Is Neck Pain a Muscle or Nerve Problem?

Neck pain is an extremely common problem that most people will experience at some point in their lives. But what actually causes neck pain? Is it a muscle issue or a nerve problem? The answer is that neck pain can involve both muscles and nerves, and determining whether it’s one or the other is important for finding the right treatment.

Muscle-Related Neck Pain

Many cases of neck pain are caused by strained muscles in the neck and upper back. Muscles can become strained and tight from poor posture, awkward positions, repetitive motions, and overuse injuries. When muscles are tight and inflamed, it puts pressure on surrounding tissues and can cause localized neck pain.

Muscle tension frequently causes neck pain that feels like a dull, achy soreness. It often results in stiff or reduced range of motion. Turning the head or bending the neck can make the discomfort worse. The pain is typically located in the back of the neck and upper shoulders. Muscle spasms may also occur with sudden sharp pains through the neck muscles.

Over time, chronic muscle tension can lead to myofascial pain syndrome. This condition is characterized by trigger points, which are irritated knots in muscle fibers that cause referred pain when compressed. Myofascial trigger points cause neck pain that can radiate to the head, shoulders, and upper back.

Nerve-Related Neck Pain

While muscles are a common source of neck pain, issues with nerves in the neck can also cause pain symptoms. The cervical spine contains nerves that branch out from the spinal cord and supply the head, neck, shoulders, and arms. Pressure or irritation on these nerves can result in neuropathic neck pain.

Pinched nerves in the neck are a frequent cause of nerve-related pain. Herniated discs, bone spurs, and other spinal conditions that narrow the nerve roots or spinal canal put pressure on nerves. This can cause pain, numbness, tingling, and weakness that radiates down the arms and even into the hands and fingers. Nerve compression in the neck is often called cervical radiculopathy.

Nerve dysfunction or damage from injury or disease can also lead to neck pain. A pinched nerve usually causes sharp, shooting pain down the arm, while nerve damage tends to cause a more constant, burning neck pain. The pain often follows the path of the affected nerve.

How to Tell if It’s Muscle or Nerve Pain

Because both muscle and nerve issues can cause pain in the neck area, how do you know which one is the culprit? Here are some clues:

  • Muscle pain is usually a stiff, sore, aching type of pain while nerve pain often feels sharp or burning.
  • Muscle pain is localized to the neck, shoulders, and upper back but nerve pain radiates down the arms and hands.
  • Muscle tightness and spasms are associated with muscle pain. Numbness, tingling, and weakness indicate nerve involvement.
  • Muscle pain is worsened by staying in one position too long. Nerve pain can be heightened by neck movement.
  • Muscle pain develops from overuse but nerve pain can seem to come on for no reason.
  • Pressing on muscles reproduces muscle pain. Pressing on nerves may improve nerve symptoms.

When to See a Doctor

Severe neck pain that persists for more than a few days or causes loss of movement and function requires medical attention. See a doctor right away if the pain radiates down the arm, you have numbness or weakness in the arm or hand, or you have trouble with coordination or bladder/bowel control. These can indicate nerve compression that shouldn’t be left untreated.

A doctor can evaluate your symptoms, perform imaging tests if needed, and determine whether a muscle or nerve issue is causing your neck pain. This will guide appropriate treatment to help resolve your pain and get your neck moving comfortably again. While neck pain can be annoying and debilitating, the right diagnosis leads to more effective care.