Neck pain should normally resolve within a few weeks; if it has gone on for more than three months with no response to treatment, the patient may need to be referred to a pain clinic.14

For acute pain, less than six weeks, or sub-acute pain, lasting 6-12 weeks, oral analgesics – ibuprofen, paracetamol or codeine – can be considered depending on suitability for the patient, and/or a topical NSAID. Dosing should be in line with the NICE Clinical Knowledge Series (CKS) ‘Analgesia – mild-to-moderate pain’ guidelines.14,21

A short-term muscle relaxant (eg a benzodiazepine) may also be appropriate as for low back pain above.14,18

As with back pain, encourage the patient to remain active and lead as normal a life as possible, although activities such as driving may need to stop if the range of neck movement is restricted. Cervical collars should be avoided as they restrict mobility and may prolong symptoms.14

Physiotherapy can be added to the management regime, with a physiotherapist helping the patient with stretching and strengthening exercises, range-of-motion exercises, and some form of manual therapy.

Reducing the number of pillows at night so that the spine and head are better aligned may benefit many people. A firm pillow which provides lateral support and supports the hollow of the neck may provide some comfort when sleeping.