Neck Pain Treatments

Pain treatment usually includes a combination of medications, physical therapy, and complementary treatments.

Neck pain can be a symptom of many conditions. For the best treatment results, you may need a comprehensive care plan—one that includes a combination of medications, physical therapy, and other remedies. The severity and cause of your neck pain overall will help your doctor determine which strategies are right for you.

Below are some possible treatments your doctor may propose based on the source of your neck pain.

Muscle Strain

For neck pain cased by serious muscle strain, your doctor may recommend transcutaneous electrical nerve stimulation (TENS)—the use of electric current devices to stimulate the nerves for therapeutic purposes, and/or pulsed electromagnetic field (PEMF) therapy—the use of pulsed electromagnetic fields to aid in regenerating tissue and reducing swelling faster. Neither is as scary as it sounds and some stimulation devices can even be used at home. Other therapies can include physical therapy, deep tissue massage, yoga, acupuncture, or chiropractic care. Three months of neck-specific exercise, for example, was found to be an effective treatment for patients with muscular neck pain caused by whiplash, according to a 2018 study by Peterson.

Over-the-counter pain relieving medications, such as Tylenol, or a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen (Advil) or naproxen (Aleve), can help to relieve minor neck muscle pain. Prescription medications such as muscle relaxants may be recommended to relieve muscle spasms. In some cases antidepressants may be prescribed to treat neck pain by blocking pain messages to the brain.

If the pain persists, two types of injections may be offered. A cervical epidural injection inserts anti-inflammatory medicine into the neck space that surrounds the membrane covering your spine and nerve roots. This injection often relieves pain for several months at a time by decreasing inflammation pain. Trigger point injections (TPIs), inserted into specific knots of muscle, can also provide relief.

(Source: 123RF)

Cervical Disc Herniation

Individuals diagnosed with disc herniation in the neck region are usually treated non-surgically with rest, NSAIDs, physical therapy, acupuncture, chiropractic manipulation, or therapies such as yoga, tai chi, or meditation. PEMF, described above, can also help reduce inflammatory cytokines, a large group of signaling proteins that are secreted by specific cells of the immune system to mediate and regulate immunity and inflammation, which play a dominant role in disc degeneration.

Injections into the cervical spine offer another treatment strategy, as these injections can help to reduce inflammation and/or reduce the size of the bulging disc material. Epidural steroid injections (ESIs) and newer injection options like collagenase, ethanol gel, or stem cells, are growing forms of treatment as well. Platelet rich plasma (PRP) and stem cells are being studied for use in the discs of the lower back, but have not yet been studied for use in the cervical spine.

If mechanical pressure on a nerve is identified as the main problem of your neck pain, a damaged disc can be surgically removed (called discectomy), replaced by an artificial disc (called arthroplasty), or replaced by an interbody device filled with bone or graft material that fuses the vertebrae (called a spinal fusion). Another surgery, called a laminoplasty, opens the spinal canal where the nerves are traveling so that there is more room for the nerves and dilapidated discs to coexist.

However, surgery comes with risks. Lingering pain in the form of post-laminectomy syndrome, also known as failed back surgery syndrome (FBSS), may occur.

Rheumatoid Arthritis

When neck pain stems from rheumatoid arthritis (RA), a variety of treatment options may be available to you. These include:

  • DMARDs: When RA is first diagnosed, early, aggressive therapy is usually recommended to reduce inflammation and prevent joint destruction. As a group, drugs that fight RA are called disease-modifying antirheumatic drugs (DMARDs). Methotrexate, for example, is one common DMARD typically prescribed.
  • biologics: If traditional DMARDs fail, Biologics (protein molecules) and other tumor necrosis factor (TNF)-blockers may be prescribed. Patients with RA tend to exhibit excessive TNF, which causes inflammation. One example of a biologic is infliximab, which uses proteins with monoclonal antibodies to halt excess TNF production. Another example is etanercept, which uses proteins with soluble receptors to block TNF actions.
  • steroids: glucocorticoids and prednisone may be given to reduce swelling.
  • surgery: the most important indications for surgery are opioid-resistant pain and neurologic deficits (abnormal functions of body areas).
  • emerging drugs: tanezumab, which pumps up nerve growth, and Janus kinase (JAK) inhibitors, which block enzymes located within stem cells, stimulating immune responses that contribute to symptoms of RA.

Alternative therapies such as yoga and exercise may also be recommended to keep your joints moving. Learn more on our Rheumatoid Arthritis Treatment page.

Meningitis

When neck pain is determined to be from bacterial meningitis, treatment includes a heavy course of antibiotics designed to kill the bacteria, typically infused in a hospital setting. Neck pain from viral meningitis, on the other hand, is generally considered to be benign and self-limiting, meaning it resolves spontaneously and usually without specific treatment.

Tumors

Surgery, radiation therapy, chemotherapy, or a combination of these treatments may be used to treat neck pain caused by a tumor. Age, general health, stage of cancer, and the location of the tumor will all play a role in the treatment course strategy.

To learn more, visit this comprehensive list of cancer organizations for support, information, and financial aid.

Cervical Myelopathy

A 2018 studyconcluded that while 30 to 50% of adults may experience neck pain in a given year, neck pain due to cervical myelopathy, while rare (4 per 100,000 people), requires urgent medical management, according to research published in the British Journal of General Practice by McCartney. Typical surgeries for this condition include anterior cervical decompression and fusion and posterior cervical decompression; both work to free the spinal cord from compression. Other surgeries sometimes used to treat cervical spondylosis in general are total disc replacement (TDR) and laminoplasty, a surgical procedure that relieves pressure on the spinal cord.

NSAIDs, such as aspirin or ibuprofen, and neuropathic pain medications, such as gabapentin, pregabalin, amitriptyline, or duloxetine, may help in the interim. Physical therapy, posture improvements, or modifying strenuous activity may be prescribed as well throughout your course of treatment.

Updated on: 05/03/19
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