DEAR READER: There are 33 vertebrae in the spine, seven of which are in the neck. The neck holds up your head, which, on average, weighs about 10 pounds. With poor posture, even a few centimeters of poorly distributed weight can place an enormous burden on the neck muscles. So muscles tighten up as a defense mechanism and cause pain. Other than posture, other possible causes are osteoarthritis of the neck, fibromyalgia, polymyalgia rheumatica and hypothyroidism.

I recommend you see a sports therapist or request a referral to the physical-therapy department of your local hospital. You can be taught proper exercises that will strengthen the neck and, I hope, eliminate pain and stiffness.

If you have any insight or direction as to what I need to do, I would be grateful. I have tried everything except acupuncture, which I think I will do next.

By the way, I am 70 years old and in excellent health otherwise. I do take amlodipine besylate for blood pressure, vitamins C and D, calcium, red yeast rice for cholesterol-lowering properties, glucosamine, MSM and an 81-milligram aspirin. Plus, I have been on OsteoValin for a year as a substitute for Fosamax, which I took for five years. I need help.

DEAR READER: Neck pain is a common condition that can result from a number of disorders and diseases, including poor posture, herniated disc, degenerative disc disease, pinched nerve, whiplash from an auto accident and strain. The pain can be minor to severe and cause tingling, sensitivity, headache, dizziness, tight shoulders and a host of other unpleasant and often debilitating symptoms.

Because you are taking OsteoValin and were taking Fosamax six years ago, I assume you have been diagnosed with osteoporosis. OsteoValin is a nonprescription supplement designed to prevent further bone deterioration. One of its three key ingredients is strontium. Overuse of the supplement can result in headaches. Amlodipine besylate can also cause headaches and muscle pain.

Speak with your physician about your concerns. Perhaps you can consider a trial period of other medications and/or eliminate one or more.

Treatment of your neck pain depends on the underlying cause. You may require an X-ray, CT or MRI, which are all noninvasive procedures used to determine exactly what is occurring and what the best course of action might be. It is important to rule out whether a pinched nerve or other nerve problem is to blame.

In the interim, consider heat or cold packs, physical therapy, over-the-counter topical analgesic creams (perhaps containing capsaicin or menthol), muscle relaxants, acupuncture, massage, hydrotherapy or yoga. Your physician or local hospital’s physical-therapy department should be able to guide you.

To provide related information, I am sending you a copy of my Health Report “Managing Chronic Pain.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.