Can Neck Pain Be A Sign of Something Serious?

Neck pain can be serious, but not often. Most neck pain is caused by musculoskeletal conditions, followed by neurological conditions, and most rarely, an infection, tumor or autoimmune condition.

Neck pain affects about 10 to 20 percent of adults and can have numerous causes. Most neck pain is caused by musculoskeletal conditions (e.g., cervical strain, cervical spondylosis, cervical discogenic pain), followed by neurologic conditions (e.g., cervical radiculopathy) and non-spinal disorders (e.g., infection, malignancy, rheumatologic disease). 

Many neck injuries are referred to as ‘cervical’ injuries because they occur in the cervical spine, which consists of the uppermost vertebra of the spine, located in the neck. 

Musculoskeletal conditions that cause neck pain include: 

• Cervical strain 
  • Can be a result of poor posture, sleep position, and physical stress of everyday activities
• Cervical spondylosis 
  • A result of degenerative changes in the spine
• There may be associated pinched nerves (radiculopathy)
  • Cervical discogenic pain 
• Disc degeneration
  • Whiplash injury 
  • Neck injury that results from an acceleration-deceleration process that causes sudden extension and flexion of the neck, such as in a motor vehicle accident
  • This motion can injure intervertebral joints, discs, and ligaments; cervical muscles; and/or nerve roots
• Cervical facet osteoarthritis
  • A result of osteoarthritic changes
• Myofascial pain syndrome 
  • A regional pain disorder associated with trigger points, taut bands, and pressure sensitivity that may occur after injury or overuse 
• Diffuse skeletal hyperostosis 
  • Abnormal bone formation in the insertions of the ligaments and tendons of the spine

Radiculopathy/myelopathy conditions that cause neck pain include:

• Cervical radiculopathy 
• Dysfunction of the spinal nerve root
• Degenerative changes of the spine such as cervical foraminal stenosis and cervical herniated disc account for 70 to 90 percent of cases
• Less common causes include herpes zoster, Lyme radiculopathy, and diabetic polyradiculopathy
• Cervical spondylotic myelopathy  
• Spinal cord injury or dysfunction caused by degenerative changes narrowing the spinal canal
• Ossification (bone formation) of the posterior longitudinal ligament
• Abnormal calcification of the posterior longitudinal ligament, usually in the cervical spine 

Non-spinal conditions that cause neck pain include:

• Cardiovascular disease: chest pain (angina pectoris) and heart attack (myocardial infarction)
• Infection: bone infection (osteomyelitis), inflammation between the discs of the spine (discitis), deep neck abscess, meningitis 
• Malignancy: cancer that has spread (metastasized) to the cervical spine 
• Neurologic conditions: tension headache, involuntary contraction of neck muscles (cervical dystonia), brain tissue extending into the spinal canal (Chiari malformations)
• Referred shoulder pain: nerve impingement, adhesive capsulitis, rotator cuff tear 
• Rheumatologic conditions: polymyalgia rheumatica, fibromyalgia 
• Thoracic outlet syndrome 
• Vascular conditions: vertebral artery or carotid artery dissection 
• Visceral causes: esophageal obstruction, biliary disease, apical lung tumor 

If neck pain is accompanied by any of the following symptoms, see a doctor because it may be a sign of something serious: 

• Pain is severe or does not go away
• Pain spreads down arms or legs 
• Fever 
• Headache 
• Nausea and vomiting
• Weakness
• Numbness or tingling 
• Fatigue
• Confusion 
• Mood swings 
• Dizziness
• Loss of coordination
• Unexplained weight loss