What is a stiff neck?
Most cases of stiff neck will resolve and don't last long. However, a stiff neck can sometimes be a sign of something more serious that requires treatment from a doctor.
The cervical spine describes the neck portion of your spinal cord. The bones, muscles, ligaments, cartilage, nerves, and spinal cord in the neck provide for a wide range of motion and function. Any problem in any of these systems can lead to stiffness or pain in the neck.
Most cases of neck stiffness will resolve on their own and don't last very long. However, a stiff neck can sometimes be a sign of something more serious that requires treatment from a doctor.
Symptoms of a stiff neck
Neck stiffness and pain can have several symptoms including:
- Neck pain that becomes worse when you are still for a long time
- Muscle spasms or tightness
- Decreased range of motion or ability to move your head
- Headache
Causes of a stiff neck
If you are experiencing pain or discomfort in the neck, or a limited range of motion, it may have been caused by one of the following underlying causes:
Injury
The neck is a delicate area and is susceptible to injuries from car accidents, falls, or playing sports. Any sudden jerking movement that causes the neck to move outside of its normal range of motion can cause an injury that results in neck stiffness.
One of the most common jerking injuries of the neck is called whiplash. Whiplash frequently happens in car accidents where a sudden stop jerks the head backward.
Cervical spine disorders
The cervical spine consists of seven bones with discs in between them. These discs act as shock absorbers and allow the neck to move freely. Each bone has an opening for the spinal cord and nerve bundles to pass through. Any issues with the bones, discs, or nerves can cause pain and stiffness in the neck.
Any of these cervical spine conditions can result in neck stiffness:
- Disc herniation, when one of the discs protrudes out into the spinal canal and causes pain and stiffness.
- Cervical spondylosis, a narrowing of the opening in the bones where the spinal cord runs through, which frequently happens with aging
- Osteophytes, also called bone spurs, which occur when there is a bony overgrowth on the cervical spine
Arthritis
Cervical spondylosis, or arthritis in the neck, occurs with aging in many people. This age-related wear on the neck bones is very common in people over the age of 60, with over 85% affected. The most common signs of cervical spondylosis are pain and stiffness, but some people have no symptoms.
Muscle tension and strain
The muscles in your neck can be strained by many everyday activities including poor posture, sleeping without proper support, exercise, repetitive motions, working at a desk for too long, or even stress. This type of neck stiffness usually resolves on its own in a few days to a few weeks, depending on the severity.
Bacterial meningitis
More rarely, bacterial meningitis can cause symptoms of neck stiffness. This infection causes inflammation in the layers of tissue that cover the brain and spinal cord. This condition is a medical emergency and needs to be treated immediately. This type of neck stiffness makes touching the chin to the chest difficult and is usually accompanied by a headache and fever.
When to see the doctor for a stiff neck
If you have any of the following symptoms along with neck stiffness, visit your doctor to identify the cause and start treatment:
- Fever
- Night sweats
- Headache
- Chest pain or discomfort
- Difficulty breathing
- Confusion
- Numbness, tingling, or loss of sensation
- Severe pain
- Persistent pain
- Pain that stems from an injury
Diagnosing a stiff neck
Your doctor will start by taking your medical history, including any recent injuries you may have had, and doing a physical exam. Many times, an exam will be enough for a diagnosis, but depending on the findings, you may need further imaging studies and tests which could include any of the following:
- X-ray
- Computerized tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Blood tests
- Electromyography
- Nerve conduction studies
- Lumbar puncture, also called a spinal tap
Treatments for a stiff neck
The treatment for neck stiffness and pain will depend on the cause, but may include a combination of any of the following:
- Nonsteroidal anti-inflammatory drugs (NSAID)
- Muscle relaxants
- Corticosteroid injections
- Cervical collar
- Rest
- Heat or ice therapy
- Physical therapy
- Stretching exercises
- Referral to a specialist
- Antibiotics and other emergency care if there is an infection