When is neck pain a cause for concern?

Neck pain (back of neck, not the front) must be further evaluated by a specialist with an MRI scan if accompanied by the following:

1. following an injury (e.g. fall, accident, manipulation)
2. following a cancer treatment
3. following fever/chills/rigors with or without sore throat or difficulty in swallowing
4. spreading of neck pain down your arm
5. spreading of neck pain upwards with headache, drowsiness, nausea or vomiting
6. "pins and needles" numbness in either one or both hands/fingers, or rest of your body
7. unsteadiness or weakness in either one or both hands/fingers, or both legs (e.g. tendency to drop things, tendency to trip or lose balance)
8. unremitting or worsening pain, day and night, after 2-3 weeks despite adequate neck rest/care and medications from your GP

Thank you for your question. In general, neck pain is a concern if it persists for more than a few days.

It may be a sign of problems in the neck or spine which include:

1. Degenerative disc disease
2. Neck strain
3. Osteoarthritis
4. Cervical spondylosis
5. Spinal stenosis
6. Herniated disc
7. Cervical radiculopathy

Neck pain can also arise from:

1. Common infections, such as virus infection, leading to lymph node (gland) swelling and neck pain
2. Rare infections, such as osteomyelitis, septic discitis, meningitis
3. Muscular problems of the neck
4. Poor positioning of the neck while sleeping

Please see a doctor in order to rule out any potentially complicated diagnosis.

Best regards
Dr Quah

Neck pain is a common occurrence especially with the use of our mobile devices like handphones and tablets. Most of the time, it is due to poor posture and prolonged looking down on the laptop computer.

Neck pain when it is persistent, worst at night and affects your sleep, needs to be assessed by a doctor. If you have any of these symptoms, you will also need an assessment to determine its severity:

1. history of fall or injury
2. associated with tingling or pain going down the arm, forearm
3. past history of cancer
4. your gait is stiff, less steady
5. fever, sorethroat
6. neck stiffness with fever (no history of trauma)

The doctor may order simple tests like x-rays or blood tests and even an MRI if he/she suspects compression of the nerves or spinal cord.

Dr James Tan