Neck Strain or Spasm
Neck pain associated with muscle tightness often originates from poor posture such as sleeping wrong or sitting at a desk incorrectly. Typically, this pain will subside after a few days or weeks. Treatment may include rest, stretching, heat, ice, NSAIDs, and muscle relaxers. If the poor posture is not corrected, the pain may persist or recur. In these cases, it is important to correct the bad posture to help resolve it and prevent it from happening again.
Performing trigger point injections to the muscles around the neck and shoulders may help relieve pain. Trigger points are spots in muscles that are painful to the touch and also refer pain to other parts of the body. The most common locations for trigger points are in the neck. The pain may also move from the neck area to the shoulder and even possibly farther down the arm. The tight and painful muscles are typically injected with numbing medicine, such as lidocaine, using a small needle. The needle and the numbing medicine cause the muscle to relax, thus providing pain relief. In certain cases, Botox can be injected to provide even longer lasting relief of the pain.
Arthritis of the Neck
If your neck pain is caused by arthritis in the small joints in your spine, then NSAIDs, physical therapy, or injections are possible treatments to reduce your pain. X-ray will help identify the arthritis in the spine. NSAIDs can help reduce pain initially and physical therapy can help strengthen the muscles around the spine to take pressure off the arthritic joints to promote pain relief and prevent painful stress on the joints. If these conservative treatments fail, then steroid injections to the facet joints (the small joints in the spine) or medial branch blocks, which block the nerves that supply sensation to the facet joints in the spine, can be attempted.
Less commonly you might have pain in your neck that goes down into your arm. This may be associated with numbness or tingling sensations, and possibly even weakness. In these case, your pain is most likely caused by a pinched nerve in your neck. MRI and EMG can help confirm this diagnosis. NSAIDs, oral steroids, neuropathic pain medications (to treat nerve pain), and physical therapy are conservative treatment options that may be attempted at first to help control the pain. If these treatments to do not help, then epidural steroid injections to target the pinched nerve root can be attempted. In certain cases, surgery may be required.
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