Back of Neck Pain: 8 Common Causes & What to Do

Medical review: Dr. Clarisse Bezerra
Family Doctor
June 2022
  1. Poor posture 
  2. Stress and anxiety 
  3. Contracture or torticollis 
  4. Sinusitis
  5. High blood pressure 
  6. Arthrosis
  7. Meningitis
  8. Aneurysm

Back of neck pain is usually not a sign of a serious problem. Many times, it is associated with excess tension caused by emotional stress, increased blood pressure or anxiety. With these situations, it is also possible to notice that the neck muscles are more rigid or painful on both sides of the neck. 

You are advised to see your doctor if the neck pain is incapacitating, takes longer than 48 hours to resolve, if you additionally have chest pain or palpitation, or if you also experience vomiting or fever over 38ºC (or 100.4ºF). These are signs of meningitis or an aneurysm, which are serious conditions that require immediate treatment. 

In these cases, you should see a doctor for testing, so that the cause of pain can be identified an appropriate treatment can be initiated. The doctor may refer you to a cardiologist if blood pressure is noted to be high, or to an orthopedic surgeon if the pain is related to spinal or muscular issues. 

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The most common causes of pain at the back of the neck are: 

1. Poor posture 

Bad posture is one of the most common causes of pain at the back of the neck. It is frequent in those who work in a seated position or in front of a computer, as these people often sit incorrectly or have their screen at an inappropriate height. Poor posture can cause muscular tension and compromise spinal nerves, which can result in pain behind the neck. 

How to treat: In this case, it is important to pay attention to your posture when sitting. Your back should be fully supported by the back of the chair, and your feet should be flat on the ground. Avoid crossing your legs. The computer monitor should be at about 50 to 60 cm (19 to 23 inches) away from your face and at the same height as your eyes. You may need to use a screen stand so achieve this. Check out some neck stretches you can do throughout the day if you work in front of a computer or sit or stand for hours.

2. Stress and anxiety 

Stress and anxiety can lead to poor posture, as well as muscular tension that results in back of the neck pain, headaches and body aches.

How to treat: To relieve stress and anxiety, you should engage in activities that promote relaxation, like meditation, physical activity, watching a movie or resting. This can help with the neck pain and your overall well-being. Try our tea recipes to help cope with anxiety naturally.

3. Contracture or torticollis 

Another very common cause of pain at the back of the neck is the presence of muscular problems, like contractures or torticolis in the neck or upper back. Generally, this type of pain emerges following intense back or shoulder workouts, but it can also happen due to poor posture throughout the day or when sleeping. Pain is often felt when turning the neck. 

How to treat: Apply warm compresses to the back and neck, and rest. If the pain does not improve, you should see your family doctor, as anti-inflammatories or muscular relaxants (like cyclobenzaprine) may be necessary. Learn more about ways you can treat torticollis to get back to your routine quickly.

4. Sinusitis

Sinusitis is an inflammation of the lining of the nasal cavities that is characterized by the accumulation of secretions. It can lead to increased facial pressure, mainly in the nose and eyes, although some people also feel that their head is heavy and the back of their neck hurts. Learn about other sinus infection symptoms to monitor for.

How to treat: You should see your doctor to identify the cause of the sinus infection and start treatment as necessary. Decongestants or antibiotics may be necessary, especially if the infection is bacterial in nature. The doctor may also recommend anti-inflammatories to relieve symptoms, or you can try some natural remedies to complement medical treatment.

5. High blood pressure 

Situations that cause a significant increase in blood pressure, like stress, are all main causes for pain at the back of the head. This pain can radiate to the forehead, leading to a sensation of head heaviness, and can also cause other symptoms like blurred or foggy vision. Although some people do not experience any, others can notice other symptoms of high blood pressure.

How to treat: The best way to resolve this type of pain is to relax so that your blood pressure lowers. You should consider making diet changes, like avoiding foods that are high in salt, and drink plenty of fluids like water. Regular physical activity, monitored by a healthcare professional, may also be indicated to improve blood circulation and treat blood pressure. See the natural remedies for high blood pressure you can incorporate into your treatment plan.

If your blood pressure is out of control, or if you feel pain at the back of the neck frequently, you should see your cardiologist to evaluate your blood pressure changes and your current treatment plan.

6. Arthrosis

Arthrosis is characterized by the breakdown or degeneration of joints, and can cause pain at the back of the neck. This occurs because there are many joint spaces between the vertebrae in the spine. Any degeneration of these joints can cause pain that radiates to the back of the neck. Usually, this type of pain worsens with neck movement throughout the day, and improves with rest. 

How to treat: To relieve pain flare-ups, you should see an orthopedic surgeon to start treatment with analgesics, anti-inflammatories or glucosamine or chondroitin supplements. To prevent pain, you should engage in activities that help to relieve pressure over the joints and strengthen the back and neck muscles, like water aerobics, pilates or yoga. 

7. Meningitis

Meningitis is one of the most serious causes for pain at the back of the pain. Although it is rare, it can happen at any age, especially in areas of outbreak. Pain at the back of the neck or throughout the head is usually very intense and occurs with other symptoms like fever, nausea, vomiting and excessive fatigue. Pain at the back of the neck worsens when lowering the head and tucking the chin to the chest. This is one of the diagnostic tests that doctors use to assess for meningeal inflammation. 

How to treat: Meningitis requires immediate diagnosis and treatment, therefore you should proceed immediately to the hospital if you suspect meningitis. Treatment may involve the use of antibiotics. 

8. Aneurysm

A cerebral aneurysm is a dilation of a blood vessel in the brain which can eventually rupture and cause a hemorrhagic stroke. Generally, this condition does not cause any symptoms prior to rupture, but there are some cases in which you may feel a persistent ache at the back of the neck. Once the aneurysm ruptures, pain is very intense and sudden, and it tends to worsen over time. 

How to treat: If you suspect an aneurysm rupture, you should proceed immediately to the hospital or call an ambulance. A ruptured aneurysm presents very similarly to a stroke and can be life-threatening. 

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Edited by Tua Saude editing team in June 2022. Medical review completed by Dr. Clarisse Bezerra - Family Doctor in May 2022.

References

  • GIMÉNEZ, Salvador. Cervicalgias. Farmacia Profesional. 18. 2; 46-53, 2004
  • PRENDES, Elizabeth et al . Cervicalgia. Causas y factores de riesgo relacionados en la población de un consultorio médico. Revista Cubana de Medicina Física y Rehabilitación. 8. 2; 202-214, 2016
Medical review:
Dr. Clarisse Bezerra
Family Doctor
Dr. Bezerra possesses a medical degree and specializes in family medicine. She is licensed to practice under CRM-CE licence #16976.