For minor, common causes of neck pain:

• Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).
• Apply heat or ice to the painful area. One good method is to use ice for the first 48 - 72 hours, then use heat after that. Heat may be applied with hot showers, hot compresses, or a heating pad. Be careful not to fall asleep with a heating pad on.
• Stop normal physical activity for the first few days. This helps calm your symptoms and reduce inflammation.
• Perform slow range-of-motion exercises -- up and down, side to side, and from ear to ear -- to gently stretch the neck muscles.
• Have a partner gently massage the sore or painful areas.
• Try sleeping on a firm mattress without a pillow or with a special neck pillow.
• Use a soft neck collar for a short period of time to relieve discomfort.

You may want to reduce your activity only for the first couple of days. Then slowly resume your usual activities. Do not perform activities that involve heavy lifting or twisting of your back or neck for the first 6 weeks after the pain begins. After 2 - 3 weeks, slowly resume exercise. A physical therapist can help you decide when to begin stretching and strengthening exercises and how to do them.

Avoid the following exercises during your initial recovery, unless your doctor or physical therapist says it is okay:

• Jogging
• Football
• Golf
• Ballet
• Weight lifting
• Leg lifts when lying on your stomach
• Sit-ups with straight legs (rather than bent knees)

Seek immediate medical help if you have a fever and headache, and your neck is so stiff that you cannot touch your chin to your chest. This may be meningitis. Call your local emergency number (such as 911) or get to a hospital.

Call your health care provider if:

• Symptoms do not go away in 1 week with self care
• You have numbness, tingling, or weakness in your arm or hand
• Your neck pain was caused by a fall, blow, or injury -- if you cannot move your arm or hand, have someone call 911
• You have swollen glands or a lump in your neck
• Your pain does not go away with regular doses of over-the-counter pain medication
• You have difficulty swallowing or breathing along with the neck pain
• You have pain that gets worse when you lie down or wakes you up at night
• You have such severe pain that you cannot get comfortable
• You lose control over urine or stool (incontinence)

Your doctor will perform a physical examination and ask detailed questions about your neck pain, including how often it occurs and how much it hurts. Other questions may include:

• Is your pain in the front, back, or side of your neck?
• Are both sides of your neck affected equally?
• When did the pain first develop?
• Is it painful all the time or does the pain come and go?
• Can you touch your chin to your chest?
• What makes your neck feel worse? What makes your neck feel better?
• Do you have neck weakness or neck stiffness?
• Do you have any accompanying symptoms like numbness, tingling, or weakness in your arm or hand?
• Do you have swollen glands or a lump in your neck?

These questions help your doctor determine the cause of your neck pain and whether it is likely to quickly get better with simple measures such as ice, mild painkillers, physical therapy, and proper exercises. Most of the time, neck pain will get better in 4 - 6 weeks using these approaches.

Your doctor will probably not order any tests during the first visit, unless you have symptoms or a medical history that suggests a tumor, infection, fracture, or serious nerve disorder. In that case, the following tests may be done:

• X-rays of the neck
• CT scan of the neck or head
• Blood tests such as a complete blood count (CBC)
• A spinal tap for a cerebrospinal fluid analysis if meningitis is suspected
• MRI of the neck

If the pain is due to muscle spasm or a pinched nerve, your doctor may prescribe a muscle relaxant and possibly a more powerful pain reliever. Over-the-counter medications often work as well as prescription drugs. The doctor may prescribe a neck collar or, if there is nerve damage, refer you to a neurologist or neurosurgeon for consultation.

If meningitis is suspected, you will be sent to an emergency department for further tests, antibiotics, and hospital admission.