Hola! I have only rudimentary Spanish, but I was using this dictionary to try and translate some Colombian song lyrics, and stumbled upon the above entry. I don't think I've ever heard the English expression used quite that way.

To my knowledge, it's (e.g.)

He's a ((real)) pain in the neck.

or

He gives me a pain in the neck.

I'm not sure whether there's anything else I should do (or could even do) to back this up, so for now I'll just leave this here.