A stiff neck is typically characterized by soreness and difficulty moving the neck, especially when trying to turn the head to the side. It may also be accompanied by a headache, neck pain, shoulder pain and/or arm pain. In order to look sideways or over the shoulder, an individual may need to turn the entire body instead of the stiff neck. However, how an individual manages and cares for the stiff neck symptoms can affect pain levels, recovery time, and the likelihood of whether it will return.
By far the most common cause of a stiff neck is a muscle strain or soft tissue sprain. In particular, the levator scapulae muscle is susceptible to injury. Located at the back and side of the neck, the levator scapulae muscle connects the neck’s cervical spine with the shoulder. This muscle is controlled by the third and fourth cervical nerves . The levator scapula muscle may be strained throughout the course of many common, everyday activities, such as:
- Sleeping with the neck at an awkward position
- Falling or sudden impact that pushes the head to the side, such as sports injuries
- Turning the head side to side repeatedly during an activity, such as swimming the front crawl stroke
- Slouching with poor posture while viewing the computer monitor or looking downward at a mobile phone for prolonged periods
- Experiencing excessive stress or anxiety, which can lead to tension in the neck
A stiff neck can vary in intensity, ranging anywhere from an annoying discomfort to extremely painful, sharp, and limiting. Typically, attempting to turn a stiff neck to a particular side or direction will eventually result in so much pain that the motion must be stopped. The amount of reduction in neck motion can affect the individual’s activity levels. For example, if the head cannot be significantly turned in one direction without excruciating pain, driving will likely need to be avoided until symptoms improve.
- Rest. Taking it easy for one or two days gives injured tissues a chance to begin to heal, which in turn will help relieve stiffness and possible muscle spasm. For example, someone who swims may want to avoid certain swim strokes that involve lots of head twisting for a few days. However, it is recommended to limit rest to one or two days, as too much inactivity can lead to a weakening of the muscles, and weak muscles have to struggle to adequately support the neck and head.
- Cold and/or heat therapy. Cold therapy/ice packs help relieve most types of neck stiffness by reducing local inflammation. Applying ice during the first 24 to 48 hours of a painful flare-up usually has the most benefit in terms of reducing inflammation. Applying heat to the neck can spur blood flow, which fosters a better healing environment. Some patients prefer ice, whereas others prefer heat. Both may be used alternately.
In addition to lowering the risk of a stiff neck in the short term, maintaining a strong, flexible neck, and using good posture can also help keep the cervical spine healthier in the long term.