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The cervical spine consists of 7 vertebrae, which are separated from each other by intervertebral discs. The spinal canal consists of an arch of bone that forms a hollow space along the back. The spinal cord and associated nerves pass through this canal. Ligaments, tendons, muscles, and tissues hold the vertebrae together and form the neck.

. Stenosis - One common cause of chronic neck pain is cervical foraminal stenosis, which is caused by impingement of a nerve root on one side of the spine due to degeneration of the vertebrae. Stenosis is the result of age-related changes in the facet joints of the vertebrae.
. Herniated cervical disc - Many people with neck pain suffer from a herniated disc, which is where the inner disc material (nucleus) bulges or protrudes through the hard, outer layer (annulus).
. Cervical DDD - When discs suffer wear and tear from aging, they lose water content, which is called degenerative disc disease (DDD).
. Myofascial pain - Chronic muscle strain related to poor posture will make the neck and upper shoulder muscles sore and aching.
. Spinal instability - Resulting from a motor vehicle accident or fall, increased motion between the vertebrae leads to instability.

Depending on the cause of the neck pain, associated symptoms include arm pain, numbness, and tingling. If neck pain is associated with cervical strain (whiplash), muscles spasms may be present. Pain related to spinal arthritis can cause morning stiffness and decrease range of motion of the neck.

If you have neck pain, the doctor will want to uncover the cause of the discomfort. He/she will take a detailed medical history, conduct a physical examination, and orders some diagnostic tests (MRI, CT, and x-rays).

Depending on the cause of the pain, treatment options are:

Physical therapy - A therapist will teach you strengthening and flexibility exercises to improve range of motion. For pain relief, options include massage, electrical stimulation, ultrasound, and heat therapy.

Medications - The doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or narcotic analgesics for the pain.

Immobilization - When whiplash occurs, the doctor may recommend a soft cervical collar to prevent further injury and provide support.

Trigger point injections (TPIs) - The doctor can inject painful trigger points with an anesthetic, which has a success rate of 90-100%, according to a recent study.

Facet joint injections (FJIs) - With this procedure, the doctor inserts small needles into the cervical facet joints along the vertebrae. Once placement is confirmed using x-ray guidance, the doctor will inject a corticosteroid, with or without an anesthetic, near the spinal nerves through these needles. A recent double-blind study of chronic neck pain found that this procedure had an efficacy rate of 80-83%.