Neck pain (without arm symptoms)
Before anything else — 4 symptoms that need urgent careReviewHide
- •Neck pain after significant trauma
- •Fever with neck pain
- •Severe headache with neck stiffness
- •Progressive neurologic symptoms
Likely conditions
Common causes based on epidemiology alone — a physical exam and sometimes imaging are needed to identify which one applies to you.
Who to see first
Primary Care Physician
Your general physician — family medicine, internal medicine, or DO.
When to see them: First visit for most non-emergent new pain — they can coordinate PT and determine whether specialist referral is needed.
Treatment sequence
Published guidelines (NASS, AAOS, ACP, NICE) recommend a conservative-first sequence unless red flags are present. Each step below lists the evidence strength and the primary source.
- 1Week 1–2Moderate evidence
Self-care and ergonomic review
Maintain motion within tolerance. Avoid prolonged static postures. Heat/cold, OTC NSAIDs. Workstation ergonomic assessment if desk-based work.
- 2Week 2–6Moderate evidence
Physical therapy
Cervical PT focused on posture, deep neck flexor strengthening, and manual therapy. Moderate evidence for short-term pain reduction.
- 3Week 6–12Moderate evidence
PM&R or pain management consult
For persistent axial neck pain, consider cervical facet medial branch blocks or radiofrequency ablation for confirmed facet-mediated pain. Surgical intervention for axial neck pain alone is not indicated.
Common causes
- •Muscle strain or tension
- •Cervical facet joint arthropathy
- •Cervical disc degeneration without herniation
- •Whiplash (post-trauma)
Your next steps
- 1Screen yourself for red flags. If any apply, go to an emergency department before continuing with this Guide.
- 2Start the first stage of the treatment ladder. Most new pain episodes improve significantly in the first 2–6 weeks with self-care and PT.
- 3If symptoms persist, book with the specialist above. Bring: when it started, what makes it better or worse, medications tried, any imaging you have, and the questions from our surgery decision framework.