper back or neck. Trigger points can be chronically painful or acutely tender to the touch. The pain might stay in one spot or it can be referred pain that spreads to/from another area in the body.
• Fibromyalgia. Fibromyalgia is hard to diagnose, but it typically involves pain in the muscles, tendons, and ligaments in several areas of the body, including in the neck.
• Spinal tumor. A tumor, such as from cancer, could develop in the cervical spine and damage tissues or press against a nerve.
• Spondylolisthesis. This condition occurs when one vertebra slips over the one below it. It can be due to a tiny fracture in the vertebra, ligament laxity, or possibly from advanced disc degeneration.

Many other neck pain causes are also possible.

Risk Factors for Developing Neck Pain

Many different risk factors for neck pain have been suggested in the medical literature, such as³McLean SM, May S, Klaber-Moffett J, Sharp DM, Gardiner E. Risk factors for the onset of non-specific neck pain: a systematic review. J Epidemiol Community Health. 2010; 64(7):562-72. https://www.ncbi.nlm.nih.gov/pubmed/20466711^,4Jun D, Zoe M, Johnston V, O’Leary S. Physical risk factors for developing non-specific neck pain in office workers: a systematic review and meta-analysis. Int Arch Occup Environ Health. 2017; 90(5):373-410.:

• Reduced neck strength
• Previous neck problems
• Poor posture
• Smoking
• Labor-intensive occupation
• Female sex
• Feelings of low support from work, family, or friends

There is some controversy regarding neck pain risk factors as some studies have reached conflicting conclusions.⁵Paksaichol A, Janwantanakul P, Purepong N, Pensri P, van der Beek AJ. Office workers’ risk factors for the development of non-specific neck pain: a systematic review of prospective cohort studies. 2012; 69(9):610-8. More research is needed to confirm which factors truly present the highest risk for developing neck pain.