There are very few upper-body movements that don't require use of the neck. That's why neck injury is one of the most common problems treated by orthopedists and physiatrists (doctors who specialize in rehabilitation medicine).

Most neck injuries are due to "one time overload-for example, putting too much strain on the neck by not keeping it in a neutral position while lifting a heavy object. Neck pain also can be caused by strain due to repetitive motions, such as twisting and turning the neck while exercising...muscle tension from stress.. arthritic changes...or whiplash. Also, neck pain can be "referred" pain stemming from shoulder or elbow injuries or gallbladder disease.

Good news: Since neck pain usually includes muscle inflammation, it responds well to self-care. Even chronic pain usually can be relieved—and prevented—with simple exercises. Surgery is recommended in rare cases, such as those in which neck pain is accompanied by radiating arm pain and compression of a nerve.

Reasons For Neck Pain

Severe neck pain usually comes on suddenly, but often there's an underlying irritation and/or weakness in the muscles. In most cases, the sufferer reports that the neck feels a little weak or sore, then suddenly worsens—after turning the head abruptly, for example.

When to get help: Neck pain that doesn't begin improving within 48 hours or is accompanied by neurological symptoms—tingling in the arms, hand weakness, loss of muscle strength, etc.—indicates a more serious problem. Examples…

  • Disk damage. A herniated disk (the gelatinous material inside a disk pushes through the outer coating and presses against nearby nerves) can be excruciatingly painful and, in severe cases, cause permanent spinal cord damage,

Red flag: A loss of bowel and/or bladder control or any of the above neurological symptoms. See a doctor immediately.

  • Arthritic changes. The joints in the neck can deteriorate or stiffen due to osteoarthritis or rheumatoid arthritis.
  • Whiplash. Injury results when the head is jerked violently forward and backward, as can occur during a car accident.

The above problems are diagnosed during a physical exam, often in conjunction with an X-ray and/or magnetic resonance imaging (MRI) scan. Treatment involves controlling inflammation and restoring strength and range of motion.

Rapid Pain Relief

In the absence of neurological symptoms, arthritis or traumatic injury, patients can assume that neck pain is probably due to muscle strain. To reduce muscle inflammation and pain…

  • Apply ice immediately. It's the quickest way to reduce inflammation as well as pain but only if you apply it within the first 24 to 48 hours. Hold a cold pack or ice cubes wrapped in a towel or washcloth to the painful area for 20 minutes once an hour throughout the day,

Important: Do not apply heat during the first two days after an injury. It relieves stiffness but can increase inflammation and pain.

  • Take the proper anti-inflammatory drug. Over-the-counter ibuprofen (Advil) and naproxen (Aleve) are equally effective at relieving muscle pain and inflammation.

Main difference: Ibuprofen is a relatively short-acting drug—generally lasting four to six hours. Naproxen lasts eight to 12 hours. Acetaminophen (Tylenol may help, but it mainly eases pain, not inflammation.

Caution: Ibuprofen and naproxen can cause stomach upset... acetaminophen can cause liver damage when combined with alcohol. Don't take any of these drugs for more than a week without consulting your doctor.

  • Stretch muscles often. Stretching lengthens muscle fibers and reduces the tension caused by neck-related ergonomic problems, such as how you sit at a computer or hold a telephone. Helpful...

While standing or sitting, slowly lower your ear toward your shoulder. Stop when pain significantly increases. Hold the stretch for a few seconds, then relax. Switch to the other side. Repeat eight to 12 times, five times a day.

Bring your chin toward your shoulder, following the directions above.

Although chiropractic treatment can help alleviate pain that emanates from the neck joints, its effects are not long-lasting. Acupuncture also may be helpful but needs to be repeated until the pain dissipates.

Long-Term Neck Care

Most people with chronic neck pain need to perform strengthening exercises (consult your doctor first) and change their posture.

Important: Don't sleep on your stomach—and don't raise your head too high with pillows. Both put excessive pressure on the neck.

Better: Sleep on your side with your head level—propped just high enough to keep your nose in line with your navel. The pillow (when compressed) should be just thick enough to support the side of your head without elevating it.

If you spend a great deal of time on the telephone, use a headset. Cradling a phone between the neck and shoulder is one of the most common causes of neck pain. Choose a headset that is comfortable for you. Good ones, such as those made by Plantronics, are available for $40 to $100 at electronics stores.

If you spend time at a desk, adjust your workstation. The center of a standard computer monitor should be directly at eye level (a bit lower if it's a large monitor)...your knees should be slightly lower than your hips...and use your chair's armrests when possible to avoid hunching forward.

Strengthen your neck and shoulders—they share some of the same muscles. Keeping these muscles strong makes them more flexible and less prone to injury. Perform eight to 12 repetitions of each of the following exercises three times, two to three days a week. Once you can do 12 repetitions easily, gradually increase the weight lifted.

  • Shrugs. While standing straight with your arms down at your sides, hold a two-pound dumbbell (or a household object, such as a can of soup) in each hand. With palms facing your thighs, shrug your shoulders as high as possible, keeping WW your head straight. Hold for five seconds, then return to the starting position.
  • Flies. Lie on your back on an exercise bench, with a two-pound dumbbell in each hand. Hold your hands out to the sides so that the weights are about even with your chest. Keeping your back straight, raise your arms over your chest in a semicircular motion until the 3 weights touch in the middle over your chest. Lower them back to chest level in the same semicircular motion.
  • Side deltoid raise. While standing straight with your arms down at your sides, hold a two pound dumbbell or other weight in each hand, with your palms facing your thighs. Keeping your elbows slightly bent, raise your arms up and out to your sides until they're shoulder level (your palms will be facing the floor in this position). Hold for five seconds, then slowly lower the weights.

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