Neck pain

What is it?

There are two main types of neck pain

Acute neck pain – pain that has been present for less than six weeks
Chronic neck pain – pain that has been present for over three months

This guidance covers only acute neck pain which is the most common:

Acute neck pain is most commonly idiopathic (of no known cause) or attributed to a whiplash injury
Most are probably due to minor sprains or bad posture
Full recovery occurs in most cases
The usual advice is to keep the neck active
Painkillers are helpful until the pain eases
Chronic (persistent) pain develops in some cases, and further treatment may then be needed

How does it affect people?

Pain develops in the neck and may spread to the shoulder or base of the skull. Movement of the neck feels restricted and moving the neck may make the pain worse. The pain sometimes spreads down an arm, sometimes as far as to the fingers. Sometimes, ‘pins and needles’ develop in part of the arm or hand. This is due to irritation of a nerve going to the arm from the spinal cord in the neck.

Approximately 40% of patients recover fully from idiopathic neck pain
Approximately 30% continue to have mild symptoms
30% of patients continue to have moderate or severe symptoms.
Approximately 56% of patients fully recover within three months from the onset of acute whiplash-associated neck pain
60-85% fully recover within one – two years
15-40% continue to have symptoms
5% are severely affected

How is it treated?

The majority of cases of acute neck pain will resolve without the need for any specific medical treatment. Initially, painkillers or anti-inflammatory medication may be required under guidance from the GP.

Symptoms commonly begin to improve after a few days, and are usually gone within a few weeks. However, the time taken for symptoms to settle varies from person to person. Some people develop chronic (persistent) neck pain. If an employee develops chronic neck pain, the tendency is for the pain to come and go with ‘flare-ups’ from time to time.

Generally the advice on managing neck pain is as follows:

Keep the neck moving as normally as possible
At first the pain may be quite bad, and your neck may need to be rested for a few days
Gently exercise the neck as soon as you are able to
Do not allow the neck muscles to ‘stiffen up’
Gradually try to increase the range of the neck movements every few hours
Gently move the neck in each direction several times a day
As far as possible, continue with normal activities

How might it affect work?

Most employees with acute neck pain are able to continue working or return to work within a few days, even if they have some residual or recurrent symptoms, although their work may require short term modifications to allow this. Getting back to ‘normal’ activity, including work, is crucial to good recovery. The symptoms vary widely from one individual to another, making generalisation difficult. However employees may experience discomfort with some or all of the following tasks;

Repetitive neck/head movements (may affect driving)
Acute neck pain may be exacerbated by heavy lifting
Sitting for prolonged periods at a computer
Repetitive bending

What do I need to do as the manager?

Discuss the problems with your employee specifically in respect of the tasks above and how they relate to work activities. Identify what tasks they can and cannot perform and the length of time that they can perform them. Where changes can be reasonably accommodated you should modify duties to enable the employee to return or continue at work. It is likely that their capability will improve quite quickly so you should review the work with the employee every 2-3 days. Make sure that they are able to cope and where possible increase their workload in stages to help facilitate their return to full duties.

Focus on support; helping them to remain at work or to return to work as quickly as possible
Employees do not need to wait until they are pain free before they return to work
Check that the sitting position at work or at their computer is not poor. (That is, not with the head flexed forward with a stooped back.)
Modified duties should be a temporary measure and not normally last for more than 4 weeks
In case of an absence of more than 4 weeks, or difficulty in returning to normal duties after 4 weeks, refer to Occupational Health for advice

Points to remember

Fit notes

If an employee produces a fit note indicating that they require modified duties, discuss this with them and consider if the modification recommended can be reasonably accommodated.

Job tasks and risk assessments

Review the risk assessment for the employee’s job role and work tasks including the ability to drive safely where required. Take into consideration any temporary modification that may be required to accommodate their reduced ability to undertake certain tasks.

General guidance

If you require further information, refer to the general advice on managing attendance.