Neck and upper back pain is often caused by poor posture, muscle strain, or sleeping position. See a doctor if you have numbness or pain after an injury.
Common causes
- Poor posture and long hours at a screen.
- Muscle strain or tension.
- Sleeping position or an old pillow.
- Arthritis or degenerating discs.
- Herniated disc or pinched nerve.
What helps
- Heat or ice.
- Gentle stretching and posture breaks.
- Over-the-counter pain relievers.
See a doctor
After an injury, or if there is numbness, weakness, fever, or pain that lasts more than a few weeks. Go to emergency care for chest pain.
Posture and screens
“Tech neck” develops when the head tilts forward. For each inch the head moves forward, the neck bears more load. A study in Surgical Technology International estimated the effective load on the neck at about 27 pounds at 30 degrees of tilt and about 60 pounds at 60 degrees.
Muscle strain
Overuse, sudden movements, sleeping in an awkward position or carrying a heavy bag can strain the muscles of the neck and upper back.
Joint and disc causes
- Cervical spondylosis, or wear of discs and joints.
- Herniated cervical disc with possible arm pain or numbness.
- Facet joint irritation.
- Pinched nerve (radiculopathy).
Other causes
- Whiplash after a car accident.
- Stress and tension.
- Poor sleeping pillow or mattress.
- Fibromyalgia.
- Meningitis, which causes severe neck stiffness with fever and headache.
Self care
- Use heat or ice packs for 15 to 20 minutes.
- Take over the counter pain medicine as directed.
- Gentle neck stretches and range of motion exercises.
- Adjust the monitor to eye level and keep the elbows at 90 degrees.
- Take a break every 30 minutes to move.
- Sleep on your back or side with a pillow that keeps the neck neutral.
Exercise
Strengthening the deep neck flexors, shoulder blades and upper back helps reduce pain, according to physical therapy research.
Seek care urgently if
Pain follows an injury, or comes with numbness, weakness, loss of bladder or bowel control, fever with stiff neck, or chest pain, shortness of breath or pain spreading into the arm.
Posture, screens and neck load
The human head weighs about 10 to 12 pounds, and a 2014 study in Surgical Technology International estimated that the force on the neck rises to about 27 pounds at a 15 degree forward tilt and about 60 pounds at 60 degrees, as happens when looking down at a phone. Long hours of screen use, poor desk setup and sleeping on a high pillow are common causes of upper back and neck pain. Muscle strain, tension and trigger points in the trapezius muscles produce aching and stiffness. Place the monitor at eye level about an arm’s length away, keep the elbows at 90 degrees and take a movement break every 30 minutes.
Joint, nerve and urgent causes
Cervical spondylosis (age related wear) is common after 50. A herniated disc or narrowing in the neck can pinch a nerve, causing arm pain, numbness or weakness, called cervical radiculopathy. Whiplash from car crashes can cause neck pain that lasts weeks. Gentle stretching, heat, over the counter pain relievers and short term activity usually help. Seek urgent care for neck pain with fever and a stiff neck that stops the chin touching the chest, since this can signal meningitis, or after trauma, or if there is loss of bowel or bladder control, arm weakness or chest pain.
Based on data from the Mayo Clinic and the American Academy of Orthopaedic Surgeons
