Updated October 17, 2014.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Remember, axial neck pain refers to pain over and/or around the cervical spine or neck. The source of axial neck pain originates from the neck muscles/ligaments/joints. This is in contrast to radicular sources of neck pain, which involve nerve compression. With axial neck pain, patients may note headaches or pain in their shoulders, in addition to neck soreness and/or stiffness.

What Happens When I Go To My Doctor with Axial Neck Pain?

Your doctor will determine whether your neck pain is acute or chronic, as this will alter your individual therapy plan and goals. He will perform a thorough physical examination to determine whether there are any additional radicular or neurological symptoms, as this may also alter your treatment plan.

What Treatments Will Help My Neck Pain?

• Posture: Your doctor or a physical therapist can give you guidance on modifying your posture to help calm your neck muscles and reduce pain. Simple things like not carrying a heavy purse or computer bag on your shoulder, sitting straight up at your desk with your shoulders back, and sleeping flat with a small pillow under the neck, or with your thighs elevated on pillows, can go a long way.

 

• Medications: Tylenol (Acetaminophen) and NSAIDs (e.g. naproxen, ibuprofen) are commonly used for pain relief. If the pain is severe, your doctor may recommend a short-term course of mild opioids or tramadol. Muscle relaxants, like cyclobenzaprine (Flexeril) are also sometimes helpful.

 

• Neck Exercises: Gentle exercises at home, including shoulder rolls and neck movements, will help restore neck function. Here are examples of neck exercises, according to UpToDate, an evidence-based support resource for those in the healthcare profession:
  • Try to touch your chin to your chest and hold for a few seconds before returning to the neutral position.
  • Turn your head slowly in one direction. Push gently on your chin with your fingertips. Then repeat on the other side.
  • Tilt your head in one direction, trying to touch your ear to your shoulder. Push gently on your temple with your fingertips. Repeat on the other side.
  • Shoulder rolls: While sitting or standing, pull your arms backwards in an attempt to touch your shoulder blades to each other. Then, roll your arms forward then backwards "in a rhythmic, rowing motion."

 

What if My Symptoms Do Not Go Away?

If your symptoms persist, then your doctor will consider other treatment modalities including :

• referral to a neck or spine specialist, like a physiatrist
• physical therapy

If your pain still persists, your doctor may suggest one of the following:

• Trigger Point Injections: Trigger points are localized, hyper-irritable spots located in over a muscle. Trigger-point injections entail "injecting" an anesthetic (using a needle) right into the trigger site for prompt pain relief.

 

• Cervical Medial Branch Blocks: This is used for those who suffer from disorder of the facet joints or zygapophyseal joints in the neck. The facet joints are small joints located between and behind each vertebrae. The medial branch nerves carry pain signals from the facet joints to the brain and spinal cord. So, a cervical medial nerve block (containing either or both an anesthetic and steroid) interrupts this pain transmission.

 

• Percutaneous Radiofrequency Neurotomy: In this procedure, an electrode is placed on specific sites on the neck. A high frequency current is then passed through the electrode, generating heat, which denatures or destroys the nerves that innervate the painful joint.

 

• Transcutaneous Electrical Nerve Stimulation (TENS): In this procedure, an electrical current is emitted from a device to stimulate nerves. The precise mechanism of how TENS work is not fully understood. Pain relief may be produced by endorphin release when the nerves are stimulated. Or, TENS may provide pain relief by activating the "pain gate mechanism." In this theory, nerves from an injured or inflammed muscle or tissue release pain messages that travel to the spinal cord. These pain messages encounter "nerve gates" in the spinal cord. TENS may stimulate receptors in the skin that block or "close the gates," preventing pain signals from reaching the brain.

 

Take Home Message

For the majority, axial neck pain resolves with simple, conservative measures. If the pain persists, your doctor will re-evaluate and consider other interventions, like physical therapy, or trigger point injections. Talk with your doctor about what the best plan is for you and your neck discomfort.

<sub>Sources

Alvarex, David, D.O, and Rockwell, Pamela, D.O., Trigger Points: Diagnosis and Management. American Family Physician. February 15, 2002.

Anderson BC, Isaac Z, Devine J. Treatment of neck pain. In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2014. Accessed October 2014.

Lord SM. Barnsley L. Wallis BJ. McDonald GJ. Bogduk N. Percutaneous Radio-Frequency Neurotomy for Chronic Cervical Zygapophyseal-Joint Pain. N Engl J Med 1996; 335:1721-1726.

Maayah M, Al-Jarrah M. Evaluation of Transcutaneous Electrical Nerve Stimulation as a Treatment of Neck Pain due to Musculoskeletal Disorders. J Clin Med Res. Jun 2010; 2(3): 127–136.

Manchikanti L, Singh V, Falco FJ, Cash KM, Fellows B. Cervical medial branch blocks for chronic cervical facet joint pain: a randomized, double-blind, controlled trial with one-year follow-up. Spine (Phila Pa 1976). 2008 Aug 1;33(17):1813-20.

http://www.saspine.org/surgery/radio_frequency_neurotomy.pdf. Accessed Oct 2014.</sub>

DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.