What are the current guidelines for the pharmacological management of acute neck pain in adults?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For adults with acute neck pain, current guidelines recommend offering oral analgesics such as ibuprofen, paracetamol, or codeine, depending on pain severity, personal preferences, tolerability, and risk of adverse effects .

Consider referral for physiotherapy treatment, including manual therapy, neck range of motion exercises, and scapulothoracic and upper extremity strengthening exercises, especially for those with mobility deficits .

Advice and education about maintaining activity, correcting posture, and reducing pillow height are also recommended as part of management .

There is limited evidence for the use of muscle relaxants, but expert opinion suggests they may have some benefit, with consideration of potential side effects .

Educational content only. Always verify information and use clinical judgement.