Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

Neck pain - non-specific - Management
What are the features of non-specific neck pain?

  • Typical features of non-specific neck pain:
    • Aggravated by particular movements, posture, and activities; and relieved by others. Commonly, exercise makes the pain worse and rest relieves it, but the opposite may also be true.
    • Radiates in a non-segmental distribution down the arm, up into the head, into the shoulder, or across the scapulae.
    • May be associated with paraesthesia or hyperaesthesia, but with no objective loss of sensation or muscle strength.
    • May be associated with odd sensations, such as temperature change or subjective weakness, but no objective loss of muscle power.
    • May have accompanying cervical stiffness — reversible or irreversible. Muscle stiffness and spasm are common.
    • May be associated with headache or dizziness, or pain in the spine.
    • Rarely, it may be associated with:
      • Dysphagia (due to large anterior osteophytes).
      • Syncope, triggering of migraine, or pseudo-angina.
  • Typical signs of non-specific neck pain:
    • Positional asymmetry: varies from a change in the most comfortable resting position of the neck to torticollis (the neck pulled to one side).
    • Unequal restriction or limited range of movement (forward flexion, backward extension, lateral flexion, and rotation to both sides), although this is common with ageing.
    • Tenderness in hypertonic muscles or intervertebral joints, which is usually poorly localized.
    • Soft-tissue signs: localized areas of increased muscle tone that can be palpated as nodules or tender bands.

© NHS Institute for Innovation and Improvement