A stiff neck is characterized by limit mobility of the neck, especially in side to side motions. This is typically accompanied by tightness or discomfort, either in the muscles or bones of the neck. Neck pain can also be accompanied by pain in the shoulders, back, or arms. A stiff neck is an extremely common condition, and most American adults will experience a stiff neck at some point in their lives.
What Is Stiff Neck
What Causes Stiff Neck
A stiff neck can have a variety of causes, ranging from everyday activities to more serious health conditions. Causes of a stiff neck include:
- Remaining in the same position for too long (i.e. hunched over at desk)
- Sleeping in an uncomfortable position
- Rigorous exercise
- Accidents, falls, and injuries
- Ruptured disk
- Infection of the spine*
- Cancer of the spine*
*These causes are extremely rare
Risk Factors For Stiff Neck
The following factors may increase the risk of developing a stiff neck:
- Participation in strenuous exercise
- Prolonged computer/laptop usage
- Poor posture
- Certain pre-existing health conditions such as osteoporosis and fibromyalgia
Diagnosing Stiff Neck
Though a stiff neck can most often be self-diagnosed, there are some diagnostic tests your doctor may perform to rule out the possibility of other, more serious health conditions. These include:
- Medical history and physical exam to determine your current health state, locate the area of the pain, and check for any other symptoms
- Imaging techniques to visualize the fracture, such as:
- X-Ray, which utilizes x-rays to produce images of the bone.
- MRI, which utilizes magnetic frequencies to produce three-dimensional images of the bone and body matter surrounding it.
- CT/CAT scan, which combines x-ray and computational technologies to produce a detailed image of the body structures.
- Dual-energy x-ray absorptiometry (DXA/DEXA), in which x-rays are used to determine bone density, and therefore the prevalence of osteoporosis.
- Blood tests to rule out the possibility of spinal infections/abscesses.
Symptoms of Stiff Neck
The following may be signs of a stick neck:
- Pain in the neck
- Incomplete range of neck motion
- Pain in the shoulder, arms, or back
Stiff necks should improve after several days of rest. If you do not see improvement during this time, contact a doctor immediately to rule out the possibility of a more serious health condition.
Living With Stiff Neck
If you have a stiff neck, consider the following tips:
- Monitor your symptoms carefully. A stiff neck is usually caused by benign factors, however there are a few potentially serious conditions, such as spinal infection, that may also be the cause of the pain. Be sure to monitor your pain closely and report any other symptoms you may be experiencing to your doctor. If you are experiencing a stiff neck in combination with fever, chills, and flu-like symptoms, contact emergency services. This may be the sign of a serious spine infection.
- Try switching up your sleeping position. Stiff necks are often the cause of an uncomfortable sleeping position. This might mean moving your body or changing the firmness of your mattress and/or pillow.
- Stretch before exercise. Exercising without first stretching your muscles can increase the risk of strain or injury. Do a slight warm up (i.e. jumping jacks) before you stretch to raise your heart rate and wake up your muscles.
- Use a combination of heat and ice. 20 minutes on, 20 minutes off. This will help to both decrease inflammation and swelling, while also keeping the muscles relaxed.
- Incorporate stretching into your daily routine. This could mean keeping a yoga practice or doing a series of neck stretches at your desk. This will help to keep the neck muscles limber.
There are no screening methods for detecting a stiff neck.
Medication And Treatment
According to the National Institute of Health, the following treatments are available for a stiff neck:
- Rest. This is maybe the most important treatment of all for stiff necks. Withholding from regular activity levels for several days or weeks can help give the neck muscles time to recover.
- Heating pads and/or ice packs. Apply heating pads/ice packs to the affected area of the neck. Ice should be used for the first 2-3 days, and heat should be used following that. Be careful not to leave the ice or heat on the skin for too long, as it may injure you. To be safe, follow a routine of 20 minutes on and 20 minutes off.
- Physical therapy, which may be as simple as at-home exercises or as extensive as several sessions with a trained therapist. This will help to regain neck mobility and strengthen neck muscles. Consult your doctor about what type of physical therapy is best for you.
- Massage by a licensed masseuse, which helps to loosen muscles and decrease overall levels of pain.
Treatment for neck pain may also be accompanied by pain management, either over-the-counter or by prescription. If taking over-the-counter medication, be sure not to use it consecutively past a few days. This may cause further complications such as liver disease and ulcers. If taking prescription pain killers, be sure to talk to your doctor about the full risk and benefit of each pain killer.
Over-the-counter (OTC) pain medications include:
- Acetaminophen (Tylenol, aspirin-free Excedrin).
- Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Motrin/Advil) or naproxen (Aleve and Naprosyn).
- Topical pain relievers such as:
- Counterirritants, such as menthol and camphor
For more information about prescription-strength pain medications, talk to your doctor or visit the thirdAGE Pain Management Condition Center.
Complementary and Alternative Treatment
The following alternative treatments may help reduce the symptoms of stiff neck:
- Herbal teas to help reduce pain and inflammation. Anti-inflammatory herbs include:
- St John’s Wort
- Arnica, an herb that is highly regarded around the world for its anti-bruising, anti-swelling, and anti-inflammatory effects. Arnica can be taken in cream or tincture form. Be sure to follow the directions accompanying the arnica that you choose to prevent harmful over-use.
- Acupuncture, a form of traditional Chinese medicine that uses the insertion of needles throughout the body to restore the flow of bodily energy. Acupuncture target at stiff necks can help to relax the neck muscles, release tension in the body, and decrease pain.
- Yoga and tai-chi. These mind/body techniques help to strengthen/stretch the muscles and center the mind. Be sure to mention your injury to your instructor so that you can receive proper instruction for the modifications you may need to make.
- Chiropractic therapy. Chiropractors can help to reduce neck stiffness and pain by focusing on the alignment of the skeletal system.
- Reiki. Reiki is a form of energy healing in which a trained Reiki master manipulates the flow of bodily energy. Reiki can help reduce pain, especially in chronic pain patients.
If you are caring for a loved one with a stiff neck, consider the following:
- Apply ice and heat. Ice for the first 2-3 days after symptoms arise and heat for the days following that. Do not leave the ice or heat on for too long – only about twenty minutes each. Leaving the packs on for longer at a time can lead to skin damage.
- Monitor symptoms closely. See a doctor if symptoms do not go away within a few days. If fever, chills, or flu like symptoms develop, contact emergency services as this may be the sign of serious infection.
- Be mindful of activity limits. Encourage your loved ones to rest as often as the doctor recommends.
- Facilitate conversation with your loved one. Talk about your feelings and thoughts to avoid an uncomfortable build-up of tension.
When To Contact A Doctor
Contact a doctor if you experience any of the following:
- Pain that worsens or does not improve within one week
- Change in arm/hand sensations
- Pain is disruptive to daily life (despite OTC pain medications)
Contact emergency services if your experience any of the following. These may be signs of serious infection or heart attack:
- Flu-like symptoms
- Shortness of breath
- Sudden onset of pain in arm or chest
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Questions For A Doctor
You may want to ask your doctor the following questions:
- Is my neck stiffness the result of a more serious condition?
- What can I do to make my neck stiffness go away?
- Am I a candidate for physical therapy?
- How long will it take for me to return to normal activity levels?
- Will I be able to return to normal activity levels?
- Am I more at risk for neck injuries?
- What do you believe is the cause of my neck stiffness?
- What symptoms should I be monitoring myself for?