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Why You Have a Stiff Neck & Ways to Get Rid of It

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Understand your stiff neck symptoms with Buoy, including 9 causes and common questions concerning your stiff neck.

9 most common causes

Whiplash
Diffuse Idiopathic Skeletal Hyperostosis
Tension Headache
Subarachnoid Hemorrhage
Illustration of various health care options.
Lyme Disease
Bacterial Meningitis
Aseptic Meningitis
Illustration of a health care worker swabbing an individual.
Retropharyngeal abscess
Illustration of various health care options.
Wryneck

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Symptoms

Stress and tension on the neck and upper body can result in uncomfortable stiffness, aches, and pains that hinder all kinds of daily activity. You should read below to recognize other symptoms associated with neck stiffness to prevent future damage and receive appropriate care.

Common characteristics of a stiff neck

Symptoms of neck pain that result from stress and constant wear and tear include:

  • Restriction in movement
  • Pain that radiates to the arms, shoulders, or upper back

You may observe that you have a tendency to massage the neck or move the neck around to alleviate neck stiffness symptoms. However, this is only a temporary fix. See a physician to investigate the potential causes of your neck stiffness and available treatment options.

Main Causes

Neck structure

The neck, also known as the cervical spine, has many components, which includes those listed below. See this image for a visual representation. Anything that causes stress, overuse and damage to these components can result in neck stiffness symptoms.

  • Vertebrae: The individual bones.
  • Intervertebral discs: The discs that separate the bones and act as shock absorbers when the neck moves (intervertebral discs).
  • Muscles and ligaments: The muscles and ligaments of the neck that hold the cervical spine together.
  • Nerves: These start in the head and travel down the body through the spinal cord.

Positional causes

Positional causes, in terms of posture and how you hold your upper body on a daily basis, can cause stress on the neck. Posture may seem like a small issue but overtime it can cause significant pain and injury.

  • Be aware of your posture: Notice and be aware of how you are standing and how your neck is positioned. Try to notice the unintentional stress you may be putting on your upper body as you work at your desk or as you exercise.
  • Extra weight: Carrying a heavy backpack or purse consistently on one shoulder can put unnecessary stress on one side of your neck and cause stiffness and pain.
  • Sleeping position: When you wake up in the mornings, notice your neck position as you were sleeping.
  • Exercise: Take note of your technique and form during exercises that require repetitive lifting, pulling, pushing, twisting, and bending in different directions.

Traumatic causes

Stiffness in the neck will result after any type of injury to the cervical spine. Whiplash from situations such as motor vehicle accidents can cause significant trauma to the neck, but traumatic causes are varied and are not limited to car accidents.

  • Sports injuries: Neck injuries are common in contact sports, such as football and hockey, and in sports that may involve falls, such as skiing, volleyball, or cross-country biking.
  • Falls: You may injure your neck during a fall, such as from a ladder or tripping on an icy sidewalk. Sometimes, such falls can disrupt and dislocate the discs in the neck resulting in the disc "jutting out" (herniation) and causing irritation on the nerves, muscles and ligaments of the neck.

Inflammatory causes

Processes that cause swelling and inflammation of the components of the cervical spine can cause compression and pressure that results in neck pain and injury.

  • Arthritis: Arthritis is a general term for multiple conditions that cause painful inflammation and stiffness of the bones and joints. Arthritic processes can affect many parts of the cervical spine and cause irritation that often leads to injury.
  • Infections: Bacterial and viral infections, especially those that affect the membranes surrounding the brain and spinal cord (meningitis), can result in referred pain in the neck area that manifests as stiffness that is also associated with symptoms such as headache and fever.

Age-related causes

Causes of a stiff neck related to aging may include the following.

  • Degeneration: Age-related wear and tear can cause deterioration of any of the components of the cervical spine. The discs are most commonly affected and age-related changes make them less flexible and more susceptible to tearing and rupture. These changes often result in stiffness that is chronic and difficult to alleviate.
  • Narrowing: Over time, wear and tear of the actual bones and vertebrae can lead to narrowing of the spaces in the cervical spine (stenosis). This narrowing results in irritation of components that are now too close together, resulting in neck stiffness and pain.

9 conditions with stiff neck symptoms

This list does not constitute medical advice and may not accurately represent what you have.

2. Retropharyngeal abscess (adult)

Retropharyngeal abscess is a collection of pus in the tissues in the back of the throat. It is a potentially life-threatening medical condition.

Rarity: Ultra rare

Top Symptoms: sore throat, loss of appetite, fever, shortness of breath, being severely ill

Urgency: Hospital emergency room

Stiff neck quiz

Take a quiz to find out what's causing your stiff neck.

Take stiff neck quiz

Wryneck

Wryneck is a twisted neck in which the head is tipped to one side, while the chin is turned to the other.

This is a self-limiting condition. If you are experiencing any pain, you can take over the counter pain medication like Tylenol

Rarity: Common

Top Symptoms: neck pain on one side, difficulty moving the neck, constant neck pain, pain that causes the neck to bend

Symptoms that always occur with wryneck: pain that causes the neck to bend, neck pain on one side, constant neck pain

Symptoms that never occur with wryneck: neck pain that shoots to the arm, arm weakness, arm numbness

Urgency: Self-treatment

Whiplash

Whiplash, a soft tissue injury to the neck, is the result of a sudden jolt to the neck. This injury most frequently occurs after a car is rear-ended.

You do not need treatment. Your whiplash should improve within a week. In the meantime, you can take an over-the-counter painkiller to manage your pain. If your symptoms do not improve, you should see your primary care physician.

Tension headache (first onset)

Tension headache is described as feeling like there is a band around the head that gets tighter and tighter. The headaches may occur in episodes – a few times a week – or chronically, where they almost never entirely go away.

This is a common type of headache but the cause remains unclear. It may be a combination of stress and an overactive sensitivity to pain.

Symptoms include dull, aching pain and tightness in the forehead, sides, and back of the head, and sometimes pain in the neck and shoulder muscles. Unlike migraines, there is usually no nausea, vomiting, or sensitivity to light.

Tension headaches are not dangerous in themselves, but can interfere with work and with quality of life.

Diagnosis is made through patient history and sometimes physical examination. CT scan or MRI may be done to rule out a more serious cause of the headaches.

Over-the-counter and other pain relievers are sometimes prescribed. Lifestyle changes to reduce stress, improve diet, and increase exercise are often helpful, as is massage and biofeedback.

Rarity: Common

Top Symptoms: new headache, nausea or vomiting, moderate headache, loss of appetite, mild headache

Symptoms that always occur with tension headache (first onset):new headache

Symptoms that never occur with tension headache (first onset):photo and phonophobia, throbbing headache, headache resulting from a head injury

Urgency: Self-treatment

Subarachnoid hemorrhage

Subarachnoid hemorrhage is bleeding in the area between the brain and the thin tissues that cover the brain. It's typically caused by a ruptured aneurysm (out-pouching of an artery's wall).

Call 911 immediately. This condition is a medical emergency requiring immediate attention.

Retropharyngeal abscess

Retropharyngeal abscess is a collection of pus in the tissues in the back of the throat. It is a potentially life-threatening medical condition.

This is a medical emergency. Please seek out urgent care at your closest Emergency Department today. Diagnosis is done with imaging. Treatment is immediate surgical drainage and antibiotics.

Lyme disease

Lyme disease is a bacterial illness transmitted through the bite of the deer tick (black-legged tick) after it has been attached for at least 36-48 hours. These may be tiny, immature ticks that are difficult to see, often attaching in a place on the body where hair grows.

The disease does not spread through casual contact, either between humans or between humans and pets.

Early symptoms include fever, chills, headache, and body aches. There may be a rash around the tick bite, which sometimes enlarges to form a clear circle around the bite.

Later symptoms are severe with headaches, neck stiffness, further rashes, facial drooping (palsy,) and joint pain and swelling. This is a medical emergency. Take the patient to the emergency room or call 9-1-1.

Untreated Lyme disease in a pregnant woman can lead to stillbirth, but antibiotics will usually prevent this.

Diagnosis is made through symptoms as well as a blood test.

Treatment consists of oral antibiotics in most cases, though severe cases may require IV antibiotics.

Rarity: Ultra rare

Top Symptoms: fatigue, headache, irritability, muscle aches, loss of appetite

Urgency: Primary care doctor

Diffuse idiopathic skeletal hyperostosis

Diffuse idiopathic skeletal hyperostosis (DISH) is calcification or a bony hardening of ligaments in areas where they attach to the spine. Ligaments are supposed to be flexible, so DISH can cause symptoms such as pain, stiffness, and restricted movement.

You should visit your primary care physician who will be able to confirm the diagnosis with X-ray, and localize the problem to specific areas in your spine. This disease is managed with pain medication, physiotherapy, and, in rare cases, surgery.

Rarity: Rare

Top Symptoms: joint pain, upper back pain, stiff neck, stiff back, trouble swallowing

Urgency: Primary care doctor

Bacterial meningitis

Bacterial meningitis is an infection of the meninges, the layers of membranes that cover the brain and spinal cord. Streptococcus, E. coli, and other bacteria can cause meningitis.

People can carry and spread the bacteria without being infected. The disease can be transmitted through casual contact such as coughing, sneezing, or kissing, or by eating food contaminated with the bacteria.

Most susceptible are infants and young people, especially in group settings such as day cares or dormitories. However, anyone can become infected.

Symptoms escalate quickly and include headache, fever, stiff neck, nausea and vomiting, confused mental status, and sensitivity to light.

Bacterial meningitis can lead to sepsis and permanent brain damage, and is a life-threatening medical emergency. If it is suspected, take the patient to the emergency room or call 9-1-1.

Diagnosis is made through physical examination and spinal tap, to obtain a sample of the spinal fluid.

Treatment involves a course of antibiotics, often during hospitalization.

There are vaccines to protect against bacterial meningitis. Any medical provider can be consulted about obtaining them.

Aseptic meningitis

Aseptic meningitis is also called sterile meningitis. Meningitis means there is an inflammation of the meninges, which are the membranes surrounding the brain and spinal cord.

Aseptic, in this case, means that the inflammation is caused by viruses or fungi and not by bacteria. Most commonly involved are the chicken pox, herpes simplex, and West Nile viruses.

The viruses which cause aseptic meningitis are spread through direct contact and through the air, and also by contact with fecal matter.

Most susceptible are health care workers and anyone with a weakened immune system.

Symptoms include headache, stiff neck, fever, sore throat, oversensitivity to light, chills, and mental confusion.

Diagnosis is made through blood tests, chest x-ray, CT scan of the head, and lumbar puncture to test the cerebrospinal fluid (spinal tap.)

Virtually all cases of aseptic meningitis clear up on their own after one to two weeks. Treatment sometimes involves antiviral medication, but for most types of aseptic meningitis treatment consists of supportive care as the patient recovers.

Stiff neck quiz

Take a quiz to find out what's causing your stiff neck.

Take stiff neck quiz

Treatment and relief

At-home treatments

If your neck stiffness symptoms are a result of stress or improper positioning, try these self-care tips and suggestions to gain relief:

  • Apply ice then heat: Putting ice on your neck will help reduce pain and relax sore or tight muscles. Limit application of ice or heat to 15 minutes at a time and repeat every couple of hours.
  • Stretch and strengthen: As directed by your doctor or physical therapist, do gentle exercises at home to maintain range of motion in your neck and prevent stiffness.

When to see a doctor

See your doctor promptly if you have symptoms of stiffness that are also associated with shooting pain or numbness and tingling in the neck area. Regardless if you have these symptoms or not, persistent neck stiffness should be evaluated and your physician can determine the diagnosis. He or she may recommend:

  • Non-inflammatory medications: Your doctor may prescribe this type of medication to combat arthritic processes that are causing neck stiffness symptoms.
  • Surgery: If at-home remedies and medication options from your doctor do not provide relief, you and your doctor may look into surgical options.

When it is an emergency

Call 911 immediately if you experience symptoms below. These may be signs of meningitis which requires urgent treatment and follow-up.

FAQs

Here are some frequently asked questions about stiff neck.

Can you get a stiff neck from stress?

Yes, stress can cause elevation of the shoulders and neck. This posture can strain the muscles of the neck, back, and either side of the spine, including the paraspinal muscles and trapezius muscles. The tension placed on these muscles over time can cause a sense of strain or tension on the neck, wherein it is painful to move the neck through a full range of motion or it is difficult because of stiffness.

Why do I suddenly have a stiff neck?

A sudden stiff neck can be caused by many things, including and most commonly an unusual or different sleeping position. Any new physical activity involving the upper body, such as lifting or throwing an object, can also strain a muscle and cause a stiff neck. Sudden neck stiffness is often accompanied by some movement or position that it can be attributed to, but often not. It can be treated with an over-the-counter pain medication like ibuprofen.

How long does a stiff neck usually last?

A stiff neck may last differing amounts of time depending on the cause. If working out, carrying a bag, a certain sleeping position or physical activity is the cause of a stiff neck, it will likely continue until the activity is stopped. Otherwise, neck stiffness if it is muscular in origin usually won't last much longer than a few days.

Why do I have a stiff neck with my headache?

Sometimes the muscles at the base of the head or back of the skull can be tense. When those muscles become tense, they can cause a tension headache. It is important to note that some infections can cause headache and neck stiffness that is severe. If you have a headache, neck stiffness, fever, confusion, change in vision, or vomiting, you should seek immediate medical evaluation.

Why is my neck stiff on one side?

Usually, one-sided neck stiffness is produced by movement that affects one side of the neck more than the other. Lifting weights, an uneven purse or book bag, luggage, or a sleeping position in which the neck is unsupported on one side can all cause one-sided neck stiffness.

Questions your doctor may ask about stiff neck

  • Are you experiencing a headache?
  • Have you ever been diagnosed with a specific type of headache?
  • Have you noticed any vision changes?
  • Have you been experiencing any muscle weakness that is symmetrical (equal on both sides of your body)?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

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  2. Misailidou V, Malliou P, Beneka A, Karagiannidis A, Godolias G. Assessment of patients with neck pain: A review of definitions, selection criteria, and measurement tools. J Chiropr Med. 2010;9(2):49-59. NCBI Link
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  4. Alao T, Waseem M. Neck Trauma. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. NCBI Link
  5. Meningitis and encephalitis fact sheet. National Institute of Neurological Disorders and Stroke. Updated July 6, 2018. NINDS Link
  6. Cervical Spine. American Association of Neurological Surgeons. AANS Link