Symptoms pain in side of neck
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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There are multiple causes for neck pain. Neck pain may originate from any of the structures in or next to the neck. These include muscles and nerves as well as vertebrae and the cushioning discs in between. Neck pain may also come from areas near the neck, like the shoulder, jaw, head, and upper arms.
When the neck is sore, a person may have difficulty moving it, especially to one side. Many people describe this as having a “stiff neck”… or a “crick” in the neck.
If neck pain involves nerves (eg., a disc pressing on a nerve), a patient may feel numbness, tingling, or weakness in their arm, or hand.
Most neck pain comes from muscle strain or spasm. Many everyday activities are the culprits. Such activities include hunching over a desk for hours, slouching while watching TV or reading, having the computer monitor too high or too low, sleeping in an uncomfortable position, or twisting and turning the neck in a sudden manner while exercising.
Traumatic events like motor vehicle accidents or falls can cause severe neck injuries like vertebral fractures, whiplash (sudden jerking or "whipping" of the head forward and then backward), blood vessel damage, and even paralysis.
Other causes include a herniated disc, fibromyalgia, and arthritis (rheumatoid or osteoarthritis).
Meningitis, although much less common, can also cause significant neck stiffness. In addition, swollen lymph nodes or thyroiditis (inflammation of the thyroid gland) may be associated with neck pain on the side. Problems related to the trachea and esophagus may also be responsible for neck pain.
Rarely, inflammation of the blood vessels (arteritis) may cause neck pain.
For minor, common causes of neck pain, a person can try:
• Taking mild pain and anti-inflammatory medicine like acetominophen or ibuprofen.
• Applying heat or ice to the painful area. One good method is to use ice for the first 48 to 72 hours, then use heat after that. Heat may be applied with hot showers, hot compresses, or a heating pad. One should be careful not to fall asleep with a heating pad on as this may cause burns.
• Performing slow neck range-of-motion exercises -- up and down, side to side, and from ear to ear -- to gently stretch the neck muscles.
• Having a gentle massage for the sore or painful areas.
• Trying to sleep on a firm mattress without a pillow or with a special neck pillow.
Patients should see their doctor if:
• They have had the pain for one week or longer without relief from self-care measures.
• Their pain is associated with fever and headache, and the neck is exceedingly stiff.
• They have numbness, tingling, or weakness in their arm or hand.
• Their neck pain was caused by a fall, blow, or injury.
• They have swollen glands or a lump in their neck.
• Their pain does not respond to standard doses of over-the-counter pain medication.
In addition to a careful physical and neurologic exam, other tests may be needed.
• CT or MRI scan of the neck and/or head
• Blood tests such as a complete blood count or a thyroid test
• A lumbar puncture (spinal tap) for a cerebrospinal fluid analysis if meningitis is suspected
If the pain is due to muscle spasm or a pinched nerve,a muscle relaxant and possibly an analgesic or anti-inflammatory agent may be prescribed. The doctor may prescribe a neck collar. Referral to a neurologist or neurosurgeon is a good idea.
Treatments for muscle spasm - the most common cause of pain in the side of the neck- may include physical therapy, transcutaneous electrical nerve stimulation, and injections.
We have had excellent experience using Botox for those painful spasms that don't respond to other more conservative measures.
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