Avatar universal

Pain in neck/upper spine when tilting head backwards

I've had this problem for quite a while now. I'm a 26 year old male. I have a desk job but never suffer from any pain while at the desk or afterwards. The cause may be from weight training that I started 8 months ago, although I never felt any pain in any of the gym sessions or had a sore neck or upper back afterwards.

I only noticed the problem when I was flossing my teeth before bed one night and tilted my head back to get a better angle. When it was almost all the way back (as far as it would go normally) I noticed a pain/hard ache in the back of my neck/upper spine. Around where the crease develops between the head and upper back when tilting the head back. If I had to pinpoint it I'd say it's near the top of the spine but not quite in the neck. About where the last couple of vertebrae are that you can feel if you massage your upper spine.

I kind of forgot about it as the pain was only present in that certain position and as it's an uncommon position it doesn't affect my lifestyle. However I'd say it's been present for at least a few months.

Anyway, the reason for this post is that I went to a physio as I had a little bit of ulnar nerve twinges in my left elbow/tricep after working out. He then worked on my neck 'to relieve pressure'. His techniques were kind of pulling on my head from behind (when I was lying down) and poking in the neck area.

Unfortunately in the week after this I had pain in both arms and some tingling in my right little finger. He'd obviously caused a lot of irritation to the ulnar nerve where it originates in the neck.

I've just had 4 weeks off all exercise and am feeling better, although the pain in my neck is still there and is a bit worse than before thanks to the physio (but again only when tilting my head back).

I went to another physio and he just said that my nervous system was extremely irritable (thanks to what the other guy had done) and it should calm down after a couple of weeks. It's a week later and I'm feeling much better from a nerve point of view, but the pain in my upper spine/neck is concerning.

Does anyone know what this could be? How to get rid of it? Who would be the best person to see for treatment?

My experience is that physical therapists are pretty much useless unless used for rehab/sports injuries etc, it's just trial and error for anything else. Doctors are clueless and just send you for scans, and I don't think a scan would reveal anything as I'm fine doing everything else apart from tilting my head back. I'm also a bit dubious of chiropractors as they are the same as physios and from my recent experiences I don't want to risk having manual therapy to make things worse again. I realise this doesn't leave many options left but any first hand experience or advise would be appreciated.
39 Responses
1711789 tn?1361308007
Hi there!

Well, without a detailed clinical evaluation it would be difficult to determine the cause of your symptoms. Possibilities that may need to be considered include postural issues, joint inflammation/ degeneration, neuro-muscular causes such as muscle sprain, nerve impingement, injuries to muscles/ ligaments, inflammations, spinal causes such as degeneration, micronutrient deficiencies, referred pain from other regions etc. I would suggest getting this evaluated by a primary care physician initially and depending on the cause diagnosed/ suspected, it can be managed accordingly or specialist care may be sought. Meanwhile you could try using some warm compresses or taking some tylenol/ OTC NSAIDS and see of these seem to help.
Hope this is helpful.

Take care!
Very good advice

Avatar universal
Update on this problem - it's still there!

Still have pain when tilting my head back. A couple of weeks ago I 'slept funny' and woke up and couldn't turn my head to the left at all and was in extreme pain. I know this happens sometimes and don't think it's related to the original problem. Anyway after a week it was gone and I could move my neck again but it brought back some twinges along the ulnar nerve in my arms for the duration of the week.

All the nerve pain is gone now 2 weeks later and I have just been back to the doctor who said he doesn't know why I am still getting pain when tilting my head back or why the nerve is irritated so easily. He sent me for an MRI on the cervical spine which came back with everything being healthy and normal.

I am now at a loss as to what to do. The MRI shows the most detail of any scan and that was totally clear so what can be the problem?

I have read that it could be a strain of the trapezius and read that other people have the same symptoms (tilting head back causes pain). If this is the case why is it not healed after 4 months?

I try to have good posture at work (with a desk job in front of a computer).

The only thing that seems to relieve the pain is swimming. It seems that my heart rate going up and pumping blood around my body reduces any inflammation in my neck and all the pain goes away, but a few hours later I'm back to pain when tilting my head back.

The worst thing for it seems to be sleeping. I'm used to sleeping on my front with my head facing to one side and I seem to wake up now with the trapezius area muscles in the top of my back/lower neck being stiff. When I get up it eases. I'm currently trying to sleep on my back/side to remedy it but I seem to turn in my sleep.

Any suggestions as to what is wrong or what to do to get better would be appreciated.
Avatar universal
Hey Ryan,

I have the EXACT same problem. My doc seems to think it's a ligament problem and my C6 and C7 (the two lower vertebrae of your neck/upper back) are stiff as a result which is why it's causing the pain. I'm not convinced. I've also had this for a few months now and I've seen specialists and doctors and physio's and osteo's and nothing has worked. I'd at a loss. I'd love to keep in touch to see whether either of us find some kind of result from this. It's sad that doctor's just don't seem to know that much about it at ALL. My pain level fluctuates but is always constant and only when I tilt my head back. Thoughts are with you, I know how much it *****.
Avatar universal
To me it appears to be tight muscles on your upper neck area.  When they are tight ot probably is pinching a nerve.  That's why when your dr. Stretches your neck, ot feels good.  Just look up some muscle exercises focusing on your neck area..
Avatar universal
I'm having the same issue for a couple months now. I work in Cardiology so I'm either at my desk or with patients. I try to keep good posture as well. My coworker is a Massage Therapist (her second job) and she said it's a muscular thing in my neck so I'm going to try to have her work on it. She also showed me how to stretch my neck muscles. This whole thing is really irritating but I haven't done much to fix it except the stretching. I'll let you know how it goes with the massage, keep in touch and let me know how you're doin.
Avatar universal
I have this same problem, except it started almost a year ago when I ran into someone head-first while playing hockey.
It hurts when I tilt my head back, but also when I do other things (i can't quite describe exactly how)
I'm going to see an osteo next week, so hopefully the pain will stop.....
Avatar universal
Same thing with me. I am a 27year old female with the same issue. For me, the pain is not constantly occurring, it is only when i tilt my head. This is also accompanied by a slight tingling feeling in my right pinky finger and up towards my elbow. The pain in this area becomes more intense as i flex my wrist. I have a doctor visit next week. Last time I saw my PCP, I informed him of the neck issue, and he looked for MS. Results were negative. I wish I knew what this was besides strange and uncomfortable.
5522174 tn?1369180434
I am having the exact same thing!  I woke up one morning with the stiffest neck I have ever had.  It took 4 days to go away!  I now am left with a very painful and uncomfortable feeling when I tilt my head back and also when I am driving with my left arm elevated on the wheel.  I constantly feel like I have toi straighten out.  I have been to mt Chiro 6 times in 3 weeks and it only seems to be getting worse.  I now have a ache in my inner elbow that seems to send the worst pins and needles to my thumb, pointer and index finer.  My Chiro said they are unrelated but I feel very strongly that they are connected.  Sleeping is the worst!  I wake up in pain 10 times a night !  why is this happening?  Im starting to get worried.  Please keep me posted if you guys come up with anything.  
I also experienced this kind of pain. I had nerve test done as well as an MRI. It was diagnosed as cubital  tunnel syndrome as well as carpel tunnel syndrome. I had surgery and  the pain and tingling and electric shock feelings have subsided 85$%. However I do have herniation's   as well as bulging disk;s in my neck  as well as  in my lower back. I was informed that the pain & discomfort  I still experience is more then likely caused because of these  herniation's or bulging disks. The pain is now traveling down to my right side buttock when I tilt my head back or  when I turn my head (neck) from right to left or left to right. I am  experiencing severe pain. I am currently researching why I am in pain when I tilt my head back as well as  when sleeping  on my side.
I hope you are feeling better and I recommend you see an orthopedic specialist and have  an MRI . Also it can not hurt to get a second or 3rd opinion. Wish you well.
1326416 tn?1370927001
I think you should see a specialist (a physiatrist in this case I think would be best). An MRI, and an EEG, or EMG test will greatly help to diagnose you i'm sure. Everyone gave you solid info. Good Luck, and don't hesitate to ask anything else about anything in the future! take care,
Why a physiatrist?
Avatar universal
I have had the problem with pain in my neck for years as well. The worst it has ever been though was on July 5th. I woke up and had not only the pain in the right side up high in my neck, but both of my arms were in severe pain. It was excruciating. I have been seeing a pain management specialist for years because of both cervical and lumbar arthritis, bone spurs, and bulging disks. She was not sure what was going on but gave me prednisone and upped my pain meds from Lortab for breakthrough, to Percocet. I also take Morhpine for long acting pain management. She had also recently sent me for an EMG to a quack that called himself a Neurologist because I have been having pain, stiffness, and weakness in both of my hands off and on since last year that has been getting more off, than on. They have been trying to figure out if the pain in my hands (worse on right) is coming from my neck issues, or from Rheumatoid Arthritis because I also experience all over body pain which is always at its worst in the morning. He said that he had found that I had carpal tunnel in both hands, and then he just kind of stopped. He really did not test my neck. I felt like two little zaps on the right side and he didn’t even touch the left side.

I am almost finished with the Prednisone and my arms feel almost back to normal, but every time I lay down, my hands get really tight and I can't close them without really working and gently bending them to close again. Especially the right hand....the first and third fingers on the right hand also pop and really hurt after lying down. I have pain in the palm of my right hand too.

The neck pain is still there and I think the reason that it got so much worse was from looking up and titling my head back for over an hour while watching the fireworks display on July 4th.

It has been really painful in the past to do anything that requires bending my head backwards, ie; getting hair washed at hair salon (brings tears to my eyes), painting a ceiling, watching a movie at the theater while being too close to the screen, etc.

In looking at the findings on my most recent MRI taken on 6/24/13, the only issues stated on the "Right" side or "Bilaterallly" of my neck are "At C3-4, bilateral uncovertebral osteoarthropathy but no significant central stenosis. There is mild right neural foraminal narrowing."

Does anyone know if this would be enough to cause my hands to hurt, especially the right one, and not be able to close them after lying down for any period of time, and to also cause pain in my arms so bad?
Avatar universal
Hey guys, I'm having sort of the same problem with my neck. But I can't tilt it back at all or roll my head left or right. It sort of just stops moving, and I get this EXTREMELY sharp pain on the right side of my neck. The pain is coming from somewhere between my shoulder blade and the top of my spine/where the neck begins.  It's not only when I tilt my head backwards, but also when I'm trying to get out of bed, you don't realize how much muscles in your neck are used to simply get of bed or do simple tasks, until you get injured there.

But I injured it just last night playing basketball with my friends. I jumped to save the ball from going out of bounds, and didn't realize there was a fence in front of me. So as I hit the fence with all of my momentum with the top half of my body, specifically left should, and then immediately got this sharp pain in my neck. I have yet to make any progress with tilting my head any further since the initial injury. I've been taking Tylenol, but it hasn't really been doing much.

I am hoping it's just a pinch nerve, as you guys were saying, and I'm just over thinking it. I just really don't want this to get any worse. I'm thinking of just resting it and keep the moving of my neck to a bare minimum for a couple of days to see if it heals at all. What do you guys think I should do?
Avatar universal
same problem... tilting my head back... also turning to either side at some point it reaches a similar painful sensation... I do lift weights constantly and believe it has to do to some extent with this type of activity, just my thought process is that it may have to do with muscular balance and tightness due to growth. Just my "own" hypothesis. That post about stretching sounds like a good idea. I also do yoga about once a week, and it has helped me in other areas about muscular tightness, soreness, pain.
Avatar universal
Same here. Woke up fine, opened my patio door and felt a pop in the left side of my neck. Had to golf 3 days later in a tournament so loaded up on Alieve and Ben gay. Got through golf fairly well and now it feels like the back of my neck is bruised and my muscles are very tight. Icing and heat help but it's still lingering after 2'weeks. Going to see a chiropractor this week if it keeps it up, and mine too gets stiffer at night during sleep. Glad I'm not alone in this. It's not so painful I can't do anything but is quite annoying
Avatar universal
I have the same issue when I tilt my head back as well.  This has been going on for a little over a month with no relief.  It seems to get irritated when I crane my neck forward or am looking down for a while.  At a total loss on what to do.  Seems I'm not alone.  
Avatar universal
This is my first time posting and was interested in the thread, has anybody had any luck in finding a solution, ive been having problems with tight neck muscle and traps, i found myself a very good personal trainer who dealt with posture correction , even though i though my posture was good it wasnt , my muscles are imbalanced and he said it is very common, for any of you who have not found a solution try a good personal trainer. Mine even took photos of my posture and showed me where it was out and why this can cause all the symptoms that everyone on here has mentioned.

Hope this helps
1994812 tn?1382902049
You could have a Cervical Herniated Disk, chiari, or a tethered spinal cord.  Get an MRI!
1994812 tn?1382902049
I had many of the symptoms described here and had occult tethered cord.  It took 3 years to get the diagnosis and I did a lot of physical therapy, massage, and chiropractic/osteopathic manipulations with no results.  Was told it was a muscoskeletal issue or a whiplash injury or a mental illness.  Nothing explained how it moved from being a shoulder problem to a full body problem.  

I had full body spasms when I tilted my head back or look down.  I still have it to a lesser degree as I am 2 months post op and theres still much healing to do (nerves heal slow).  So anyone in here, with clean cervical MRI but still have neck pain, try a thoracic and lumbar mri to see if you have a tumor or tether or any other progressive disease!
Avatar universal
I have the same problem also. pain just wont go away took advil, ty, aleve. still
didn't work for me. So one day I visit my mom she said what's wrong with you, then she said go see your dad which he's a doctor. buster. j/k. so I went to see my dad and he just says lay down front forward and acupuncture me told me to come back every week same day i was there. so it worked  NO MORE PAIN. So try it see if it works for you. never trusted my dad so now i do. took me 7 years. don't wait. so don't be going and getting surging done to your neck or spinal cord in till you find out what it is. or you're regret it
Avatar universal
I had similar problems and had also been diagnosed with fibromyalgia in the past.  I saw a great doctor who ordered a positional MRI of my neck. It  was normal in the flexed forward and neutral positions but in extension (tilted back) my spinal cord was being pinched to a diameter of 4.6mm. It is called positional cervical cord compression. I had it surgically corrected. You may want to research this and ask your doctor about it.
Avatar universal
I was dusting the overhead fan, I tilted my head back and had the biggest badest headache in the world, and it went behind both my eyes what on earth is happening, I fell in my bathroom last year and cracked my head on the cabinet it took weeks to get better and now this.
is this related in any way?
Avatar universal
I have a simler problem. It changes a bit everyday actually. The pain feels like soarnes. But I have no reason to be sore. I haven't been working out (lazyness). The pain is in my shoulders, back, and neck. It gets a lot worse at night, which is very annoying. When I tilt my head down the feeling is simler to pulling of hamstrings. I don't understand what's wrong since I'm only 14.
Avatar universal
I have a simler problem. It changes a bit everyday actually. The pain feels like soarnes. But I have no reason to be sore. I haven't been working out (lazyness). The pain is in my shoulders, back, and neck. It gets a lot worse at night, which is very annoying. When I tilt my head down the feeling is simler to pulling of hamstrings. I don't understand what's wrong since I'm only 14.
Avatar universal
my hypothesis is that it is all due to muscle weakness and poor posture and the sensitive place people are finding themselves these days. Luckily there are many posture correction techniques and strength training exercises.  A combination of the muscular strength and knowledge about posture will give you the basic tools to avoid becoming slouched over your mobile device while your back neck and shoulder muscles slowly deteriorate with every cup of coffee, exposing your weak and maligned spine to the pain that comes from vertebrae stacked on top of one another with no muscular support, and in many cases an actual pulling downward of the head for extended periods of time, over and over again, neck bent the wrong way as it should remain in an upright position with a slight curve back in the opposite direction.  The discs between each vertebrae that keep things cushy start to get compressed and put pressure on the nerves inside the cord!  Love the cord people please.  Many adjustments, electronic devices, balls, rollers, chair lumbar supports, yes yes yes whatever it takes.  But workout the back like 2 - 3 times a week and become a strong person.  Otherwise, you can stay very weak but you will likely have to live with bony shoulders and very gentle activity.  One night of drinking and sleeping on that neck wrong could throw you into a fizzy and you will be fighting with your friends and neighbors and coworkers.  You will only want to sleep and then when you are away you will likely only want coffee.  You will go to yoga which will work, but seems like you are still very sensitive.  I think the only true way is to develop back muscles and a strong core to give you that killer posture.  Then you need to maintain that and get over the whole tight little girl muscles that you probably have (somewhere in there).  Speaking to myself here, not anyone in the forum in specific.  Hope this helps.
Avatar universal
I to have same problem with my neck I had philosophy  after two sessions it was a lot better neck stretches help I was doing ok till two days ago spent 20mins on my rowing machine and the pain is back I allso do a lot of knitting,
I realised I need do do neck stretches first .
Stretch out fully I find swimming front crall is the best for me as breaststroke throw you neck back I am a great swimmer and I am going back swimming next week  suffer ed most of last year with my neck , I am not letting myself get like that again Hope this helps other people to find a
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