Medicines and side effects

A side-effect is an unwanted symptom caused by medical treatment. Side effects can be caused by all kinds of medicines, including prescription and over-the-counter medicines, complementary medicines including herbal preparations, vitamins, and some products dispensed by naturopaths and other practitioners of complementary medicine. It’s estimated that around 230,000 Australians are admitted to hospital every year because of problems associated with the use of medicines, including side effects. Death can also occur in severe cases. It is in your best interests to manage your medicines wisely. See your doctor or pharmacist for further information and advice.

Prescription medicines can cause side effects

All medicines can cause unwanted side effects. For example, antibiotics such as those in the sulfonamide and penicillin families cause allergic reactions in around five per cent of the population. Skin rashes are a common reaction. However, whether a reaction is caused by the medicine or the illness that it is used to treat is sometimes difficult to tell.

A further complication is the interaction of medicines with any other medicines the person may be taking, including prescription, over-the-counter and complementary medicines. .

Complementary medicines also cause side effects

About 60 per cent of Australians use complementary medicines at least once a year. Many people believe that alternative or complementary preparations, such as herbal remedies, are safer because they are derived from natural sources. This isn’t always true.

Some herbs can act on the body as powerfully as any conventional medicine, and unwanted side effects can occur.

Some examples of complementary medicines that can cause side effects include:

echinacea – more than 20 different types of reactions have been reported, including asthma attacks, hives, swelling, aching muscles and gastrointestinal upsets
feverfew – pregnant women are cautioned against using this herb, as it can trigger uterine contractions. In animal experiments, the use of feverfew was found to trigger spontaneous abortions (miscarriages)
asteraceae plants – (from the daisy family, including feverfew, echinacea, dandelion and chamomile) – side effects include allergic dermatitis and hay fever.

Complementary medicines can interact with prescription medicines

About 20 per cent of Australians are thought to take complementary medicines and prescription medicines at the same time. This increases the risk of side effects, because the active ingredients in the various preparations can interact in a negative way.

For example, the medicines may have similar active ingredients that act in the same way, or the complementary medicine may increase or reduce the effectiveness of the prescription medicine.

Some interactions between complementary medicines and prescription medicines that can put people’s health at risk include:

Echinacea may interact with medications broken down by the liver.
Many complementary medicines – including feverfew, ginkgo and chamomile – may increase the risk of bleeding in people taking anticoagulant medicines such as warfarin and anti-inflammatory medicines such as aspirin.
St John’s wort has caused breakthrough bleeding and could cause unwanted pregnancy in women taking the oral contraceptive pill.
St John’s wort increases serotonin. Taking St John’s wort at the same time as other medicines that increase serotonin (such as antidepressants) increases the risk of serotonin toxicity (serotonin syndrome) – symptoms include tremors, high temperature and low blood pressure and can range from mild to life threatening.

Alcohol used with medicines can cause side effects

Consuming alcohol with some medicines can also cause unwanted and sometimes dangerous side effects. For example:

Alcohol can cause drowsiness or dizziness when taken with antihistamines, antidepressant medicines, sleeping tablets or medicines for anxiety.
Medicines for high blood pressure and travel sickness, and some pain relievers can also be affected by alcohol.
Some antibiotics interact negatively with alcohol. For example, the antibiotics metronidazole and tinidazole can cause a severe reaction if combined with alcohol, including nausea, vomiting, skin flushing, headache and a fast or irregular heartbeat. Other antibiotics can cause stomach upset, drowsiness or dizziness if combined with alcohol. Ask your doctor for advice about alcohol when you are prescribed antibiotics.

Alcohol can stay in your system for several hours after your last drink, so it is important to be aware that interactions can occur if you take your medication within this time frame.

Talk to your doctor or other health professional for advice about your medication and drinking alcohol.

What to do if you experience side effects

If you experience side effects when taking medication:

In an emergency, call triple zero (000).
Note the side effects and consult your doctor if you have any concerns. The dose or type of medicine may need to be adjusted.
If you are sensitive to a particular medicine, and a substitute is not available, your doctor may suggest desensitisation therapy.
Call the NPS Medicines Line on 1300 633 424 or the Adverse Medicines Events Line on 1300 134 237 for advice. These phone-line services allow consumers to report or receive advice on side effects. They are not emergency services.

How to reduce the risk of side effects

To reduce your risk of experiencing side-effects:

Take all medicines strictly as prescribed. (Taking medication incorrectly can cause side effects.)
Don’t take anyone else’s medicines.
Learn about your medication. All prescription medicines have an information leaflet called Consumer Medicine Information (CMI). This includes detailed information on the medicine in plain English, including use, side effects and precautions. Your pharmacist can give you the CMI for your medicine.
Ask your pharmacist for advice if you buy over-the-counter medicines. They can advise you about side effects and interactions with other medicines you are taking. Be aware that medicines you buy in the supermarket can also cause side effects.
Tell your doctor about all the medicines you take, including prescription, over-the-counter and complementary medicines.
Ask your doctor if improving your lifestyle could reduce your need for medication. Some conditions can be better managed with changes to your diet and regular exercise.
Have an annual review of all the medicines you take. This is particularly important for older people because, as people age, they are more likely to have side effects from medicines. Any medicines considered no longer necessary should be stopped. Ask your doctor if you might benefit from a Home Medicines Review. A pharmacist will review all the medicines you take.
Return unwanted and out-of-date medicines to your pharmacy for safe disposal. This service is provided free of charge.
Talk to your pharmacist about dosage aids that can help you organise your pill taking. You may be at risk of making mistakes if you take many different medicines at different times.
Ask your doctor or pharmacist questions so you can clearly understand the benefits and risks of your medicines.

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5 common medicines that could kill you (you have them in your house)

By Emily Cummings, FamilyShare

The idea of overdosing usually brings illegal drugs to mind, but that’s not always the case. The danger of overdosing on common medicines is all too real — and still comes with the same deadly side effects as illegal drugs do. If these medicines are lurking in your cabinet, make sure you are following the suggested dosages to avoid severe injury or even death.

1. Midol

Your once-a-month visitor usually comes with serious cravings and a bottle of Midol to make your week of torture less painful, right? Be careful. Like other painkillers on this list, Midol contains Acetaminophen (APAP) which helps relieve your pain, however, APAP is also easy to overdose on. Midol can cause liver failure or even death if you overdose on these small pills.

Take only the recommended dose and don’t take other pills that contain APAP. Initial signs of an APAP overdose include loss of appetite, nausea, vomiting, stomach pain, sweating and confusion or weakness.

2. Tylenol

Tylenol offers the same risk as Midol, which is Acetaminophen. In normal doses, the drug is eliminated in the urine, but some of it is turned into a byproduct that’s deadly to your liver. If you take too much, your liver can’t keep up and starts to fail. Doctors recommend only taking 3,000 milligrams of APAP in a 24-hour period.

What is tricky is how many other drugs contain APAP. If you take Tylenol for your cold, and then Midol for your period cramps, you'll pass the recommended dosage. Deadly combinations are all too easy to make, so double check your labels and be certain you aren’t taking too much APAP.

3. Advil

Advil and other ibuprofen-like drugs are NSAIDS — nonsterodial anti-inflammatory drugs which can cause death and serious gastrointestinal bleeding and ulcers if not taken as directed. NSAID drugs hospitalize over 100,000 people and kill 16,500 in the US each year due to overdoses, wrongful combinations, or incorrect usage (not taking pills with a little food or milk, etc). The most important thing to keep in mind is to carefully manage your pain in the safest way possible. If you find that yoga or a hot soak relieves you headache, do that instead of popping pills. WebMD also suggests talking with your doctor to carefully coordinate your pain management regime and make sure medications aren’t conflicting.

4. Epsom salts

Perfect for a soothing baths, epsom salts are also used as a natural laxative because they contain magnesium sulfate. Dissolving epsom salts in water to use as a laxative is approved by the FDA, but epsom salts can cause some serious side effects. A high dose can rupture your intestinal wall, cause infection and/or react dangerously to other ingredients you ingest (such as coffee or herbs). Always consult with your doctor before trying any treatment, even one so seemingly harmless as epsom salts.

5. Cough syrup

Along with other cold medicines that contain Dextromethorphan (DXM), cough syrup doesn’t have any serious side effects when taken as directed, but extreme doses of this medication can cause a sort of hallucinogenic state; making it a popular and cheap way for teens to get high. Teens are extracting the DXM from the syrups to take as a powder or pills, which is making overdosing on cold medicine much more common.

To prevent your stash of cold medicine being used for recreational purposes, don’t stock up on these over-the-counter medicines, monitor the amount you have and don’t allow your children to keep these drugs in their bedrooms or backpacks.

Don't ignore the dangers of over-the-counter medications. Talk to your doctor to make sure you aren't conflicting doses and do your research before taking more than one medication. Always follow the directions before taking any sort of medication, and be sure to keep an eye on your children to make sure they aren't abusing these potentially dangerous drugs.

Emily is a graduate of Brigham Young University and is a staunch believer in pie as breakfast food. Read more about her travels and tastings at ercummings.blogspot.com.

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10 of the most dangerous street drugs in the world

The drugs that will rot your flesh, destroy your vital organs, and turn you into a zombie.
As Ireland announces it will decriminalise heroin and Ohio considers legalising marijuana, we look at 10 most dangerous street drugs in the world, their histories and side-effects.

10. Purple Drank

One of the more unusual drugs around at the moment, purple drank was popularised in 90’s hip hop culture, with the likes of Jay Z and Big Moe all mentioning it in their songs. It is a concoction of soda water, sweets and cold medicine, and is drunk due to cold medicine's high codeine content, which gives the user a woozy feeling. However it can also cause respiratory issues and heart failure.

9. Scopolamine

Scopolamine is a derivative from the nightshade plant found in the Northern Indian region of South America (Ecuador, Colombia and Venezuela). It is generally found in a refined powder form, but can also be found as a tea. The drug is more often used by criminals due its high toxicity level (one gram is believed to be able to kill up to 20 people) making it a strong poison. However, it is also believed that the drug is blown into the faces of unexpecting victims, later causing them to lose all sense of self-control and becoming incapable of forming memories during the time they are under the influence of the drug. This tactic has reportedly been used by gangs in Colombia where there have been reports of people using scopolamine as a way to convince victims to rob their own homes.

The CIA also revealed in 1993 that they had trialled the drug as a truth serum during the Cold War. However it is believed it wasn’t effective due to scopolamine’s ability to induce hallucinations at a low dosage.

8. Heroin

Founded in 1874 by C. R. Alder Wright, heroin is one of the world’s oldest drugs. Originally it was prescribed as a strong painkiller used to treat chronic pain and physical trauma. However, in 1971 it was made illegal under the Misuse of Drugs Act. Since then it has become one of the most destructive substances in the world, tearing apart communities and destroying families.

The side effects of heroin include inflammation of the gums, cold sweats, a weak immune system, muscular weakness and insomnia. It can also damage blood vessels which can later cause gangrene if left untreated.

7. Crack cocaine

Crack cocaine first came about in the 1980’s when cocaine became a widespread commodity within the drug trafficking world. Originally cocaine would have attracted a high price tag due to its rarity and difficulty to produce, but once it became more widespread the price dropped significantly. This resulted in drug dealers forming their cocaine into rock like shapes by using baking soda as a way of distilling the powder down into rock form. People were doing this because it allowed for them to sell cocaine at a lower quantity and to a higher number of people.

Since then it has gone on to form one of the biggest drug epidemics in the world, and during the height of its popularity it was believed that over 10 million people were crack cocaine users in the US alone.

The side effects of crack cocaine include liver, kidney and lung damage, as well as permanent damage to blood vessels, which can often lead to heart attacks, strokes, and ultimately death.

6. Crystal meth

Not just famous because of a certain Walter H White, but also because it is one of the most destructive drugs in the world. First developed in 1887, it became widely used during the Second World War when both sides would give it to their troops to keep them awake. It is also believed that the Japanese gave it to their Kamikaze pilots before their suicide missions.

After the war crystal meth was prescribed as a diet aid and remained legal until the 1970s. Since then it has fallen into the hands of Mexican gangs and has become a worldwide phenomenon, spreading throughout Europe and Asia.

The effects of crystal meth are devastating. In the short-term users will become sleep depraved and anxious, and in the long-term it will cause their flesh to sink, as well as brain damage and damage of the blood vessels.

5. AH-7921

AH-7921 is a synthetic opioid that was previously available to legally purchase online from vendors until it became a Class A in January 2015. The drug is believed to have 80% of the potency of morphine, and became known as the ‘legal heroin’.

While there has only been one death related to AH-7921 in the UK, it is believed to be highly dangerous and capable of causing respiratory arrest and gangrene.

4. Flakka

Flakka is a stimulant with a similar chemical make-up to the amphetamine-like drug found in bath salts. While the drug was originally marketed as a legal high alternative to ecstasy, the effects are significantly different. The user will feel an elevated heart rate, enhanced emotions, and, if enough is digested, strong hallucinations. The drug can cause permanent psychological damage due to it affecting the mood regulating neurons that keep the mind’s sertraline and dopamine in check, as well as possibly causing heart failure.

3. Bath salts

Bath salts are a synthetic crystalline drug that is prevalent in the US. While they may sound harmless, they certainly aren’t the sort of salts you drop into a warm bath when having a relaxing night in. They are most similar to mephedrone, and have recently been featured throughout social media due to the ‘zombification’ of its users.

The name comes from the fact that the drug was originally sold online, and widely disguised as bath salts. The side effects include unusual psychiatric behaviour, psychosis, panic attacks and violent behaviour, as well as the possibility of a heart attack and an elevated body temperature.

2. Whoonga

Whoonga is a combination of antiretroviral drugs, used to treat HIV, and various cutting agents such as detergents and poisons. The drug is widely available in South Africa due to South Africa’s high rate of HIV sufferers, and is believed to be popular due to how cheap it is when compared to prescribed antiretrovirals.

The drug is highly addictive and can cause major health issues such as internal bleeding, stomach ulcers and ultimately death.

1. Krokodil

Krokodil is Russia’s secret addiction. It is believed that over one million Russians are addicted to the drug.

Users of krokodil are attracted to the drug due to its low price; it is sold at £20 a gram while heroin is sold for £60. However, krokodil is considered more dangerous than heroin because it is often homemade, with ingredients including painkillers, iodine, lighter fluid and industrial cleaning agents. This chemical make-up makes the drug highly dangerous and likely to cause gangrene, and eventually rotting of the flesh.

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7 Dangerous Drug Mistakes

Experts explain the dangers of mixing drugs, not checking labels, and other common drug mistakes.

The football player Terrell Owens blamed his recent trip to the hospital on a bad mix of painkillers and a supplement. The son of Anna Nicole Smith reportedly died with a mixture of the antidepressants Lexapro and Zoloft and the drug methadone in his system.

The veracity of these incidents is yet to be determined. But the danger of mixing drugs, supplements, and/or alcohol is very real.

At least 1.5 million people in the U.S. are harmed annually by medication errors, according to a report issued in July 2006 by the Institute of Medicine.

Reducing your risk, experts agree, is often a matter of using common sense and asking your doctor or pharmacist the right questions. WebMD asked a pharmacist, two doctors, and a nurse to weigh in on the most common mistakes that lead to medication errors and to suggest practical ways to minimize or eliminate the risks.

1. Mixing Drugs That Interact Adversely

"Antidepressants and methadone together can be a real problem," says Russell Jenkins, MD, a member of the board of directors for the Institute for Safe Medication Practices in Huntingdon Valley, Pa., and a former primary care doctor for 27 years. "Each drug can increase the sedative effect of the other."

"Painkillers and supplements can be a problem, because you don't know what is in the supplements, since they are not under [the same] Food and Drug Administration regulation [as drugs are]," he adds.

Certain other combinations -- even if one of the drugs is over-the-counter -- should also be avoided.

Many antibiotics reduce the effectiveness of oral contraceptives, says Matthew Grissinger, RPh, a pharmacist and education safety analyst at the Institute for Safe Medication Practices. "Use backup protection if you are on the pill and need an antibiotic."

The blood thinner Coumadin, taken by people with blood clots or with heart valve conditions, shouldn't be mixed with ginseng, says Jenkins. Nor should it be used with aspirin, says Grissinger. "It's an additive effect," he says of the Coumadin-aspirin combination. "It increases your chance of internal bleeding or, if you get a cut on your finger, the blood won't clot as quickly." Indeed, there are many drugs and supplements that are off-limits when you are taking Coumadin.

If you have elevated blood pressure, even if you're on medication to control the pressure, you should not take over-the-counter oral nasal decongestants without talking first to your pharmacist or doctor, Grissinger says. The preparations can raise your pressure.

2. Mixing Drugs and Alcohol

"Prescription pain medicines and antianxiety medications such as Valium and Xanax can have an additive effect when mixed with alcohol," says Grissinger. "You won't be alert. Your driving response time will suffer. Don't mix these together."

Another drug that shouldn't be mixed with alcohol: acetaminophen (Tylenol) and alcohol, because it can harm your liver.

Cough and cold preparations with antihistamines shouldn't be mixed with alcohol because they will amplify the sedative effects, Grissinger says. This warning applies to the use of narcotic pain medications, too.

"Be careful mixing alcohol with certain antibiotics," says Jenkins. "The main antibiotic-alcohol interactions are with metronidazole (Flagyl) and the sulfa drugs -- commonly used antibiotics." An example of a sulfa drug is Bactrim.

Mixing metronidazole and alcohol can cause nausea, vomiting, flushing, headache and stomach pain, Jenkins says. 3. Leaving the Doctor's Office Without Enough Information

"When you leave your doctor's office, you need to know the name of the medication and what it is for," says Grissinger. Ask how many times a day you should take it, he adds, and how you might react.

"Ask for written instructions," says Jenkins. "At the doctor's office, people only remember about a third of what the doctors tells them," he says, citing several studies. 4. The Wrong Prescription From the Pharmacy

This isn't always your fault, of course, but there's plenty you can do to reduce the risk. First, how it happens: "A pharmacist may not be able to read the doctor's handwriting," Grissinger says. To remedy this, ask your doctor to write down on the prescription pad what the drug is for. That way, if the drug is one of many with sound-alike, look-alike names, your pharmacist can double-check that he's giving you the right drug by looking at the drug's purpose.

Always check your medications before leaving the pharmacy to be sure it's your name on the bottles, Grissinger says. "If you are picking up a refill, open the bottle in front of the pharmacist and make sure the pills look the same. If they don't, ask why not." It might be as simple as the health plan changed manufacturers, he says, but check to be sure.

5. Using Multiple Pharmacies

"If you go to multiple pharmacies, they can't screen for drug interactions," Grissinger says, because they won't have a complete list of all the medications you are on, as a single pharmacy is likely to keep in its computer. If you use your HMO's ground pharmacy and also use its mail-order service, each may not have a list of the medications filled at the other, he says.

If you insist on using multiple pharmacies due to convenience or cost savings, "show them a list of every medicine you take," Grissinger says.

If you go to another health care professional -- for example, a dermatologist in addition to your primary care doctor -- they should ask you which other medications you are on before prescribing you another. But if they don't, be prepared to tell them. Either way, take a list of your medications and the doses with you, says David W. Bates, MD, chief of the division of general medicine at Brigham and Women's Hospital and professor of medicine at Harvard Medical School. Bates served on the Institute of Medicine committee on identifying and preventing medication errors.

6. Not Taking Medications as Directed

"Compliance is a major problem, especially in the elderly," Jenkins says. "As many as one-third of older people don't take medicines as directed." It may be cost related, he says, or simple forgetfulness.

What to do? You can use the boxes that help mind your pills by having a day of the week for each, or simply put your medicines in a place where you will remember to take them. Grissinger's mother, for instance, keeps medication she must take daily on the kitchen windowsill, in full view.

When medicine is prescribed, Jenkins says, ask your doctor if there is a way to take the medicine less often during the day, such as switching to a higher dose or a different medicine that doesn't require as many doses.

While some forget to take medicines, others overdo, says Bates. "Too much of a drug gets people into trouble," he says. And that includes over-the-counter preparations. "People will not get enough relief and will take more thinking it will be helpful." Often, it spells trouble, he says.

7. Not Asking Enough Questions as a Hospitalized Patient

Each year, about 400,000 preventable drug-related injuries occur in U.S. hospitals, according to the Institute of Medicine report.

Speak up, or ask a family member to do so for you, suggests Kathleen R. Stevens, EdD, RN, professor and director of the Academic Center for Evidence-Based Practice at the University of Texas Health Science Center in San Antonio. Stevens also served on the Institute's committee.

"The most common 'error' is not getting a drug at the right time," she says. "Some drugs are very time-sensitive."

In addition to keeping track of when it's time to get medicine, or asking a family member to help, there are other questions worth asking, she says. When a nurse brings in medicine, she says, ask: "What is this for? What can I expect in terms of responding? Is it not indicated for use with any of the other medications I have?"

You should expect a nurse to ask your name and check your wristband ID before giving you medication, according to the Institute for Safe Medication Practices.

Stevens tells patients to bring to the hospital (or have a family member, if it was an emergency admission) all the medications you are on, including the dose of each.

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whiplash

Whiplash occurs when a person’s head moves backward and then forward suddenly with great force. This injury is most common following a rear-end car collision. It can also result from physical abuse, sports injuries, or amusement park rides.

Whiplash results when the soft tissues (the muscles and ligaments) of your neck extend beyond their typical range of motion. Your symptoms might not appear for a while, so it’s important to pay attention to any physical changes for a few days following any accident.

Whiplash is thought of as a relatively mild condition, but it can cause long-term pain and discomfort. How do whiplash injuries occur?

Whiplash occurs when the muscles in your neck suffer a strain because of a rapid movement backward and then forward. The sudden motion causes your neck’s tendons and ligaments to stretch and tear, resulting in whiplash.

Some things that can cause whiplash include:

car accidents
physical abuse, such as being punched or shaken
contact sports such as football, boxing, and karate
horseback riding
cycling accidents
falls in which the head violently jerks backward
blows to the head with a heavy object

What does whiplash feel like?

Symptoms usually appear within 24 hours after the incident that caused the whiplash. Sometimes, symptoms may develop after a few days. They can last for several weeks.

Common symptoms include:

neck pain and stiffness
headaches, specifically at the base of the skull
dizziness
blurred vision
constant weariness

Less common symptoms associated with chronic whiplash include:

problems with concentration and memory
ringing in the ears
inability to sleep well
irritability
chronic pain in the neck, shoulders, or head

You should follow up with your doctor immediately if:

your symptoms spread to your shoulders or arms
moving your head is painful
you have numbness or weakness in your arms

How is whiplash diagnosed?

Most mild to moderate cases of whiplash can be treated at home using over-the-counter (OTC) drugs, ice, and other remedies. However, you should seek medical help if you have the following symptoms:

pain or stiffness in the neck that goes away and then returns
severe neck pain
pain, numbness, or tingling in your shoulders, arms, or legs
any issues with your bladder or bowels
localized weakness in an arm or leg

Your doctor will normally ask you questions about your injury, such as how it occurred, where you feel pain, and whether the pain is dull, shooting, or sharp. They may also do a physical exam to check your range of motion and look for areas of tenderness.

Your doctor might order an X-ray to ensure your pain isn’t connected to any other type of injury or degenerative disease such as arthritis.

Other tests, such as CT scans and MRI, will allow your doctor to assess any damage or inflammation in the soft tissues, spinal cord, or nerves. Certain imaging studies, such as diffuse tensor imaging (DTI) or positron emission tomography (PET scan), may be helpful, especially when there may be a brain injury. These tests will help localize and measure the extent of an injury to the brain or other areas.

Treatment for whiplash

The treatments for whiplash are relatively simple. Doctors will often prescribe an OTC pain medication like Tylenol or aspirin. More severe injuries may require prescription painkillers and muscle relaxants to reduce muscle spasms.

In addition to medication, physical therapy plays a crucial role in recovery. You may want to apply ice or heat to the injured area and practice simple exercises to build strength and flexibility in your neck. Practice good posture and learn relaxation techniques to keep your neck muscles from straining and to help with recovery.

You might also be given a foam collar to keep your neck stable. Collars should not be worn for more than three hours at a time. They should only be used the first couple of days after your injury, as well.

Complications associated with whiplash

Some people with whiplash do experience chronic pain or headaches for years following their accident. Doctors may be able to trace this pain to damaged neck joints, disks, and ligaments. But chronic pain following a whiplash injury typically has no medical explanation.

However, very few people have any long-term complications from whiplash. Usually, recovery time is anywhere from a few days to several weeks. According to the National Institute of Neurological Disorders and Stroke, most people recover fully within three months.

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Do You Have a Stiff Neck? Try These Simple Remedies

With so many of us gazing into computers or staring down at our smart phones most of the day, it’s no wonder data from the Centers for Disease Control and Prevention reports that nearly 20 percent of us have experienced neck pain within the past three months.

A stiff neck typically is the result of muscles weakening over time from poor posture or misuse, says chiropractor Andrew Bang, DC, of Cleveland Clinic’s Center for Integrative Medicine.

Looking down at your computer monitor all day can cause the muscles around the neck joints to tire and become overstretched. Driving for long periods of time or looking at your smart phone can have the same effect. If you’re doing this day after day, it can add up and can displace your neck joints.

“When your neck muscles become weak and you try to turn your head, the joint no longer moves smoothly because it’s now out of place,” Dr. Bang says. “Often the joint catches on something, either pulling a muscle or hitting the nerve irregularly, or maybe both. Then you’ll have instant pain and your body has a protective spasm. Your body doesn’t want you to get hurt more, so it will clench, causing you to feel like you can’t even move — and leaving you wondering what you did to injure yourself.”
Stretching can keep pain at bay

Putting your monitor at eye level, sitting up straight and avoiding tilting and twisting your head down or to the side while you’re on the computer can help you avoid neck pain. When you’re driving or looking at your smart phone, be sure to take frequent breaks and avoid having your neck bent forward for long periods of time, Dr. Bang says.

The key to relief for a stiff neck is proper stretching and manipulation, Dr. Bang says. Here are some stretches you can try at your desk or in the car that may help you to avoid a stiff neck:

Roll your shoulders backwards and down 10 times
Squeeze your shoulder blades together 10 times
Push your head backwards into your car head rest or hands and hold for 30 seconds
Bring your ear to your shoulder 10 times on each side

Take care when you sleep

Dr. Bang says if your neck is bothering you, you also should pay attention to your sleep positions. Sleep only on your side or on your back – never on your stomach, he says.

“When you sleep on your stomach, often you will end up twisting your head one way or the other for hours at a time,” Dr. Bang says. “Sleeping on your stomach also can affect your low back because your belly sinks in to the bed if you don’t have enough support.”

For minor, common causes of neck pain, try these simple remedies:

Apply heat or ice to the painful area. Use ice for the first 48 to 72 hours, then use heat after that. Heat may be applied with warm showers, hot compresses or a heating pad. Be sure not to fall asleep with a heating pad or ice bag in place to avoid skin injuries.
Take over-the-counter pain relievers such as ibuprofen or acetaminophen.
Keep moving, but avoid jerking or painful activities. This helps calm your symptoms and reduce inflammation.
Do slow range-of-motion exercises, up and down, side to side, and from ear to ear. This helps to gently stretch the neck muscles.
Have a partner gently massage the sore or painful areas.
Try sleeping on a firm mattress without a pillow or with a special neck pillow.
Ask your health care provider about using a soft neck collar to relieve discomfort. Do not use the collar for a long time. Doing so can make your neck muscles weaker.

If the pain gets in the way of your daily activities, Dr. Bang says to call your doctor.

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Neck pain

Overview

Neck pain is a common complaint. Neck muscles can be strained from poor posture — whether it's leaning over your computer or hunching over your workbench. Osteoarthritis also is a common cause of neck pain.

Rarely, neck pain can be a symptom of a more serious problem. Seek medical care if your neck pain is accompanied by numbness or loss of strength in your arms or hands or if you have shooting pain into your shoulder or down your arm. Symptoms

Signs and symptoms include:

Pain that's often worsened by holding your head in one place for long periods, such as when driving or working at a computer
Muscle tightness and spasms
Decreased ability to move your head
Headache

When to see a doctor

Most neck pain improves gradually with home treatment. If not, see your doctor.

Seek immediate care if severe neck pain results from an injury, such as a motor vehicle accident, diving accident or fall.

Contact a doctor if your neck pain:

Is severe
Persists for several days without relief
Spreads down arms or legs
Is accompanied by headache, numbness, weakness or tingling

Causes

Your neck is flexible and supports the weight of your head, so it can be vulnerable to injuries and conditions that cause pain and restrict motion. Neck pain causes include:

Muscle strains. Overuse, such as too many hours hunched over your computer or smartphone, often triggers muscle strains. Even minor things, such as reading in bed or gritting your teeth, can strain neck muscles.
Worn joints. Just like the other joints in your body, your neck joints tend to wear down with age. Osteoarthritis causes the cushions (cartilage) between your bones (vertebrae) to deteriorate. Your body then forms bone spurs that affect joint motion and cause pain.
Nerve compression. Herniated disks or bone spurs in the vertebrae of your neck can press on the nerves branching out from the spinal cord.
Injuries. Rear-end auto collisions often result in whiplash injury, which occurs when the head is jerked backward and then forward, straining the soft tissues of the neck.
Diseases. Certain diseases, such as rheumatoid arthritis, meningitis or cancer, can cause neck pain.

Prevention

Most neck pain is associated with poor posture combined with age-related wear and tear. To help prevent neck pain, keep your head centered over your spine. Some simple changes in your daily routine may help. Consider trying to:

Use good posture. When standing and sitting, be sure your shoulders are in a straight line over your hips and your ears are directly over your shoulders.
Take frequent breaks. If you travel long distances or work long hours at your computer, get up, move around and stretch your neck and shoulders.
Adjust your desk, chair and computer so that the monitor is at eye level. Knees should be slightly lower than hips. Use your chair's armrests.
Avoid tucking the phone between your ear and shoulder when you talk. Use a headset or speakerphone instead.
If you smoke, quit. Smoking can put you at higher risk of developing neck pain.
Avoid carrying heavy bags with straps over your shoulder. The weight can strain your neck.
Sleep in a good position. Your head and neck should be aligned with your body. Use a small pillow under your neck.
Try sleeping on your back with your thighs elevated on pillows, which will flatten your spinal muscles.

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