1 Did the pain follow a violent movement?

2 Are any of the danger signs in the warning box present?

3 Do you have one or more of the following symptoms?

• Severe headache
• Fever
• Dislike of bright light
• Drowsiness and/or confusion
• Flat, dark red spots that do not fade when pressed ( Checking a red rash)

4 Did you wake with a stiff, painful neck?

5 Do you have one or more tender swellings at the sides of your neck?

6 Do you have pain that shoots down an arm?

7 Has this pain developed suddenly?

8 Has the pain or stiffness been getting worse over a period of months?

9 Emergency! Call an ambulance

Possible cause Damage to the spinal cord is possible. Try not to move while waiting for the ambulance to arrive.

Action In hospital, you will be examined and have tests, such as X-rays and MRI, to look for the site and extent of any damage. In some cases, surgery to repair a fracture may be required.

10

Possible cause and action An injury involving the muscles, ligaments, and/or tendons in the neck is likely. In most cases, self-help is all that is needed. Rest your neck as much as possible by lying down so that your neck muscles are not supporting the weight of your head, and take over-the-counter painkillers. If the symptoms are no better within 24 hours, consult your doctor, who may suggest you wear a soft, supportive neck collar.

11 Emergency! Call an ambulance

Possible cause Meningitis, inflammation of the membranes surrounding the brain, due to infection, may be the cause of these symptoms.

Action If meningitis is suspected, you will be admitted to hospital immediately. You will receive urgent treatment with antibiotics and may need intensive care.

12

Possible cause You may have torticollis (wry neck), in which the muscles on one side of the neck contract, causing pain and stiffness. Although painful, this condition is not serious.

Action Take over-the-counter painkillers and rest your neck by lying down so that your neck muscles are not supporting the weight of your head. Torticollis usually improves in 24-48 hours without medical treatment. If you are no better in 48 hours, consult your doctor, who may prescribe a soft, supportive neck collar to wear until the symptoms have gone.

13

go to Lumps and swellings

14

Possible cause A nerve that runs down the arm may be compressed or irritated at its origin in the neck. Consult your doctor.

Action Your doctor will examine you and may arrange for tests such as an X-ray. He or she will probably suggest that you wear a soft supportive collar around your neck. You may be referred for physiotherapy.

15

Possible cause Cervical spondylosis, osteoarthritis in the bones in the neck, may be the cause. Consult your doctor.

Action Your doctor may arrange for an X-ray to confirm the diagnosis. A soft, supportive collar may relieve the pain. Over-the-counter painkillers may also help.

16

Consult your doctor if you are unable to make a diagnosis from this chart.