Pain in the back of the neck Investigation of causes, symptoms, diagnosis and treatment methods

Last updated: November 18, 2025 Pain in the back of the neck is often caused by muscle problems, improper body posture, or erosion of the vertebrae, and sometimes it spreads to the shoulder and head. The cause of pain in the back of the neck and shoulder can be from a simple strain to a protrusion of the disc, and this point tells us what the symptoms of back pain are. Fortunately, most of these pains can be controlled with anti-inflammatory drugs, modification of daily habits and stretching exercises. Only limited cases, due to neurological or structural involvement, will require more advanced treatment methods. subject Key points Important items The cause of back pain The most common causes are a combination of muscle, disc, joint and posture problems Muscle spasm, arthritis, neck disc, trauma, wrong ergonomics Back pain and shoulder pain Often caused by an injury, strain, or sprain In rare cases related to heart problems Back pain and head pain Important causes: cervical arthritis and occipital neuralgia It may be accompanied by headache, numbness or inflammation Pain on the right or left side of the neck Often caused by bad posture, stress, disc or inflammation Rare causes: bone abnormalities Back pain in children Often due to posture, infections or muscle strain Risk cases: meningitis, trauma, severe infections Neck pain while eating Caused by sore throat, tonsillitis, esophagitis, epiglottitis Need for immediate investigation in respiratory cases Prevalence of neck pain 10 to 20% every moment – 30 to 50% per year More common in women and sedentary people Back pain symptoms From mild to chronic pain with limited movement It may be accompanied by headache, numbness, spasm risk factors Bad posture, old age, depression, simultaneous pains Insomnia and previous injury Diagnosis Examination → MRI or CT in suspicious cases Warning signs: fever, low weight, trauma, night pain Therapies Analgesics, physiotherapy, stretching, non-invasive methods Surgery only in severe disc cases The best drugs NSAIDs, relaxants for spasms The medicine should be taken according to the doctor's advice home remedy Cold compress, hot compress, stretching, warm bath Suitable for mild to moderate pain Modification of lifestyle Reduce mobile time, correct sleep, regular stretching Prevent chronic pain Stretching exercises Neck rotation, lateral extension, forward/backward bending Do each movement for 3 minutes sleep state Sleeping on your back or side is the best position A suitable pillow to prevent bending of the neck

What is the cause of back pain?

The cause of neck pain usually comes from a set of anatomical factors and structural problems of the neck; Damage to the muscles and ligaments protecting the skull and spinal cord, wrong posture, gradual erosion of cervical discs and joints, and even shoulder involvement can cause or intensify this pain. In many cases, the origin of the pain is not clear and it often improves in a self-limiting manner, but if the pain is accompanied by radiating neurological symptoms, the possibility of cervical disc involvement is raised and there may be a need for more aggressive treatments such as surgery.

Some important causes are:

• Injury or spasm of neck muscles and ligaments
• Arthritis and destruction of discs and vertebral joints
• Protrusion or rupture of cervical disc
• Shoulder arthritis or rotator cuff tear with referred pain
• Improper body position and incorrect ergonomics
• Trauma, accidents or repeated pressure on the neck

The cause of neck and shoulder pain

Simultaneous pain in the neck and shoulder area is usually caused by an injury, but some health problems such as heart attacks may also cause it. Treatment will vary depending on the cause. Pain at the same time in the shoulder and back of the neck is usually common and will be due to stretching or twisting.

The cause of neck and head pain

One of the common causes of neck and head pain is osteoarthritis of the cervical vertebrae, which leads to inflammation and restriction of neck movement due to the gradual wear and tear of the neck joints. Also, damage or compression of the back nerves (Occipital Neuralgia) can cause a shooting pain from the neck to the head. Protrusion of the cervical disc also causes headaches related to the neck by putting pressure on the nerve roots.

In addition, some systemic diseases such as gout and diabetes can lead to nerve damage or local inflammation and contribute to this pain. Inflammation of blood vessels can also lead to reduced blood flow to neck and head structures and cause constant headaches; In some cases, infections also cause severe pain by causing inflammation in the neck area. Accurate diagnosis of the cause of this pain requires medical evaluation and imaging and laboratory tests so that appropriate treatment can be provided to reduce symptoms and improve a person's quality of life.

The cause of back pain on the right and left side of the neck

Neck pain on the right side and back pain on the left side are usually caused by improper positioning of the neck, muscle stiffness or repeated pressure, but sometimes it is rooted in more serious problems such as nerve involvement or joint inflammation. Cervical disc rupture can cause shooting pain in the shoulder and arm, and damage to the brachial nerve network or rheumatoid arthritis are also important causes of constant pain.

Lifestyle factors such as wrong sleeping, stress or long-term positioning in one position also play a significant role in the occurrence of these pains, and in rare cases, bone abnormalities cause neck structure disorders. For accurate diagnosis, specialized evaluations and imaging help to choose the right type of treatment.

Some common causes include:

1. Stiffness or muscle spasm caused by wrong posture
2. Rupture or protrusion of the cervical disc
3. brachial nerve plexus damage and shooting pains
4. Rheumatoid arthritis and cervical joint inflammation
5. Repetitive pressures, stress and sleep disorders
6. Bone abnormalities and neck structural problems

The cause of back pain in children

Back pain in children can be caused by simple factors such as poor posture while sitting, reading or using mobile phones for a long time; Also, intense physical activities or sleeping in the wrong position can lead to neck muscle strain and temporary pain; But in some cases, this pain can be a sign of more serious problems. Swollen lymph nodes, which often occur in response to viral or bacterial infections, can cause pain and tenderness in the neck area.

In rare cases, more serious causes such as meningitis, which is a dangerous infection of the meninges, may cause neck pain with symptoms such as fever and severe neck stiffness. Traumatic injuries caused by falls or accidents can also lead to muscle, nerve or even cervical vertebrae fractures; In addition, inflammatory diseases such as childhood arthritis and rare cases of cancers of the lymphatic or bone system can also cause neck pain. It is necessary to accurately diagnose the cause of pain in children, and if the symptoms persist or are accompanied by symptoms such as fever, weakness, or weight loss, it is recommended to see a doctor immediately.

The cause of pain in the back of the neck when eating

Pain in the back of the neck while eating can be caused by infections, inflammation or blockage of the throat and esophagus. Sore throat and tonsil infection are usually caused by viral or bacterial factors and are accompanied by pain when swallowing. In more serious cases, epiglottitis, which is a dangerous inflammation and infection of the epiglottis (a valve at the top of the windpipe), can lead to severe pain and even airway obstruction. Fungal infections, such as oral thrush, can also cause irritation and discomfort in the throat and neck area.

On the other hand, esophagitis (inflammation of the esophagus) caused by acid reflux or infection can cause pain when swallowing; Also, physical injuries to the throat, such as burns from hot food or trauma, may lead to temporary pain and inflammation. An accurate diagnosis of the cause of this pain requires a medical examination, especially if the symptoms continue chronically or are accompanied by fever, difficulty swallowing, or shortness of breath.

What is the prevalence of back pain?

Back pain or axial neck pain is one of the most common musculoskeletal problems worldwide. According to epidemiological studies, the prevalence of this condition affects about 10-20% of the population at any given time, while its annual prevalence may reach 30-50%. This pain is more common in women, and with increasing age, especially in people over 40, the probability of its occurrence increases; Also, sedentary jobs related to office work or long-term use of computers and mobile phones are considered one of the important factors in reducing the age of cervical disc onset.

Fortunately, most cases of neck pain are mild to moderate and improve with posture correction, stretching exercises, and simple treatments such as physical therapy and anti-inflammatory drugs; However, about 10 to 15 percent of patients may develop chronic or debilitating pain that requires more specialized investigations and more advanced treatments such as injections, advanced physical therapy, or even surgery. Preventing this pain with regular neck exercises, improving the ergonomics of the work environment and managing stress can significantly reduce its prevalence.

Symptoms of back pain

Pain in the back of the neck can range from a mild discomfort to a chronic and debilitating pain. This pain often spreads to nearby areas such as the base of the skull, shoulders, shoulder blades, and even the upper back. Stiffness and reduced range of motion of the neck are common symptoms of this condition, which may be aggravated when turning or bending the neck. In addition to localized pain, other associated symptoms can include tension headaches or migraines, muscle spasms, shooting pains in the arms, numbness or tingling in the upper extremities that indicate cervical nerve involvement.

In some cases, patients complain of a feeling of warmth or inflammation in the neck area and even dizziness, which can be due to muscle, nerve or vascular problems. If neck pain is accompanied by symptoms such as muscle weakness, balance problems, or changes in bowel and bladder function, it may indicate a more serious problem such as spinal cord compression or cervical disc damage that requires immediate medical attention.

Causes of back pain

Improper body posture and weak muscles increase the risk of axial neck pain. Risk factors for chronic pain include the items listed below:

• Old age
• Pain due to previous injury
• Simultaneous pain in the lower back with pain in the back of the neck
• Headache
• Depression
• Severe neck pain
• Pain that interferes with one's sleep

Diagnosis of back pain

Most cases of back pain are diagnosed according to symptoms and examination. There are a series of signs and symptoms that, if they occur, a person should see a doctor as soon as possible. The doctor may order a CT-SCAN or MRI to rule out infection, cancer, and fractures. These symptoms include previous trauma, fever, weight loss, night sweats, and pain that disturbs a person's sleep.

Rheumatic causes cause neck pain and stiffness that improves during the day. If the pain persists for more than 6 months, imaging of the spine should be considered, especially in people who have had previous surgery on the spine and neck. In some cases, back pain occurs due to cervical disc protrusion. The most common symptoms of cervical disc include neck pain along with arm pain, numbness and weakness in both hands, muscle spasms and impaired coordination of activities.

Treatment of back pain

There are many different treatments for pain in the back of the neck. Many patients with axial neck pain will not need surgery. Returning to daily activities is one of the most important measures that can prevent acute pain from turning into chronic pain. The first step in pain treatment is the use of simple pain relievers, acetaminophen and non-steroidal anti-inflammatory drugs. In some patients, muscle relaxants are also used.

Stretching and strengthening exercises are recommended both individually and as physiotherapy. Except in cases where there is a fracture of the cervical vertebrae, the use of neck protectors is debatable. A soft neck kevlar is used in severe cases, but it should not be used for more than three days. There is no consensus about other methods of improving back pain. Fortunately, many of these methods do not cause any harm to the patient.

Non-invasive methods of treatment include electrical stimulation of nerves through the skin, electromagnetic therapy, occupational therapy, acupuncture, laser therapy, and behavioral-cognitive therapy. Invasive treatments such as drug injection, neurotomy (nerve cutting) and surgery will rarely be necessary; Of course, in cases where the cause of back pain is the cervical disc, according to the severity of the symptoms, neck disc surgery may be needed, which is one of the main reasons for the need for cervical disc rupture surgery, which causes progressive disability by putting pressure on the spinal nerves.

Treatment category Short description Pharmaceutical Acetaminophen, NSAIDs, muscle relaxants to reduce pain and inflammation movements and physiotherapy Stretching and strengthening exercises; Physiotherapy to improve movement and reduce spasms Neck brace limited use of soft Kevlar; Only in severe cases and less than three days Non-invasive methods TENS (electrical stimulation), electromagnetic, occupational therapy, acupuncture, laser, CBT Invasive methods Drug injection, nerve cutting (neurotomy) Surgery Only in cases of severe cervical disc rupture/compression with progressive symptoms

If the patient needs neck disc surgery, it is necessary to observe some things after this surgery. The most important care after cervical disc surgery are:

• Avoid sitting and getting up suddenly.
• Avoid lifting heavy objects.
• Use prescription drugs carefully.
• Using physiotherapy will lead to faster recovery.
• Avoid driving for two weeks after cervical disc surgery.

The best pill for neck pain

Some pains in the back of the neck are caused by inflammation, and the best medicine for these cases is the use of non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, aspirin and other non-prescription drugs. In cases where neck pain is due to muscle cramps, muscle relaxants can be used.

home treatment for neck pain

Some home remedies can improve mild to moderate back pain. During the first to second day of the onset of neck pain, a cold compress reduces inflammation and swelling. For this purpose, an ice pack or ice pack is placed inside a towel and placed on the affected area for 20 minutes.

If the neck pain continues for a few days, warm compresses can also be used. Hot water bath also relaxes the muscles and improves the pain. Doing stretching exercises will also reduce the pain to a great extent in many cases. Note that in severe pain, home treatment for neck pain is not only ineffective, but can also increase the pain.

Lifestyle changes to improve back pain

Some lifestyle changes can help improve axial neck pain. Modifying the habits of using mobile phones, doing stretching exercises and following the correct principles of sleeping are among the effective solutions to reduce the pressure on the neck and prevent the pain from worsening.

Important tips when using a mobile phone

People who use mobile phones for a long time should observe the following points to avoid excessive pressure on the neck:

• When using the phone lying down, lie on your back so that the neck is in a neutral position.
• When sitting or standing, keep the phone at eye level to avoid excessive bending of the neck.
• When working with smart devices, take rest intervals and move your neck every 30 to 45 minutes.

Stretching exercises to reduce neck pain

Simple stretching movements can help increase the flexibility of the neck muscles and reduce tension. Some effective exercises are:

• rotation of the neck to the sides; Move the chin towards each shoulder and hold for a few seconds.
• Lateral stretching of the neck; Bring the ear closer to the opposite shoulder to feel the tension in the lateral neck muscles.
• head movement forward and backward; Bend the head slowly forward and then backward.

Do each of these movements for 3 minutes to have a better effect.

Important tips when sleeping

Sleep position plays an important role in reducing or increasing neck pain. Observing the following points can help reduce the pressure on the cervical vertebrae:

• Sleeping on your back or side is the best position for your neck, while sleeping on your stomach is not recommended.
• When lying on your side, place a pillow between your knees to keep the spine in a normal position.
• Use a small and suitable pillow that keeps the neck in line with the spine and prevents excessive bending.

By following these tips, neck pain can be significantly reduced and long-term problems can be prevented.

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Dr. Yazdan Panahi

Student of Shahid Beheshti University of Tehran. The top rank of the specialized board of neurosurgery. 7-year history of performing complex operations on the base of the skull and brain and spinal cord tumors, 7-year history of complex operations on the spine

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