What are some medications for neck pain?
____________________ Oladimeji Ewumi _ 22/08/2022
reviewed by Alisha D. Sellers, BS Pharmacy, PharmD
Doctors can treat neck pain with prescription and over-the-counter (OTC) medications. A person can also try home remedies and alternative treatments.
The neck is the flexible part of the body that supports the weight of the head. Due to its position and structure, the neck can be vulnerable to conditions that cause pain and restrict movement.
Neck pain is one of the most commonTrusted Source musculoskeletal disorders. Most cases of neck pain are mild and will resolve on their own within a few days. However, when a person’s neck pain lingers for more than a week, they may need medications or other treatments.
This article looks at OTC and prescription medications for neck pain. It also outlines some alternative treatments and home remedies.
OTC medications for neck pain
OTC medications for neck pain include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs).
Acetaminophen
Acetaminophen, also known as paracetamol or Tylenol, is usually the first-line treatment and one of the most common analgesics for people with neck pain. While its mechanism of action remains unclear, researchers believeTrusted Source it has a multidirectional effect across several metabolic pathways to relieve pain.
Doctors may administerTrusted Source acetaminophen as single drug therapy to treat mild and moderate neck pain or in combination with an opioid analgesic to treat severe neck pain.
People should take only the doctor-recommended doses of acetaminophen. They should avoid taking more than the doctor recommends or using it with alcohol to reduce their risk of liver damage.
NSAIDs
Neck pain due to infection, injury, or other conditions can affect the structures in the neck and may lead to swelling or inflammation. In these cases, doctors may recommendTrusted Source NSAIDs to alleviate pain and reduce inflammation.
NSAIDs act by inhibiting the action of the enzyme cyclooxygenase (COX). COX converts arachidonic acid to prostacyclins, prostaglandins, and thromboxanes — the enzymes implicated in inflammatory responses.
NSAIDs are available in oral tablet form or as topical creams, gels, and patches.
Examples of NSAIDs doctors commonly prescribe include:
ibuprofen (Advil)
naproxen (Aleve)
acetylsalicylic acid (Aspirin)
Prescription medications for neck pain
Doctors may prescribe medications to treat neck pain. These include:
Opioids
A doctor may prescribe opioids to treat chronic neck pain when NSAIDs and other analgesics are ineffective.
Opioids bind to opioid receptors in the nerve cells of the brain, spinal cord, and other parts of the body. This results in the blockage of pain messages from the body to the brain.
However, a 2020 analysis suggests that a minority of patients benefit from using opioids long-term and that people who use them for long periods may be at a higher risk of overdose and addiction.
Corticosteroids
Corticosteroids offer relief by reducing inflammationTrusted Source and immune responses associated with neck pain. To reduce the risk of side effects, doctors will prescribe the lowest dose to produce the desired result.
Some examples of corticosteroids include:
cortisone
prednisone
prednisolone
methylprednisolone
Corticosteroids are available in the following forms:
tablets
capsules
lotions, creams, ointments, or gels
nasal or mouth sprays
injections
Muscle relaxants
A doctor may prescribe a muscle relaxant with pain medication to treat neck pain that occurs due to stiff neck muscles or damage to spinal cord nerves.
Different muscle relaxants work in different ways. They can work on the brain, spinal cord, or directly on the muscle to reduce stiffness, pain, and any associated discomfort.
There are two classes of muscle relaxants:
Antispastics
These work on the spinal cord or muscles and can help treat spinal cord injuries and conditions that cause spasms.
Examples of antispastics include:
baclofen (Lioresal)
dantrolene (Dantrium)
tizanidine (Zanaflex)
Antispasmodics
These bind to receptors in the cell membrane of muscles and inhibit sudden involuntary muscular contractions known as spasms.
Some common forms of antispasmodic medications are:
diazepam (Valium)
carisoprodol (Soma)
cyclobenzaprine (Flexeril)
metaxalone (Skelaxin)
Anticonvulsants
Although doctors recommend anticonvulsants for people with epilepsy, their nerve-calming potential may alsoTrusted Source soothe the burning sensation from nerve damage causing neck pain.
Examples include:
divalproex sodium (Depakote)
lamotrigine (Lamictal)
valproic acid (Depakene)
carbamazepine (Equetro)
topiramate (Topamax)
Antidepressants
Doctors can prescribe antidepressants to manage chronic pain even when a person does not have depression. These medications treat pain by increasing the level of neurotransmitters in the spinal cord.
The high level of neurotransmitters can reduce the transmission of pain signals to the brain and spinal cord.
Doctors may prescribe the following antidepressants to treat pain:
Selective serotonin reuptake inhibitors
Selective serotonin reuptake inhibitors (SSRIs) increaseTrusted Source serotonin levels in the brain. They generally cause fewer side effects than other antidepressants.
Examples of SSRIs include:
citalopram (Celexa)
fluvoxamine (Luvox)
escitalopram (Lexapro)
fluoxetine (Prozac)
paroxetine (Paxil)
sertraline (Zoloft)
Serotonin-norepinephrine reuptake inhibitors
Serotonin-norepinephrine reuptake inhibitors (SNRIs) may effectively treat people with chronic neck pain and depression. They increase the levels of serotonin and norepinephrine in the brain.
Examples of SNRIs include:
levomilnacipran (Fetzima)
duloxetine (Cymbalta, Yentreve)
venlafaxine (Effexor)
Tricyclic antidepressants
Tricyclic antidepressants (TCAs) may relieve neuropathic pain by blocking the reabsorption of the neurotransmitters serotonin and noradrenaline.
TCAs include:
clomipramine (Anafranil)
amitriptyline (Elavil)
desipramine (Norpramin)
imipramine (Tofranil)
nortriptyline (Pamelor)
Other treatments
Doctors may recommend other treatments alongside medications, such as:
Epidural injections:
If chronic neck pain is due to injury or damage to a nerve root in the neck, a doctor may administerTrusted Source an epidural injection to relieve pain. The doctor will inject an epidural corticosteroid into the facet joints at the back of the spine.
Physical Therapy:
A physical therapist will teach a person alignment and neck-strengthening exercises to improve the movement and function of their neck muscles.
Surgery:
On rare occasions, a doctor may recommend surgery to ease neck pain by decompressing a nerve root or stabilizing a cervical spine. Surgery may be the last resort when all other forms of treatment are ineffective.
Home remedies and alternative treatments
A person can practice the following self-care remedies to ease neck pain:
Exercise:
A person can ask a doctor or physical therapist for easy at-home neck exercises to relieve tension and pain. Research from 2019 suggests that neck exercises may significantly benefit people with chronic neck pain.
Massage therapy:
A massage therapist or another person can lightly stroke the neck muscles with moderate pressure while the person with neck pain lies prone. According to a 2020 study, massage therapy can give short-term relief to people with chronic neck pain.
Acupuncture:
In this procedure, an acupuncturist will insert needles into the skin of the neck to produce the desired pain-relieving sensation.
Ice and heat therapy:
A person can apply an ice pack or warm pads to the point of neck pain for 20–30 minutes. Alternating the temperature on the surface of the neck can help ease any burning or tingling sensations.
Transcutaneous electrical nerve stimulation (TENS):
TENS is a portable, battery-operated device that generates electrical impulses. This mild electrical current may reduce the intensity of pain traveling to the brain and spinal cord.
When to contact a doctor
If neck pain does not resolve within a few days, a person should contact a doctor.
The American Academy of Orthopaedic Surgeons notes that a person should speak with a doctor if they have neck pain and any of the following symptoms:
fever
nausea
vomiting
tingling sensations in the neck
neck stiffness
pain spreading to other parts of the body
a lump on the neck
severe headache
severe or worsening pain
A doctor can help rule out any underlying cause and recommend the best treatment.
Outlook
A 2015 report states that neck pain is the fourth leading cause of disability. The authors also note that while most episodes of neck pain will resolve with or without treatment, nearly 50% of people will continue to experience some degree of pain or frequent occurrences.
Evidence from 2020 estimates that as much as 67% of the world population will experience neck pain some time in their lives. In addition, people who sit for over 95% of their working time have a twofold higher risk of cervical spine pain than those who have never worked in this position.
When neck pain results from pressure on a nerve, that pressure can also lead to numbness, pain, or weakness in the part of the arm the nerve supplies.
While medications, physical therapy, and home remedies can effectively treat neck pain, surgery can be the most effective form of treatment when other treatment options fail.
Summary
If a person has persistent neck pain, a doctor will identify the location and cause of pain to determine the most suitable treatment.
Medications for neck pain include OTC or prescription medications. The doctor may also recommend other treatment options, including surgery in severe cases.
Before taking a medication, a person should discuss potential side effects with the doctor to avoid adverse drug interactions.
Home remedies for neck pain include exercise, massage, and heat or ice therapy.
What are the possible causes of neck pain?
_________________________ Shannon Johnson _ 15/10/2019
reviewed by Stacy Sampson, D.O.
Many people experience neck pain or stiffness from injury, overuse, or inflammation. There are many treatment options available for neck pain, depending on what is causing it.
The neck consists of seven vertebrae. These are interlocking bones, separated by disks, that enable movement and stability.
The neck is less protected than the rest of the spine. For this reason, it may be more prone to injury or conditions that cause pain.
Many cases of neck pain are mild and will resolve on their own within a few days. Sometimes, however, neck pain can be a sign of something more serious.
This article will discuss different causes of neck pain and how to treat them.
Causes
There are many possible causes of neck pain, including:
Muscle strain
A possible cause of neck pain is muscle strain.
Straining the neck muscles can cause soreness in the area. This soreness might present as an aching or throbbing pain.
It can also cause a sharp pain, especially when moving the head.
Muscle strain can occur as a result of:
having bad posture
sleeping in a position without good neck support
sitting at a desk or computer for too long
Cervical spondylosis
Cervical spondylosis, or cervical disk degeneration, refers to when the disks between the neck’s vertebrae wear down.
This increases friction between the vertebrae and can cause pain and stiffness in the neck as a result.
These disks typically wear down over time, so cervical spondylosis becomes more common with age.
The disk can also begin to bulge out and put pressure on the spinal cord or its nerve roots. This degenerative process may worsen, leading to a herniated cervical disk fragment. This can fully push against nerve tissue to cause significant neck pain that may also radiate to the shoulder and down one or both arms.
Injury
The neck is flexible and constantly supporting the head. This makes it particularly susceptible to injury.
Examples of possible neck injury causes include:
motor vehicle accidents
impact sports, such as football
falls
diving
weightlifting
Damage to a muscle or ligament usually causes neck injuries.
In more severe cases, injury can lead to a broken neck. This is occurs when one or more of the vertebrae becomes fractured.
A broken neck can cause severe pain that may spread to other areas of the spinal cord. It also increases the risk of further injury to the spinal cord and loss of neurological function, including paralysis.
Cervical radiculopathy
Cervical radiculopathy involves a pinched nerve. This occurs when a nerve root from the spinal cord in the neck becomes irritated or compressed. This gives rise to radiating pain from the neck to the shoulder and upper extremity.
It can also cause muscle weakness, numbness, and a tingling sensation through the arms or hands.
Other conditions, such as arthritis, can also lead to cervical radiculopathy, as can injuries resulting in a herniated cervical disk.
Spinal stenosis
Spinal stenosis refers to the narrowing of the spinal canal that puts pressure on nerve roots. This narrowing usually occurs in the neck or lower back.
People with spinal stenosis can experience pain in their neck, back, or legs. The pain is usually worse with activity, but sometimes, posturing the neck in a certain way can relieve the discomfort.
Osteoarthritis typically causes spinal stenosis. Other causes of this condition include spinal tumors, birth defects, and Paget’s disease.
Meningitis
A person with meningitis may experience neck stiffness.
MeningitisTrusted Source refers to inflammation of the membranes surrounding the brain and spinal cord. An infection, such as from bacteria or a virus, can cause this inflammation to occur.
Bacterial meningitis can be serious and sometimes life threatening. If any of the following symptoms arise, immediate medical attention is necessary:
neck stiffness
fever
headache
nausea
vomiting
sensitivity to light
Cancer
Head and neck cancers can cause pain in the neck. These forms of cancer make up about 4% of all cases of cancer in the United States.
There are several different types of head and neck cancers, including:
nasal cavity and paranasal sinus cancer
laryngeal cancer
oral cancer
nasopharyngeal cancer
salivary gland cancer
Other symptoms of head and neck cancers include:
mouth sores
growths on the head or neck
voice changes
trouble breathing
jaw pain
fever
fatigue
weight loss
Home remedies
There are many ways to ease neck pain at home, including by:
taking over-the-counter pain relief medication, such as acetaminophen (also called Tylenol)
placing warm or cold packs on the neck to reduce pain symptoms
avoiding contact sports and heavy lifting
seeing a physical therapist
doing gentle neck stretches
keeping good posture
engaging in light exercises, such as yoga
using supportive neck pillows for sleep
There are also many different neck exercises that can help relieve pain. To try a simple exercise for the neck:
Stand up or sit in a chair with the feet flat on the floor, around shoulder width apart.
Slowly turn the head to the right until feeling a gentle stretch. Be careful to avoid stretching too far and causing further pain. Hold this position for 10–30 seconds.
Turn the head to the left and hold for 10–30 seconds.
Repeat these steps up to five times on each side.
For more serious cases of neck pain, a doctor may recommend corticosteroid injections or surgery.
Prevention
Regular exercise can help keep joints loose and flexible.
Some tips to prevent neck pain or injury include:
practicing good posture, especially when sitting at a desk or looking at a computer
sleeping on a supportive mattress and pillow
regularly exercising to keep joints loose and flexible
wearing a seatbelt while in the car
not diving into shallow water
wearing suitable protective gear during sports or exercise
When to see a doctor
In most cases, neck pain will go away on its own. However, it is important to see a doctor if the following symptoms occur:
neck pain following a motor vehicle accident, fall, or diving accident
pain, numbness, or weakness that spreads to the arms and legs
bowel or bladder problems
severe or worsening pain
severe headache with neck pain or stiffness
signs of fever
nausea and vomiting
a lump in the neck or head
Outlook
Neck pain is common and tends to go away on its own within a few days.
Poor posture and muscle strain or tension are some common causes of neck pain.
Some people will have more severe neck pain, sometimes with additional symptoms that occur in nearby areas. This could be a sign of something more serious. In these cases, it is essential to see a doctor.
Neck pain:
What does it mean?
________________________ Markus MacGill _ March 1, 2019
reviewed by William Morrison, M.D.
Neck pain can occur suddenly, or it can develop over time. It can be mild or serious. Some causes of neck pain need urgent attention. Sometimes, neck pain can begin in another part of the body.
The neck contains the spine, which runs down it at the back, and the air pipe at the front. Otherwise, it consists of soft tissues, including muscle, blood vessels, and nerves.
Many common forms of neck pain are not serious, but some need urgent medical attention.
Causes of neck pain include trauma, such as a road traffic accident, and medical reasons, such as osteoporosis.
This article will look at some causes of neck pain and how to treat them.
Common causes
Overexertion, an injury, or a poor sitting position are all common causes of neck pain.
Many common causes of neck pain are not serious.
They may result from:
strains and sprains
poor posture, or being in one position for too long
longer-term bone and spine problems
People with severe or long-term neck pain should see a doctor.
Sprains and strains
Strains and sprains to the muscles or ligaments in the neck may occur after physical activity.
Strains and sprains are different, but the symptoms and treatment are similar.
A sprain: The ligament becomes stretched or tears. The ligaments connect the bones at a joint. When a ligament tears, there may be a popping or tearing sensation.
A strain: The muscle or tendon become stretched or torn. Tendons connect the muscle to the bone.
Causes
A sprain or strain can happen when something causes the neck to extend further than it normally does, for example, during exercise or in a road traffic accident.
It can happen if a person
has been trying a new activity
has done more of the activity than usual
has stretched their neck too far
has made a sudden movement
has not warmed up before exercising
It can lead to:
pain in the back of the neck that gets worse when the person moves
muscle spasms in the shoulder blade
numbness or tingling in the hand, arm, or both
a headache in the back of the head
pain that gets worse after 24 hours, rather than at once
Treatment
Applying ice or heat after a sprain or strain may help to reduce discomfort.
The following may ease discomfort and help the injury to heal:
resting from any exercise that caused the injury
wearing a soft collar to support the head and neck
applying ice to help ease pain and reduce inflammation for 2–3 days after an injury
using heat pads to relieve ongoing pain
taking medication to relieve pain and relax muscles
This type of injury often disappears in time.
If initial sprain or strain aches and pains do not improve within days or do not resolve within 1–2 weeks, the person should see a doctor.
A pinched nerve
In cervical radiculopathy, a nerve becomes pinched, compressed, or irritated at the point where it leaves the spine.
There may be:
pain on one side of the neck that radiates down one shoulder and arm
and numbness and tingling in the arm and hand
muscle weakness
Causes
It can result:
when bones degenerate with age or due to a medical condition
when an accident when lifting or bending, for example, causes damage to a disk
The discomfort usually goes away within days or weeks.
Treatment
Treatment will probably involve:
pain relief medication
physical therapy
oral or injected steroids to relieve pain
A cervical collar may help, but people should only use it for a short time, as the muscles that support the neck can become weak through lack of use.
If it persists, a doctor may recommend surgery.
Arthritis
Cervical spondylosis is a type of arthritis that affects the neck. It is a common problem as people get older, and it can lead to pain and stiffness in the neck.
Causes
As people get older, the following may happen:
the cartilage and bone wear away
bone spurs develop as the body tries to compensate for the loss of bone
ligaments can become less flexible
disks between the vertebrae erode
This can lead to:
a stiff neck
pain in the neck and shoulders
tingling, numbness, and restricted movement in the arms
Treatment
Treatments include:
pain relief medication
using a neck brace to support the head and neck
massage and physical therapy
If these treatments do not work, a doctor may suggest surgery, but this is rare.
Heart attack
Serious heart events, including a heart attack, can involve neck pain.
A person with neck pain needs immediate help if they also have:
chest pain that feels like pressure or tightness
severe, ripping chest pain
difficulty breathing
pain down the left arm, shoulder, or both
feeling dizzy
sweating
nausea
Infections
Sometimes an infection can lead to neck pain.
When viruses or bacteria attack the body, the immune system responds to fight the attack. One result of this is swollen lymph nodes or “glands,” as people commonly call them. Swollen lymph nodes in the neck area can cause pain.
Neck pain can also be a sign of a brain abscess, meningitis, or other serious infections. If the pain is severe and there are other symptoms, such as a fever, a person should see a doctor.
Anyone who has recently had surgery or a wound should be alert and seek treatment for any possible infection as soon as possible.
A tumor in the area of the neck or head can also cause neck pain.
Injury
If a person has had an accident — such as a fall or a collision in sport — they may have a back or neck injury.
The person may have severe pain in the neck, or they may be unresponsive and not show any signs of pain.
There may also be:
tingling or numbness
bowel or bladder incontinence
loss of control over part of the body
difficulty breathing
Treatment
The person needs immediate medical attention.
First aid advice for possible neck injuries includes:
Calling for medical help, especially if the person is not responding.
Avoiding moving the person, and especially the head and neck, as far as possible.
A qualified first aider may immobilize the neck by holding the head still or by applying a brace.
If the person is moving their head and is generally responsive, they may still need a medical assessment. Some injuries may appear minor, but they can quickly become serious.
Wry neck (torticollis)
Sometimes, a genetic factor or injury can result in a wry — or twisted — neck, known as torticollis. The person’s head will tilt to one side.
A child may be born with congenital torticollis, but it can also result from irritation to the ligaments of the neck.
Causes
This could be due to:
an infection
an injury or herniated disk
a sharp movement
scarring or muscle shrinkage due to a burn or other injury
sleeping a bad position
a neck muscle spasm
Treatment
Treatments include:
wearing a neck brace
heat, ultrasound, or physical therapy
In severe cases that do not respond to other treatment, the person may need surgery.
Whiplash
Whiplash can result from a road accident. It is an injury to the soft tissues of the neck such as the muscles.
Any impact that causes sudden, forceful movement of the head and neck may lead to whiplash.
Symptoms include:
neck pain that may spread to include a shoulder or arm
a headache
not being able to turn the neck as far as usual
tiredness, dizziness, numbness, or nausea
muscle spasm
Doctors will first rule out or treat other more serious problems before diagnosing a case of whiplash.
Between 20 and 40 percent of people who experience whiplash will develop long-term symptoms, but treatment, including physical therapy, can help to prevent these.
No obvious cause
Sometimes a person has long-term neck pain, but medical examination finds no specific cause.
Possible causes
Reasons for this could be:
stress
inappropriate posture, due, for example, to a computer screen being too high
actions or occupations that require a person to hold their head in a particular position, such as painting ceilings, for a long time
Treatment
A massage may help relieve some types of neck pain.
A person may benefit from:
getting reassurance that there is no serious cause
keeping moving
changing their posture, including, perhaps, reviewing how they sit when driving or working
movement and stretching regularly when sitting in one position for a long time
stretching and exercise, including physical therapy and massage
painkillers
Outlook
Neck pain is a common problem. Although it can cause discomfort, it is often not serious.
However, sometimes it can:
start after an injury
occur with other symptoms, such as chest pain or a fever
persist or get worse
continue even with home or over-the-counter remedies
In these cases, or if the pain is severe, the person should see a doctor.
