Pain in the neck which may or may not radiate to the arms (radiculopathy) is usually a mechanical overuse problem and rarely is due to an illness, such as polymyalgia rheumatica, ankylosing spondylitis, rheumatoid arthritis, tumors and infections. Neck pain usually improves in 1-2 weeks, and 75% within 2-3 months.
Old injuries such as whiplash injuries are common as a cause. Muscle strains from prolonged physical activity such as extended computer work, sleeping in an awkward position, osteoarthritis with disk disease and spurs that cause nerve irritation and compression or herniated disks and spinal stenosis.
Imaging tests with x-rays and MRI scans are reserved for patients that do not respond to initial treatments. Treatment includes encouraging movement and stretching of the neck exercises, while neck braces and smoking tobacco are discouraged as they aggravate neck pains. Ice and/or heat, NSAIDs, muscle relaxers for muscle tightness, physical therapy and massage are helpful. Laying down frequently for 5 minutes with heat and gentle stretching can be helpful to prevent severe exacerbation with headaches and arm pains. Stress reduction may be needed. A small minority will need surgery of the cervical spine.