Stiff Neck

1 Stiff Neck Summary

Stiff neck or neck pain is a common symptom characterized by soreness in and around the neck or difficulty moving it.

The neck contains bones and joints of the neck vertebrae. The vertebrae are separated by shock-absorbing discs and are held together by muscles and ligaments. Injuries, abnormalities, or inflammation of any of these components may lead to stiffness or pain in the neck.

It is most commonly seen with strenuous work and other work-related tasks. The pain may spread to the shoulders and/or arms and cause a headache. The stiffness may affect the mobility of the neck, most often on one side. Many people experience this symptom occasionally.

In most of the cases, it is not a serious condition and can be resolved with simple home treatment and rest. In rare instances, it could indicate a serious injury or illness that warrants medical attention. Doctor’s advice is needed if the stiffness persists for more than a week.

Other accompanying symptoms that require medical attention include:

  • A lump in the neck
  • Swollen lymph nodes
  • Fever
  • Headache
  • Difficulty breathing or swallowing
  • Numbness
  • Tingling
  • Nausea or vomiting
  • Weakness
  • Inability to move limbs
  • Upset bowels
  • Bladder dysfunction

Neck pain without any apparent cause also warrants medical attention.

Some of the causes of stiff neck are:

  • Muscle tension or strain: This may be caused by incorrect posture, working for a long duration without changing position, or sudden jerking while exercising.
  • Injury: This is a very common cause of stiff neck and pain. Accidents, falls, and contact sports can all lead to neck injury.
  • Heart attack: Stiff neck may be a symptom of a heart attack if accompanied by other symptoms like breathlessness, nausea, vomiting, and pain in the jaw.
  • Meningitis: Fever, stiff neck, and headache are common symptoms of meningitis. This is a medical emergency that requires immediate attention.
  • Rheumatoid arthritis
  • Osteoporosis
  • Fibromyalgia
  • Spondylosis
  • Herniated cervical disc
  • Spinal stenosis

Less common causes of the condition include congenital abnormalities, infections, abscesses, tumors, and cancer of the spine.

More specific diagnostic tests are recommended after a review of your medical history and a physical examination. Information on current medications, medical conditions, and other symptoms may all help identify the underlying cause of your stiff neck.

Other tests used to diagnosis the condition include blood tests and imaging studies, like X-rays, CT scans, MRIs, and electromyography. Lumbar puncture, or spinal tap, is also used to diagnosis the underlying cause of neck pain.

In most cases, neck pain is caused by muscle sprain and may be treated within a few days.

First aid for stiff neck involves:

  • Rest: This heals the injured tissue, if any, and helps relieve stiffness and muscle spasms.
  • Stretching: Gentle stretching helps alleviate stiffness and restores the neck’s range of motion.
  • Heat and ice therapy: Cold/hot packs are useful in relieving stiffness and inflammation of the neck.
  • Medications: Many medications are available that will help reduce inflammation, pain, and stiffness.
  • Low-impact aerobic exercises: Low-impact exercises like walking are also effective against neck stiffness.

2 Causes

A stiff neck may be caused by a variety of factors:

  • Muscle strain or sprain: This is one of the most common causes of a stiff neck. The muscle at the back of the neck that connects the cervical spine with the shoulder is prone to strain and injury. The muscle may be strained by many everyday activities, including:
  • Poor posture during sleep
  • Sports injuries, like falling, or sudden impact on the shoulder or neck
  • Activities that involve repeated motions, like turning the neck from side to side
  • Poor posture while sitting, as in crouching while watching TV or a computer monitor, or looking down at a mobile phone.
  • Excessive stress
  • Holding the neck in the same position for a long duration
  • Heart attack: Stiff neck may be a symptom of a heart attack when present with other symptoms like breathlessness, sweating, nausea, vomiting, and radiating pain in the jaw.
  • Meningitis: Inflammation of the meninges, the thin membrane surrounding the brain and spinal cord, is referred to as meningitis. Stiff neck if often seen along with fever and headache in this condition. This is a serious infection that causes sudden onset of symptoms. The stiffness may make it difficult to touch the chest with the chin.
  • Arthritis: Arthritis results from damage to the discs in between the vertebrae, causing stiffness. Degeneration of discs reduces the space between vertebrae and causes stress to the neck joint. It may lead to a pinched nerve, which affects the arm and neck on one side. Other accompanying symptoms include tingling, weakness, and numbness in the hand. Rheumatoid arthritis may also lead to swelling and pain in the neck.
  • Flu: Flu may also lead to mild neck stiffness. In this condition, the whole body may ache along with the neck.
  • Osteoporosis: This condition is characterized by weakening of bones, which leads to fractures. In some rare cases, osteoporosis may affect the bones of the neck.
  • Torticollis: This is caused by severe muscle contraction on one side of the neck, and often leads to tilting of the head to one side. It may be congenital or caused by an injury.
  • Stress: Excessive stress may cause tightness and pain in the muscles at the back of the neck. It often causes severe pain while moving the head.
  • Herniated cervical discs: The protrusion of a disc from the vertebrae due to injury or trauma is referred to as herniated cervical disc. Also known as ruptured or slipped disc, it applies pressure on the nerve roots in the spinal cord, causing pain and stiffness.
  • Spinal stenosis: Narrowing of the spinal column leads to pressure on the spinal cord or nerve roots, resulting in spinal stenosis. It may be caused by arthritic inflammation.

Neck stiffness may occur also due to:

  • Congenital abnormalities
  • Abscesses
  • Tumors
  • Cancer of the spine

3 Diagnosis and Treatment

Specific tests and investigations are planned after a review of your medical history and a physical examination. Symptom specifics are also evaluated to identify the probable cause of neck stiffness.

Information on medical conditions and current medications being taken should be shared with the doctor for an accurate diagnosis. Recent head injuries, accidents, stress, and exposure to infectious organisms may also provide important information regarding the cause of the symptom.

Other common tests include blood tests and imaging studies, like X-rays, CT scans, and MRIs.

Electromyography is a diagnostic procedure that checks muscle functioning and health. It also provides important information on the functioning of nerves in the neck region. Lumbar puncture, or spinal tap, is another procedure used to identify the causative factor.

Treatment depends on the actual cause of the neck stiffness. First-aid measures, physical therapy, manipulative therapy, medications, and surgical repair are all used to treat the symptom.

Other factors that influence the treatment method are the type and severity of the injury, age, and the patient’s general health and activities. First-aid for stiff neck involves:

  • Rest: Resting the affected region expedites the healing of tissue. This will help relieve stiffness and muscle spasms in the region. However, inactivity and rest should be limited to few days so as not to weaken the muscles; weak muscles are unable to support the neck and head.
  • Stretching: Gentle stretching of the muscles also help relieve stiffness and pain. This will also restore the range of motion of the neck region. A physical therapist may help in framing the right kind of exercises for alleviating pain.
  • Heat and ice therapy: Hot or cold compresses may help reduce stiffness. Cold therapy helps alleviate pain by reducing inflammation, while hot compresses increase the blood flow to the region, helping to quicken the healing process. Heat and cold therapy may also be used alternatively for relief.
  • Medications: Over-the-counter and prescription medications are available to reduce neck stiffness. Non-steroidal anti-inflammatory drugs (NSAIDs) reduce inflammation and are commonly recommended for controlling stiff neck. Ibuprofen and naproxen are common NSAIDs used for this purpose. Medications should be taken only after discussion with the doctor, as some may have side effects or harmful interactions.
  • Low-impact exercises: Low-impact exercises like walking may help relieve stiffness in the neck by improving circulation to soft tissues, resulting in easier healing.

Other treatment methods include:

  • Corticosteroid injections
  • Neck collar                                                                                       
  • Antibiotics to control infections
  • Muscle relaxants to relieve strain in muscles
  • Traction
  • Surgical repair if there is anatomical damage

Many alternative treatment methods are also used for stiff neck. These include acupuncture, chiropractic medicine, massage, and transcutaneous electrical nerve stimulation. These methods may be used singly or in combination for better effect.

There are also simple stretching exercises that help provide relief to people experiencing neck discomfort. These movements work both the joints and the muscles together to reduce stiffness and provide pain relief.

Before one begins these exercises, note the following:

  • To warm up the stiff muscles and joints, apply a warm heating pad prior to any exercise to make it easier to carry out the stretches and provide better results.
  • Once you complete the exercise, if there is any feeling of inflammation in the joints or muscles, apply an ice pack to the affected area.
  • If the pain and inflammation persist, consult your doctor or use over-the-counter medications such as ibuprofen to reduce the pain.
  • Talk to your doctor about the severity of the pain or neck stiffness before exercising so you do not unnecessarily aggravate your condition.
  • All exercises should be performed slowly with full awareness. Your breathing should be synchronized with each one.
  • Do not conduct these exercises absent-mindedly or with less focus, since it could lead to increased pain.
  • Keep your muscles loose, especially on the area you are working on.

Below are six movements that provide quick relief from neck stiffness:

  • Neck rotation: Slowly turn your head to the left so your nose is parallel to the shoulder, then gently return it to the neutral position. Repeat this on the right side. Continue doing this three to four times. Remember not to put too much strain on the neck while conducting this exercise.
  • Head drop: Slowly tilt your head back as far as it can go with mild strain on the neck; the chin should be pointing towards the ceiling. Hold this posture for 30 seconds. Return to the neutral position. Repeat three to four times.
  • Neck retraction: Slowly bring your head straight back with your eyes forward. Hold this for a few seconds and then return to the earlier position.
  • Flexion: Clasp both your hands behind your head and bring it down slowly until your chin touches your chest. Hold this posture for a few seconds and then return to the normal position. Repeat three to four times.
  • Neck side bend: With your left hand, slowly reach over the top of your head and pull your left ear towards the left shoulder. Hold this for a few second before returning to the neutral position. Do this on the right side as well. Repeat this exercise three or four times.
  • Corner stretch: Stand approximately two feet back from the corner of a wall. The feet should be together and forearms placed on the wall. Elbows should be below shoulder height. Once the correct position is achieved, lean in as far as possible until you feel pain. You will feel the stretch in the front of the shoulders and chest. Hold this posture for 30 seconds and gradually increase the time to one minute as long as one can bear the pain. Repeat this three to five times a day.

Neck exercises, if done appropriately, can provide long-term relief and address most of the issues pertaining to neck and back pain. By conducting neck exercises, you will start experiencing greater flexibility, which helps expand the range of motion and provides elasticity to the affected joints, thus reducing stiffness in the neck. To achieve better results, perform these exercises several times every day, whenever you have free time.

If done properly, these exercises will help maintain and improve your posture. This in turn means fewer instances of neck pain. As a rule of thumb, neck strengthening exercises should be carried out every other day so there is enough time for the neck muscles to relax and repair themselves.

Before starting, first get the pain under control so there are no injuries while performing any of the exercises. Once the pain is controlled, gradual motion and stretching of the joints and muscles will reduce the remaining pain.

Tips to prevent neck stiffness include:

  • Change old pillows: It is best to use a pillow which provides relaxation and comfort and keeps your cervical spine in proper alignment.
  • Try to sleep on your back: The best position while sleeping is on your back, because it provides rest to your entire spine. Some people facing neck issues find it best to sleep on their backs and placing a pillow under each arm. Doing so takes away some of the strain from the neck.
  • Place the computer monitor at eye level: While at office or at home, sit comfortably in front of your computer. Close your eyes and, once you open them, point your gaze directly at the middle of the screen. If you have to look down at it, adjust the monitor so it is properly in front of your eye.
  • Reduce cell phone use: Texting places unnecessary strain on the neck. Try to cut down on the time spent on your mobile phone or keep it at a higher level while using it since it adds a lot of stress on the ligaments, joints, and discs in the neck.

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