Neck pain is an exceedingly common problem that most people experience at some point in their lives. While mild to moderate neck pain often resolves on its own within a few days or weeks, some cases can linger for months or even years. If you’re dealing with chronic or severe neck pain that just won’t go away, it’s important to take steps to find relief.
Causes of Persistent Neck Pain
There are many potential causes of persistent neck pain, including:
- Muscle strains and sprains. Repeated heavy lifting, poor posture, or whiplash injuries can overstretch the muscles and ligaments in the neck. This can cause chronic tightness and pain.
- Herniated discs. Discs act as cushions between the vertebrae. A herniated disc that presses on nearby nerves can cause radiating neck and arm pain.
- Spinal arthritis. Wear and tear of the spinal joints from aging or injury leads to bone spurs, inflammation, and narrowing of the spinal canal. This pinches nerves and causes pain.
- Spinal stenosis. Narrowing of the spinal canal itself places pressure on the spinal cord and nerves.
- Abnormal neck curvature. An excessively curved neck can alter spinal alignment and mechanics, leading to muscle strain and nerve compression.
When to See a Doctor
It’s reasonable to give acute neck pain a few weeks to improve on its own. But if pain persists beyond 3-4 weeks, it’s time to make an appointment with your doctor. Let your doctor know how long symptoms have lasted, what makes the pain worse or better, and whether you have any numbness/tingling in your arms or hands.
Your doctor will perform a physical exam to assess your range of motion and look for any red flags. They may order imaging tests like x-rays or an MRI to evaluate your spinal anatomy in more detail. These tests can pinpoint sources of nerve compression, arthritis, and other abnormalities.
Seeking early treatment for chronic neck pain can help avoid long-term issues. Your doctor can offer medication, injections, or physical therapy to help relieve symptoms. If conservative treatments aren’t effective, surgery may be warranted in some cases.
When to Consider Surgery
For most people with chronic neck pain, surgery is a last resort after trying more conservative treatments. But in certain cases, surgery becomes the best option to correct an anatomical problem and provide lasting relief.
Red flags that surgery may be needed include:
- Radiculopathy – Numbness, weakness, or radiating pain in the arm that hasn’t improved with 6+ weeks of nonsurgical care. This suggests nerve compression.
- Myelopathy – Symptoms of spinal cord damage like clumsy hand coordination or bowel/bladder changes. Requires urgent surgery.
- Significant cervical spine instability – Excessive motion between two cervical vertebrae due to injury. Needs fusion surgery for stabilization.
- Unrelenting pain – Chronic severe pain that remains disabling despite months of nonsurgical treatments.
- Large cervical herniated disc – A very large, symptomatic herniated disc unlikely to improve without surgical removal.
Surgery for neck pain may involve removing part of a damaged disc (discectomy), fusing two vertebrae together (cervical fusion), or other procedures. The goal is to take pressure off compressed nerves and stabilize the cervical spine.
Though recovery takes time, most patients experience significant pain relief and improved function after surgery for cervical radiculopathy or myelopathy. Discuss your options thoroughly with your spine specialist.
When to Seek Physical Therapy
If you’re dealing with stubborn neck pain, submitting to regular physical therapy is highly recommended. A physical therapist can offer treatments and targeted exercises to significantly ease neck pain and stiffness.
Physical therapy is especially helpful for:
- Improving range of motion and flexibility
- Strengthening the neck and shoulder muscles
- Correcting posture and body mechanics
- Treating muscle spasms and trigger points
- Managing pain and inflammation
- Learning proper home exercise programs
- Preventing future neck injuries
A physical therapist may use manual therapy techniques like massage, mobilization, and dry needling to loosen tight muscles. They’ll also design an exercise regimen to address your specific needs and functional deficits. Physical therapy usually brings progressive, lasting relief of chronic neck pain.
Ask your doctor for a therapy referral. Most insurance plans cover a prescribed course of PT. Commit to it at least twice a week for 6-12 weeks to get the most benefits. PT combined with other treatments can help you finally overcome stubborn neck pain.
When to Try Chiropractic Care
Seeing a chiropractor is another option if you’re struggling with neck pain that hangs on for months. Chiropractors use hands-on spinal manipulation and mobilization to improve alignment and mobility of the neck vertebrae.
The popping and cracking sounds that may occur with an adjustment are from releasing gas pockets within the joints to allow better motion. Chiropractic isn’t proven to be more effective than other treatments for most types of neck pain. But it may relieve pain and dysfunction for certain individuals.
Situations where chiropractic care could be beneficial include:
- Chronic mechanical neck pain with no identifiable cause
- Neck pain with muscle spasm or reduced range of motion
- Neck stiffness and headaches due to poor posture
Start with just a few appointments to see if this hands-on approach eases your lingering symptoms. Beware of any chiropractor who recommends months of frequent manipulations. Talk to your medical doctor before pursuing long-term chiropractic treatment.
Hope for Healing Persistent Neck Pain
If you’ve been stuck battling chronic neck pain for months on end, don’t lose hope. While neck pain can be complex, there are many different treatment avenues to explore for relief. Getting a proper diagnosis and customized treatment plan from your doctor is the first step.
From there, a combination of medication, physical therapy, lifestyle changes, massage, and possibly surgery or chiropractic care can help overcome stubborn pain. Commit to the process. With various therapies working together, most people find an effective strategy for managing persistent neck pain and getting back to normal life.