Neck Pain Treatment

Neck pain is often caused by problems in the top part of your spine (called the cervical region). Acute pain comes on suddenly and usually heals on its own within days or weeks. Chronic pain lingers for months and can be constant or intermittent.

Many cases of neck pain are minor. However, you should seek immediate medical care if your pain is caused by an injury or is accompanied by any of the following symptoms: 

• Fever
• Severe headaches
• Nausea/vomiting
• Tingling or numbness in the arms or legs
• Shooting arm pain
• Loss of bladder or bowel control
• Loss of balance or frequent falls 
• Weakness or difficulty using your hands

Conservative options can be very effective in treating neck pain. Surgery may be a last resort if these solutions don’t provide the relief you need.

Physical Therapy
A trained physical therapist guides you in exercises and stretches designed to strengthen your neck, improve your balance and flexibility, and improve range of motion -- all benefits that can alleviate your symptoms. Your therapist may suggest cervical traction, which stretches your neck to reduce compression.

Electrical Stimulation
A TENS (transcutaneous electrical nerve stimulator) unit can be used in your doctor’s office or at home. A portable version is small enough to hold in your hand. When you are experiencing pain, you place reusable electrodes on your neck and attach them with wires to the TENS device. Then you turn on the device to deliver mild electricity (it should not hurt) through your skin for 15 to 30 minutes. This stimulates your nerves and stops pain receptors in the brain.

Short-Term Bracing 
In some cases, including with trauma and fractures or instability of the spine, your doctors may recommend wearing a rigid or semi-rigid neck brace for a short time. This stabilizes your spine, allowing it to heal and helping to prevent additional injury.

Chiropractic Care
A skilled chiropractor uses spinal manipulation and other manual methods to help relieve neck pain and other symptoms such as numbness and tingling, loss of strength, or pain in the arms or legs. These hands-on techniques stretch and move the spine to restore mobility to joints restricted by injury or repetitive stress, such as sitting without proper back support. Our chiropractors can also teach you exercises for improving strength and flexibility and incorporating safe movements and proper posture into your daily activities.

Acupuncture
Using fine needles placed strategically in the skin, acupuncture stimulates the central nervous system and releases chemicals that promote healing. We offer this treatment as a complement to your regular treatment plan, not as a substitute.

Medication
Medications include over-the-counter and prescription anti-inflammatory drugs, muscle relaxers, steroids, nerve-pain medicines, and more. Our doctors balance medication recommendations with risks of side effects, dependency, and other unwanted reactions.

Spine Injections
Epidural steroid injections treat inflammation and pain right at the source -- your pinched spinal cord or nerve roots. Using X-ray imaging to guide them, doctors numb your skin and place a needle into the epidural space in your spine. You’ll feel pressure during this procedure. The medicine usually begins working within a few days to a week. You’ll be able to return to normal activities the following day. We give these injections in a special, sterile fluoroscopy suite.

X-Rays
By taking pictures of bones and joints in your neck, X-rays can help identify fractures, dislocations, bone spurs, instability, or other potential causes of pain. X-rays take about 15 minutes and are virtually painless.

MRI (Magnetic Resonance Imaging)
Magnet waves create the most detailed images of your spine, including your discs, spinal bones, spinal cord, and nerves. Images can help identify disc damage or the source of pressure on your spinal cord and spinal nerves. This test takes about 30 to 60 minutes and is virtually painless.

CT (Computed Tomography)
A series of cross-sectional pictures produce detailed, 3D images of your spine bones. This test takes about 10 minutes and is virtually painless.A series of cross-sectional pictures produce detailed, 3D images of your spine bones. This test takes about 10 minutes and is virtually painless.

Electromyography (EMG)
Electrodes are inserted directly into muscle with a thin needle to record electrical activity. You will feel some discomfort. EMG, which can last from 30 to 90 minutes, measures how well muscles and nerves are working in a certain area of your body -- in this case, your neck and arms.

Blood Tests
Rarely, neck stiffness or pain can be a symptom of an infection or another serious condition like meningitis. Blood tests can help identify these issues. 

Diagnostic Injections 
To confirm whether pain is coming from a specific area in your neck, doctors inject numbing medication into that spot. If the pain improves, doctors know more about the source of your pain.

Duke Spine Health Program
Duke’s Spine Health Program takes a holistic, patient-centered approach to neck pain. Since research shows that trying conservative treatments lowers your risk of developing chronic pain, we offer the full range of first-line options, including chiropractic care, physical therapy, acupuncture, massage, yoga, mindfulness, and more. With in-person or virtual visit options, we also help you learn about your pain and help you manage it at home. If and when you need it, we won’t hesitate to refer you for more advanced care.

Team of Specialists
Our multidisciplinary team includes physical and occupational therapists, psychologists, a massage therapist, acupuncturists, a chiropractor, physiatrists (physical medicine and rehabilitation doctors) who specialize in conservative spine care, pain management specialists, orthopedic and neurosurgery experts, and others. We work together to ensure you receive comprehensive, thorough care.

Safe, Effective Results
Our spine care team is motivated to constantly improve, so they pay close attention to outcomes and always strive to do better. As members of many national and international groups such as the North American Spine Society, Scoliosis Research Society, and Cervical Spine Research Society, our clinicians stay up-to-date on the latest technologies and advances in treating your spine injury or condition. This results in safer, more effective procedures and fewer complications. 

Improving Care
We’re always looking for ways to advance spine care treatment. In addition to ongoing clinical trials, we also collect information about outcomes that we use for quality improvement.