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You probably don’t give much thought to your neck until it starts to hurt. Acute or short-term neck pain is very common. You rarely need to worry about it.

Tense muscles are frequently the cause. Your neck muscles can tense up for several reasons. These include exposure to a cold, spending too much time on electronic devices, or sleeping in a weird position.

Acute neck pain tends to go away after a week or two. But some neck pain is ongoing or long-term.

You may wonder, when should I be worried about neck pain? Here’s what you need to know if your neck always hurts and when to know if neck pain is an emergency.

What Does Your Neck Do?

Your neck is a complex structure that connects your head to your torso. It consists of many bones, joints, muscles, nerves, blood vessels, and other connective tissues.

What is your cervical spine?

We call the bony part of your neck the cervical spine. Its main job is to support your skull.

The cervical spine is also the most flexible part of your spine. This allows for many different types of head movements.

Why neck health matters

Neck health is important for survival and daily life. Your neck needs to move well so you scan your surroundings for danger. For example, you need to look from left to right before crossing a busy street.

Your neck is like an information highway. Nutrients, motor, and sensory information travel between your brain and the rest of your body and vice versa.

Ongoing neck pain can get in the way of everyday tasks, such as work or schoolwork. A musculoskeletal condition like neck pain also increases your risk of developing mental health issues. In rare cases, neck pain may point to more serious problems.

Musculoskeletal conditions, such as neck pain, are the main reason people need physical rehabilitation. In 2012, 25.5 million Americans missed an average of more than 11 days of work because of neck pain. That’s according to a 2022 review in the journal BMC Musculoskeletal Disorders.

What Causes Chronic Neck Pain?

Many things can cause neck pain. For some people, neck pain can become chronic or ongoing. The National Library of Medicine lists four main causes of neck pain:

Cervical spine changes

As you get older, your cervical spine changes. The spinal discs can become flatter.

You may also develop osteochondrosis. This is when small bone growths, or spurs, develop along the front parts of your spine bones.

You may also develop osteoarthritis of the joints between your neck vertebrae. (Cervical spondylosis is the name for this condition.) With this condition, moving your neck gets harder, but it rarely causes neck pain on its own.

Narrowing of the vertebral canal

This often happens when a spinal disc bulges and puts pressure on a nerve root. One term for this is a slipped disc, and it may or may not cause pain. When it does, the pain can radiate into your shoulder or arm.

Overused or weak neck muscles

Your habits and lifestyle can cause you to develop neck pain. This can happen from sitting at your desk too long or straining your neck forward or down. It can also happen from tilting your head back against your neck, as you might while painting a ceiling.

Whiplash

Whiplash is the type of neck injury you get when someone drives into the back of your car, for example. The collision causes enough force for your head to snap forward and then back. For most people, whiplash often causes small injuries in their muscles and connective tissue.

After whiplash, your neck muscles can feel very tight. You may have a hard time moving your head for several days.

Risk Factors for Neck Pain

Understanding your risk factors may help prevent or diagnose neck pain early before it becomes a long-term problem. Doctors consider neck pain chronic if symptoms last longer than three months.

Certain risk factors can increase your risk of developing neck pain. These include biological, lifestyle, and psychological risk factors:

• Age.
• Anxiety and depression.
• Autoimmune diseases.
• Genetics.
• Lack of physical activity.
• Long-term stress and lack of social support.
• Neuromusculoskeletal disorders.
• Poor posture when sitting, standing, or working.
• Sleep problems.
• Work-related factors, including low job satisfaction, high job demands, and lack of workplace support.

Types and Symptoms of Neck Pain

Different types of neck pain may cause different symptoms. There are two main types of neck pain: axial pain and radicular pain.

Axial pain

You feel this type of neck pain mainly in your cervical spine and sometimes in your shoulders.

Radicular pain

Pain shoots or “radiates” along the nerves from your neck to other parts of your body. You may feel pain through the back of your head or down one of your arms.

Radicular neck pain often happens because something is irritating the nerves. You may have a spinal disc that has changed and is pushing against a nerve (this is what some call a pinched nerve). This can affect your arms’ reflexes and muscle strength.

Other symptoms include a tingling feeling in your muscles. People describe it as feeling stuck with pins and needles.

So, which neck pain is serious? Both types of neck pain can affect your physical and mental health. If your neck pain gets in the way of daily living and your quality of life, talk to your doctor.

When Should I Worry About Neck Pain?

Neck pain alone is rarely a sign of a more serious condition or emergency. Here’s when you should get medical care for neck pain:

What are red flags for neck pain?

You should see your doctor if you have neck pain and:

• You have tingling or “pins and needles” that won’t go away.
• Your hands and legs frequently feel like they “fall asleep.”
• You have leg weakness.
• You have trouble keeping your balance when walking.

Signs that neck pain is an emergency

How do you know if neck pain is an emergency? Get medical care right away if you have:

• An accident that triggered your neck pain.
• Fever or chills.
• Headache with dizziness, nausea, vomiting, or sensitivity to light.
• Loss of bladder or bowel control.
• Nerve problems and signs of paralysis. This includes tingling and difficulty moving your arms or fingers.
• Pain that stays the same whether you’re at rest or moving.
• A stiff neck.
• Unexplained weight loss.

Your doctor can help figure out what’s causing your neck pain and get you started on therapy or treatment that may help.