Pain in the nape of neck or neck pain is a very common complaint, experienced by many people. Neck pain is a painful condition, which can be a result of various factors or underlying conditions. Causes of pain in the neck are many and need to be studied well to evaluate every case individually. Pain in the nape of neck is also seen in many persons and can be equally debilitating. Cause of pain in the nape of neck can range from irregular posture or injuries to serious underlying medical conditions.
With the increasing use of computer and other technologies, use of machines, desk jobs have increased to a great extent. Also, for the use of various electronic gadgets that are handy, people often tend to ignore their posture, which can result in changes in their body and neck pain. Physical or manual labor is always a risk for pain in the nape of neck and so are several medical conditions. However, most cases of pain in the nape of neck can be managed well with timely diagnosis and appropriate treatment.
Causes of Pain in the Nape of Neck
Pain in the nape of neck is a condition, in which there is pain at the back of the neck. Neck is the upper part of the spine called cervical spine and is supported by neck muscles and soft tissues. The neck region is closely related to the upper back, shoulder, arms, jaws, ears and the lower part of the head. Various causes play an important role in causing damage to neck or to the structures supporting the neck.
Some of the Causes of Pain in the Nape of Neck Include:
Poor Posture – Poor posture is one of the commonest causes of pain in the nape of neck or back of the neck. Improper posture when sitting, reading, during desk jobs or when sleeping can affect the neck. Sleeping in awkward position, use of inappropriate pillows, etc. are common factors that contribute to pain in the nape of neck. Improper techniques of lifting weight, carrying weight overhead or other strain causing activities or posture can cause damage to the neck muscles and cause neck pain.
Muscle Strain – Muscles of the neck can get overstretched during certain activities, pulling pushing movements or during sports. Similarly overexertion, increased workload on the neck muscles can lead to muscle strain, which can cause pain in the nape of neck. Muscles of the face, shoulders or of the upper back can get strained making the neck muscles to work harder and cause neck pain.
Neck Injury or Whiplash – Injury is one of the commonest causes of pain in the nape of neck or back of the neck. Injury can be a result of trauma, fall, direct blow, sport injury or other wounds. Whiplash injury, occurring during vehicular accidents, is also a common cause of pain in the nape of neck. Such injuries occur as a result of sudden acceleration and deceleration of the neck during travel or collisions, which can cause strained tissues and neck pain.
Injury to Other Structures - Injury to the shoulders, arms or the upper back can also cause pain in the back of the neck. Symptoms in such cases may include pain and stiffness in shoulders or back along with pain in the nape of neck. Bone injuries, fractures of bones around the neck region too can cause severe pain in the nape of neck or back of the neck and may require immediate medical attention. Trauma to the temporomandibular or jaw joint can sometimes result in neck pain too, if the attached muscles or ligaments get stretched. Injury to the nearby areas like jaw joint, injury during dental extraction or ear treatments can occasionally strain neck muscles and cause pain in the nape of neck.
Degenerative/Arthritic Conditions – Degenerative changes in the neck or cervical vertebra, often lead to arthritic conditions like cervical spondylosis. These are related to aging and regular wear and tear of the vertebral joints. Other conditions that affect the cervical spine also contribute to neck pain. Cervical disc herniation, other forms of arthritis too can cause pain in the nape of neck. Ankylosing spondylitis is another condition affecting the spine, causing neck pain and stiffness. Degenerative changes of the jaw joint can also cause pain in the nape of neck along with pain on jaw movements, chewing and talking.
Rheumatic Conditions – Rheumatic conditions can make neck a vulnerable area, which often experiences muscle stiffness and pain. Conditions like rheumatoid arthritis, polymyalgia rheumatica or other connective tissue disorders can cause pain in the nape of neck, when the muscles and tissues of the neck get affected. Fibromyalgia, which is a condition that causes pain in the trigger points in the body, too can cause pain in the back of neck.
Headaches – Headaches, particularly migraines are another common cause of pain in the nape of neck. Migraine headaches, tension headaches or those associated with increased stress, often present with headache, feeling of discomfort, nausea or vomiting along with neck pain. Tensed muscles of the neck are often seen in such people, which may aggravate with trigger factors, lack of adequate sleep, stress or changes in routine.
Congenital Conditions – Certain congenital conditions can affect the position of the neck or shoulders, causing pain in the nape of neck. It can also make the neck more prone to injuries or early degeneration, thus increasing the problem. Common examples include torticollis, which is tilted neck, or other like kyphosis or scoliosis, which are changes in the spinal curvature causing changes in the way the neck and shoulder move and other conditions of the spine and neck can cause pain in the nape of neck. Torticollis can sometimes, also be acquired or a result of excessive strain to the muscles causing pain in the nape of neck.
Infections – Certain infections can affect the cervical spine can cause neck pain. Meningitis is an infectious condition that causes affects the covering of the brain and spine. Severe pain in the nape of neck, neck stiffness and high fever are usually seen in meningitis, which require immediate medical attention. Tuberculosis of spine may sometimes affect the neck region and cause pain in nape of neck. Such infections are often associated with other symptoms, which must be evaluated and immediate treatment needs to be initiated.
Brain/Neurological Conditions – Serious conditions affecting the brain include subarachnoid hemorrhage within the brain space, vascular problems in the brain or neck, brain aneurysm and brain or neck tumor. Nerve related conditions, nerve degeneration, infections affecting the nerve or neuropathies can cause irritation of the nerve roots at the neck and cause pain in the nape of neck.
Medical Conditions – Other serious conditions that can be a cause of pain in the nape of neck can include heart related conditions, angina or chest pain, myocardial infarction or heart attack, conditions affecting the throat, laryngeal cancer, etc. High blood pressure or hypertension can trigger pain in the nape of neck, due to increased pressure on the blood vessels, which pass through the neck region. Stroke, which is a serious medical emergency too can present with neck pain and is a possible cause of pain in the nape of neck.
Others Causes of Pain in the Nape of Neck– Stress and strain can sometimes result in tensed muscles and can also cause pain in the nape of neck in some people. Lack of adequate sleep, improper nutrition, deficiency of certain nutrients, etc. can hinder the body's healing process and cause neck pain. Sedentary lifestyle and physical activity can make the neck muscles weak, making them more prone to muscle tightness, injuries and degeneration. This too can cause pain in the nape of neck. Some cases of pain in the nape of neck may also be seen in women as a result of hormonal changes, particularly during menopause. These may be associated with increased stress, mood swings, muscle soreness in the body, headache, neck pain and vertigo or difficulty in balance and co-ordination.
Symptoms of Pain in the Nape of Neck
Pain in the nape of neck can be acute in nature, which lasts for a while or it can be chronic, which has been there for months. The type and severity of symptoms often vary from person to person and depend on the underlying cause of pain in the nape of neck. Neck pain itself is a symptom, however, it is important to understand the symptoms associated with it to be able to aid in the diagnosis of pain in the nape of neck.
Some of the common symptoms of pain in the nape of neck include:
Bone, joint and muscle related pain in the nape of neck is often accompanied by muscle stiffness and pain in the neck and surrounding areas. There is discomfort in turning the neck, moving shoulder or arms. Pain in the nape of neck can spread to the shoulder, hands and fingers or even to the front of the neck. Injury to the neck or other structures often presents with a history of trauma before the symptoms began and may also have visible wounds.
Associated nerve involvement often presents with tingling and numbness in the hands and fingers. Burning sensation or weakness in hands may also be noted. There may be difficulty in holding objects, handling fine objects with fingers along with pain in neck extending to the hands and fingers. Some people experience aggravation of muscle and nerve symptoms of neck pain after exposure to cold or after overexertion.
Vertigo may be an associated complaint, in which a person feels as if things are moving and may also have balance problems. Feeling of nausea and vomiting may also be seen in people with pain in the nape of neck. Headaches or migraines may present with symptoms of pain in the nape of neck along with headache, which is often triggered by a known cause.
Hypertension may present with headache, nausea, vomiting and fatigue along with pain in nape of neck. Severe heart problems may be associated with chest pain, feeling of tightness in the chest and sweating. Stroke often presents with sudden pain in arms or nape of neck, co-ordination problems and lack of speech clarity.
Other causes of neck pain or infections like meningitis may require urgent medical care along with proper assessment.
Diagnosis of Pain in Nape of Neck
As there are many causes of pain in the nape of neck, it is important to evaluate a case of neck pain with proper history and clinical examination. Neck conditions related to bone and joint can show specific signs of bone, joint and muscle disorder, based on which further investigations can be planned. Specific tests for other probable causes of pain in the nape of neck may be required.
Blood tests – Blood tests may be done to detect inflammatory conditions, autoimmune disorders, infections or other abnormalities.
Scans – X-rays of the neck or skull may be done to rule out fracture and other bony abnormalities. CT scans can help to detect bony abnormalities in the spine, brain or other areas, depending on the symptoms. MRI may help to detect tissue injuries in the neck and other areas. Tumors, growth, disorders of the nerves or other changes can also be detected with the help of these scans.
Other tests may be done depending on the possible cause and symptoms of pain in the nape of neck. Diagnosis of pain in the nape of neck can be made with appropriate investigations, which can help to plan proper treatment.
How is Pain in the Nape of Neck Treated?
Treatment of neck pain mainly depends on the cause and severity. Medications to treat pain in the nape of neck usually include anti-inflammatory medicines, pain-killers and muscle relaxants. Medicines that reduce stress, nerve regeneration medicines and nutritional supplements may be considered in some cases. Infections are treated with anti-biotics. Hypertension may be treated with anti-hypertensive drugs. Other serious conditions often need immediate treatment and hospitalization may be considered.
Injuries may be treated with ice packs, whereas warm compresses may help sore muscles in other chronic conditions. Physical therapy can help to improve pain in the nape of neck as well as other joint and muscle related conditions. Muscle relaxation, nerve stimulation and therapeutic exercises in a proper manner can help. Regular exercises of the neck, back and shoulders can help to maintain flexibility, strengthen the neck and improve range of motion.
Patient education regarding appropriate posture, regular exercises for the neck and schedule to manage desk work and rest is important. Use of pillow plays a crucial role and must be used properly, preferable with expert advice for those who have pain in the nape of neck. Following a healthy lifestyle, consuming nutritious healthy diet and being active regularly can help to maintain immunity and strength.
Warning Signs of Pain in the Nape of Neck
Some signs of pain in the nape of neck can be alarming and may require immediate medical attention. It is important to watch out for those to be able to provide prompt treatment.
- Pain in the nape of neck that lasts longer with no improvement or worsening of symptoms.
- Sudden onset of severe pain in back of neck, with stiffness, nausea and vomiting
- High fever, inability to move the neck and oversensitivity to light or noise.
- Head injury or severe pain in the head, with severe pain in nape of neck.
- Sudden weakness, trembling of arms or sudden numbness and loss of sensation in the hands.