There are two general reasons for the occasional needle-like stabbing pain in the neck.1. It may be a muscle inflammation of the cervical spine, commonly caused by chronic muscle strain due to long-term low work. This condition is common when the muscles are usually hard and the time spent working with the head down is long. 2. It may be a neuropathic pain in the neck, commonly caused by cervical spondylosis, degenerative changes in the cervical spine such as osteophytes, herniated discs or misaligned small joints that compress the nerve roots, thus causing pins and needles in the nerves of the neck. This can cause pinprick-like stabbing pain or pulling pain in the nerves of the neck, sometimes accompanied by pulling pain in the nerves of the back of the shoulder or upper limbs.