For most people neck pain is a combination of all three. Maybe you had an injury playing sports as a teenager and later in life were involved in a fender bender and now you sit at a desk all day. These things have compounded over time to cause first a little discomfort and later a more constant pain or pain that interferes with normal activities like work or sleep. Severe cases of neck pain can even cause shoulder pain or arm pain or tingling and numbness in the hands. 
Usually the first line of defense is to take an analgesic like acetaminophen or aspirin. This can help temporarily but if the pain persists folks usually go to the doctor for some tests. The first test for neck pain is usually an x-ray to rule out anything serious. 
This is where it gets interesting. Most people, including young people may have some form of “degenerative changes” in their neck. Seeing these things on x ray and being told by your doctor that they are “degenerative” (ie not going away) can cause you to think you are never going to feel better and are doomed to a life of pain pills every 2 hours,  disturbed sleep and missing out on the activities you enjoy. 
For a very large number of neck pain sufferers, this is simply not true. Neck pain can be treated in a variety of ways that don’t involve unpleasant medication, shots or surgery. It may be as simple as buying a new pillow, adjusting your work space, taking breaks or adopting a new exercise program. 

Muscular sprains and strains: By far the most common cause of short term neck pain is muscle sprains and strains. This is usually caused by heavy lifting or doing more activity than you are used to, like helping a friend move house or spending a weekend spring cleaning. These injuries tend to have associated muscle spasms and can be very painful although usually not long lasting. 

Bulging or herniated discs: Intervertebral discs separate the vertebrae in the the spine at each level. They are made out of cartilage and allow the spine to be flexible. Discs can bulge or herniate either from an injury or age related degeneration. Injured discs in the neck typically cause pain in the lower neck, shoulders or upper back. They can also create pain by putting pressure on nerve roots where they exit the spine causing pain, tingling or numbness in other areas like the shoulder hands or fingers. 

Spinal stenosis: Stenosis means narrowing and spinal stenosis refers to narrowing around the spinal cord or nerve roots caused by degeneration, disc bulging or bone spurs. Mild stenosis can be present in the neck and produce few if any symptoms. Severe stenosis on the other hand can cause pain, numbness, weakness and in severe cases interfere with balance, walking and other important functions.  

Poor posture: Most of us have what is called a “forward head” or “protracted” posture this may be caused by years of sitting for long periods at a workstation, driving long distances, poor sleep habits or not doing enough exercise to keep the spine and surrounding muscles strong. Poor posture causes muscle spasms and can cause pressure on nerves and blood vessels causing them to malfunction and become painful. 

Whiplash: Whiplash is caused by sudden, uncontrolled movement of the neck that strains connective tissues such as muscles and ligaments. For most people this injury occurs in a car wreck. It can also happen in falls and in sports activities particularly contact sports. Whiplash is a diffuse injury meaning that it is spread out over a large area in the neck and shoulders. It can be extremely painful and debilitating and may last for several months after the initial injury. 
One of the mysteries of Neck pain is that some of these things are visible on xray or MRI and some are not. The latter is particularly true in the case of whiplash. To add to the confusion, sometimes an x-ray can show features like degeneration or disc bulges or bone spurs and the patient has no pain in that area. To get a good idea of where the pain is coming from it is important to examine (among other things) movement, strength and posture. In some cases, this is all that needs to be addressed,  meaning that shots, pain pills and surgery may not be required to make a full recovery. 

Six Ways to eliminate Neck Pain and Headaches (including Migraines) without the use of medication.
A Good Pillow Considering the amount of time we spend sleeping, it makes sense that the right pillow should make a big difference. But which one should you choose? There are a lot of different configurations, hard, soft, contoured, memory foam and even water pillows. As a general rule you want to purchase a pillow that is firm enough to allow your head to align with your body as you sleep. You also want one with enough softness that it can support the curve of your neck and support your vertebrae. 

Dry Needling At Jones Physical Therapy we help a lot of people resolve their neck pain and headaches with this useful treatment. Dry Needling uses thin needles inserted into sore muscles to induce relaxation and improve flexibility in the neck. Small muscles at the base of the skull are often responsible for triggering tension headaches and even migraines. With regular treatment we can reduce and eliminate these types of headaches.

Massage Massage of the neck and shoulders can be useful in relieving pain and tension that originates in the muscles in these areas. Typically the relief is temporary but can be very useful. People who are prone to neck pain and headaches should consider having a regular appointment with a Massage Therapist to keep their symptoms in check.

Manual Therapy Neck pain can also originate in the joints of the neck shoulders and thorax. Physical Therapists are trained to mobilize these joints with their hands, causing improved movement and decreased pain. Neck pain can also originate in other parts of the body and an expert assessment by a Licensed Physical Therapist can detect these problem areas, helping you to get to the root of the problem and find the best solution possible. 

Change your Bag Heavy shoulder bags: Uneven loads over time can cause pain in not only the shoulder but also the neck. Consider carrying less stuff around with you on a daily basis. Or if you have to carry a lot of weight, think about distributing the load with a backpack or messenger bag. 

Phone Use. We all like to stay in touch. Some of us have to use the phone a lot for work, keeping up with friends or checking on the kids. Holding a phone to your ear for long periods of time leads to a stressed posture, and  creates tension in the muscles of the shoulder and neck. If you use a cell phone for long periods consider using bluetooth or hands free devices so it does not impact your neck. At work, you may want to switch from a handset to a headset. This also gives you the added advantage of being able to take calls standing up which is also good for your lower back. 

Nobody likes a pain in the neck! If you have questions about treating neck pain, reach out to my team at info@jonesphysicaltherapy.com and we will have one of our experts help you.