What causes neck pain and stiffness?

Seven bones called vertebrae are connected by spongy shock-absorbing 'discs', with a network of muscles and tough connective tissue supporting them. The spinal cord runs through a canal protected on all sides by bone. Damage or strain to any one of these can cause pain.

Pain which often starts in the neck and spreads to one or both shoulders - sometimes further down the arm - or up to the back of your head. Your neck and shoulders may feel stiff. Pins and needles are common and usually not a worrying sign, but these need to be checked out as they suggest a nerve emerging from your spine may be caught or irritated. The pain usually improves after a few days and goes within weeks.

As long as you don't have any of the 'red flags' below you're unlikely to need tests and may not even need to see a doctor. Raios-X e exames aren't recommended except in special circumstances as they don't change treatment options.

Keep moving

When you first get neck pain, it may be very painful to move and you'll need to rest in a neutral position for a couple of days. After that, as long as you don't have the 'red flags' above, it's important to keep moving your neck to stop it stiffening up - which is why neck collars or braces are not recommended unless your doctor says so.

Turn your head gently in all directions every few hours, trying to increase the range of motion gradually. Avoid prolonged sitting but keep up your normal activities as much as possible.

Medicine and self-care

Analgésicos such as paracetamol or anti-inflammatory painkillers such as ibuprofen - which also comes in a gel from your pharmacist - will help. Your doctor may recommend a short course of relaxantes musculares if there's a lot of muscle spasm. A heat pad or pack over aching muscles may also help.

A wry neck - torticollis - is when the neck gets stuck with your head twisted to one side. It may be due to strain of the muscles or ligaments of the neck, making the muscles go into spasm. Sleeping in a draught or an uncomfortable position may bring it on. It's often very painful in the muscles on one side but usually settles within a few days. In the meantime, painkillers will help.