What is acute neck pain?

Acute neck pain is a general descriptive term used for pain that has been present usually for less than six weeks. It is a time description and the term covers pain that may have started for a variety of reasons. Neck pain is felt anywhere between the base of the skull and the upper shoulder region. It is often in a very local area on the back or side of the neck, but, on occasions, the neck pain may spread. When pain is coming from structures in the upper part of the neck, it may spread to the head—a neck-related headache. Pain coming from structures in the mid to lower part of the neck may spread to the upper back region or into the upper arm.

What causes acute neck pain?

Acute neck pain is often described as an ache when the head is still. The movements of the neck are frequently reduced and, in some circumstances, a sharp pain may be felt with certain movements such as turning quickly or looking up. For some people, it may be the first episode of pain or, for others, it is a subsequent episode. Causes may include:
  • A specific incident that causes acute neck pain. For exampple a quick turn of the neck.

  • Sleeping in an awkward position.
  • A more substantial injury like getting hit on the head or an impact like falling off a bike.
In many other cases, the pain comes on gradually over hours or days, and is often related to unfamiliar activity, for instance, after painting ceilings all weekend or working in a poor or awkward posture.As a result of the incident or unfamiliar activity, the joints and ligaments of neck may become strained and painful. The muscles usually react to limit movement and they too may become painful.

Symptoms of acute neck pain

Acute neck pain can range in intensity from mild to moderate severity. Symptoms include:
  • Pain on head and neck movements.
  • The neck is usually tender to touch.
  • Sleeping may be uncomfortable.
Your physiotherapist will undertake a clinical examination of the neck to identify the likely cause of pain. X-rays are usually unhelpful and unnecessary. The exception is after a forceful injury, when it is necessary to rule out fractures.On very rare occasions, acute neck pain may have a serious medical cause. For instance, pain felt running up the front of the neck may be coming from the heart. A rapid onset and rapidly worsening upper neck pain, with a very unusual, severe headache, may indicate a problem with an artery in the neck and requires immediate medical investigation.

Conservative treatment of acute neck pain

Physiotherapists first undertake a clinical examination to determine the reason for the pain and how it is affecting the movement of the joints, and how it has affected the muscles of the neck—some muscles may be in spasm, others may not be working properly because of the pain.Treatment methods used by physiotherapists that have proven to help ease the pain and restore normal function of the neck include:
  • Explaining the reason for the pain and providing assurance
  • Gentle manual therapy
  • Gentle, specific exercise and self-help strategies.
  • Manual therapy consisting of rhythmic movement (mobilisation) to treat the neck pain, but, on occasions, a manipulation may be deemed necessary. The evidence suggests both of these manual therapy methods are equally helpful.
The gentle, specific exercises have several purposes:
  • To ensure the muscles supporting the neck continue to work
  • To help ease pain
  • To help restore normal neck movements.
  • The exercises are progressed as pain settles, as it is important that normal movement and muscle function return after an acute episode of pain.
Your physiotherapist will also advise on self-management strategies to be used at home.The use of heat can be soothing for a sore neck. The most comfortable sleeping position will depend on the individual. It is usually lying on the side or the back, ensuring that the head and neck are adequately supported by one or two pillows. Lying on the stomach is not recommended, as it places the neck in near end range positions. It is important that the exercises are practised at home and normal activities are resumed as soon as possible.