Pain in the neck and back of the head is a common combination of symptoms. The neck is a complicated structure made of bony vertebrae, ligaments, muscles and nerves.
Since the neck is connected to the skull, problems in the neck often cause pain in the back of the head as well. There are many causes of pain in the neck and back of the head, ranging from muscle strain to arthritis to uncommon conditions such as meningitis or cancer.
Muscle strain occurs when a muscle is stretched or torn. This produces inflammation, swelling and pain. Muscle strain may develop gradually from repeated overuse of the muscle or it may occur suddenly, due to a quick, unusual movement.
Whiplash from an automobile accident or sports injury is a common cause of muscle strain in the neck. As muscles from the neck extend up into the back of the head, pain is often felt in the head as well.
Muscle strain is typically treated by limiting neck movement and applying ice for the first 2 to 3 days, followed by heat. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), may also be helpful.
Many Americans spend much of their days hunched over a computer or desk. Poor posture can cause abnormal stress on ligaments and muscles in the neck, resulting in pain in the neck and back of the head.
When poor posture continues for a prolonged time, the muscles may become weak and tight. Sometimes trigger points develop in the muscles. These small areas of firm muscle — also called muscle knots — are extremely sensitive, producing severe pain when touched. This pain is felt at the trigger point and may extend to other areas as well.
Pain from poor posture is treated like a muscle sprain, as well as by learning techniques to improve posture. Trigger points may be injected with a local anesthetic or corticosteroid.
Pain may be caused by inflammation of joints located between each vertebrae in the neck or between the highest vertebra and the skull. Osteoarthritis is the most common type of joint inflammation affecting the neck. It's a wear-and-tear form of arthritis, in which repetitive movements eventually lead to joint destruction.
Osteoarthritis of the spine often produces bony outgrowths called osteophytes, or bone spurs, that can press on nerves or other tissues, causing pain. When severe, these outgrowths may press on the spinal cord. This can result in pain or other nerve symptoms in the arms, as well as weakness in the legs, balance problems or altered bowel or bladder function.
NSAIDs are commonly used to improve osteoarthritis pain. Joint injections, epidural steroids and surgery are options when NSAIDs provide insufficient pain relief.
A herniated disc occurs when part of the disc located between adjacent vertebrae is pushed out of its usual location. This may develop gradually over time as part of a wear-and-tear process or suddenly as a result of an injury.
The displaced disc material can produce pain by directly pressing on nerves arising from the spinal cord or by producing inflammation in the area. In the upper neck, nerves from the spinal cord travel upwards, so pain may extend into back of the head.
In the lower neck, nerves travel into the arm, so pain may extend into the shoulder and arm. In addition to pain, nerve irritation resulting from direct pressure or inflammation may produce numbness, tingling or weakness.
Meningitis — inflammation of the membranes surrounding the brain and spinal cord — may also produce pain in the neck and back of head. Meningitis is usually caused by an infection. In addition to pain, the neck is typically very stiff.
Other common symptoms include a fever, nausea, vomiting and drowsiness. Rarely, tumors occur in and around the neck, often within the vertebrae. The tumors may originate in the neck or spread to the neck from other parts of the body. Pain caused by a tumor is typically constant and worsens over time.
Other symptoms will depend on whether the tumor grows into or presses on nerves or the spinal cold itself. Unexplained weight loss, loss of appetite and fatigue are other signs of a possible tumor.
Seeking Medical Attention
See your doctor if you have pain that extends into your shoulder or arm, lasts more than a few days or is accompanied by symptoms suggestive of a tumor.
Seek immediate medical attention if your pain is severe, or if you have any numbness, tingling, weakness, balance problems or changes in bladder or bowel function. Also obtain prompt medical care if your neck and head pain is due to an injury or if you have significant neck stiffness or other symptoms suggestive of meningitis.
Reviewed by Mary D. Daley, M.D.
- American Academy of Orthopedic Surgeons: Neck Pain
- American Academy of Orthopedic Surgeons: Herniated Disc
- American Family Physician: An Approach to Neck Pain for the Family Physician
- American Family Physician: Radiologic Evaluation of Chronic Neck Pain
- Merck Manual Professional Version: Evaluation of Neck and Back Pain