A stiff neck is typically characterized by soreness and difficulty moving the neck, especially when trying to turn the head to the side. A stiff neck may also be accompanied by a headache, neck pain, shoulder pain and/or arm pain, and cause the individual to turn the entire body as opposed to the neck when trying to look sideways or backward.
Muscle Strain or Sprain
By far the most common cause of a stiff neck is a muscle strain or soft tissue sprain, and in particular the levator scapula muscle is susceptible to injury. Located at the back and side of the neck, the levator scapula muscle connects the cervical spine (the neck) with the shoulder. This muscle is controlled by the third and fourth cervical nerves (C3, C4).
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 that strains the neck muscles
- Sports injuries that strain the neck, such as a fall or sudden impact that pushed the head to the side
- Any activity that involves repeatedly turning the head from side to side, such as swimming the front crawl stroke
- Poor posture, such as slouching while viewing the computer monitor or looking downward at a mobile phone for prolonged periods (sometimes referred to as “text neck”)
- Excessive stress, which can lead to tension in the neck
- Holding the neck in an abnormal position for a long period, such as cradling a phone between the neck and shoulder.
Cervical Spine Disorders
Many problems in the cervical spine can lead to neck stiffness. The stiffness can be a reaction to the underlying disorder in the cervical spine. Several examples of common cervical spine disorders
- Cervical herniated disc
- Cervical degenerative disc disease
- Cervical osteoarthritis—which often occurs along with other degenerative conditions, such as spinal stenosis, and anatomical changes, such as bone spurs.
An infection is not a common cause of neck stiffness, but is a potentially serious condition and worth noting.
A stiff neck, in conjunction with a high fever, headache, nausea or vomiting, sleepiness, and other symptoms, may be indicative of meningitis, a bacterial infection that causes the protective membranes of the brain and spinal cord to be inflamed. Other infections can also cause stiff neck symptoms, such as meningococcal disease, an infection in the cervical spine. Any time a stiff neck is accompanied by a fever, it is advisable to seek immediate medical attention to check for these possibilities.
The conditions often lead to reduced range of motion in the neck and general stiffness, as the structures and nerve pathways in the cervical spine are all interconnected and a problem in any one area can lead to muscle spasm and/or muscle stiffness.
Characteristics of Stiff Neck
Symptoms associated with a stiff neck typically last for a couple of days or a week and may prompt neck pain that ranges from mildly painful but annoying to extremely painful and limiting. While there are a few instances in which neck stiffness is a sign of a serious medical condition, most episodes of acute neck stiffness or pain heal quickly due to the durable and recuperative nature of the cervical spine.
Even for mild symptoms, seek treatment to learn neck stretching/ strengthening exercises, as well as improved posture and ergonomics, to help prevent or minimize future episodes of stiffness or pain.
In the vast majority of cases, a stiff neck is caused by a simple muscle strain or sprain and may be treated within a few days.
As a general rule, it is advisable to seek medical attention if the stiff neck symptoms do not subside after one week, or if the neck symptoms occur along with other troubling
symptoms, as there may be an underlying medical condition that needs treatment.
First aid for a stiff neck caused by muscle strain or soft tissue injury may include one or a combination of the following:
- Gentle stretching
- Heat and ice packs
- Low-impact aerobic exercise
Learn more about treating a stiff neck at Spine Health.