Neck Pain

Neck pain is a common problem with many possible causes.

Most cases of neck pain are due to muscle strain, especially from poor posture or improper positioning while working, reading, watching TV, texting, using the computer, or sleeping. Neck pain can also be due to soft tissue sprains.

Neck pain generally gets better with non-surgical treatment: medication, physical therapy, heat or cold packs, etc.

The neurosurgeons at the Spine Hospital at the Neurological Institute of New York handle the few remaining cases of neck pain that may require surgery.


For the most part, episodes of neck pain may cause stiffness or soreness for a couple of days or weeks before resolving on their own.

However, the following symptoms are potential “red flags” that might lead a patient to see a neurosurgeon:

  • Pain accompanied by numbness, tingling, or weakness in the hand or arm
  • Pain that gets worse during the night
  • Pain accompanied by difficulty breathing or swallowing
  • Pain and loss of control over bladder or bowel function
  • Pain caused by a fall, injury, or other trauma


If a patient presents with neck pain, the doctor may order the following diagnostic procedures:

  • X-ray (also known as plain films): test that uses invisible electromagnetic energy beams (X-rays) to produce images of bones. Soft tissue structures such as the spinal cord, spinal nerves, the disc, and ligaments are usually not seen on X-rays, nor on most tumors, vascular malformations, or cysts. X-rays provide an overall assessment of the bone anatomy as well as the curvature and alignment of the vertebral column. Spinal dislocation or slippage (also known as spondylolisthesis), kyphosis, scoliosis, as well as local and overall spine balance can be assessed with X-rays. Specific bony abnormalities such as bone spurs, disc space narrowing, vertebral body fracture, collapse, or erosion can also be identified on plain film X-rays. Dynamic, or flexion/extension X-rays (X-rays that show the spine in motion) may be obtained to see if there is any abnormal or excessive movement or instability in the spine at the affected levels.
  • Computed tomography (CT) scan: a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
  • Magnetic resonance (MR) imaging: a diagnostic procedure that uses a combination of large magnets, radio waves, and a computer to produce detailed images of organs and structures within the body. MR scans use no radiation. They may not be possible in patients with certain implants or devices, such as pacemakers or old aneurysm clips.

Risk Factors

Acute neck pain can be caused by muscle strains or soft tissue sprains that have resulted from sleeping incorrectly, pulling a neck muscle, or suffering another minor injury.

On the other hand, neck pain can also be caused by conditions such as:

  • degenerative disc disease
  • herniated disc
  • stenosis
  • arthritis
  • spinal tumors
  • cervical radiculopathy
  • fractures


In the majority of cases, nonoperative measures can relieve neck pain. Such measures include pain medications, ice/heat, and physical therapy.

If the neck pain is caused by a more serious condition, then surgical intervention may be required.

In some cases, the surgeon may need to fuse bones together to restore stability in the spine. This procedure is referred to as spinal fusion.