Overview of neck pain

Global Burden of Disease Study 2013 Collaborators, 2015 Hoy, 2014 Vos, 2012

Neck pain is a common condition affecting 1 in 20 people worldwide at any time. It is the fourth greatest contributor to global disability. It is more common in females than males, and the prevalence peaks at around 45 years of age.

Pain experienced in the neck region can originate from structures of the cervical spine, or can be nonspinal in origin; for example referred from sources in the head, chest, shoulders or arms. Neck pain can also be associated with headaches (see Cervicogenic headache in ../../Neurology/nrg/c_nrg5-c03-s2.html#nrg5-c03-s2__tnrg5-c03-tbl3a).

Most episodes of neck pain cannot be attributed to a specific cause and are acute and self-limiting (see Nonspecific neck pain).

Causes of pain originating from structures of the cervical spine include:

acute torticollis (‘wry neck’)—acute neck pain with associated neck muscle spasm and loss of neck rotation
whipash-associated disorder—neck pain associated with an acute acceleration–deceleration force, commonly a motor vehicle collision
cervical radiculopathy
cervical myelopathy
acute calcium pyrophosphate crystal arthropathy
rheumatoid arthritis with cervical spine involvement—may be associated with atlanto-axial instability; see Important consequences of rheumatoid arthritis for more information.

Although serious pathology is rare in patients presenting with neck pain in primary care, the presence of alerting features (‘red flags’) listed in Serious pathologies requiring urgent management in patients with back and neck pain and their alerting features (‘red flags’) requires urgent investigation.