Stiff Neck

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What is a stiff neck?

A stiff neck is pain, soreness or discomfort in the neck, which is often most noticeable with neck movement. If you have a stiff neck, you may find that you need to turn your entire body in order to look to the side or behind you because of the discomfort. A stiff neck is a common condition, and most people will experience it at some point in their lives.

The neck consists of variety of structures, including the cervical spine, spinal cord, cervical discs, muscles, ligaments, tendons, and spinal nerves. Stiffness in the back or side of the neck is often caused by conditions that affect these structures, such as neck stiffness after sleeping in a position that strains the neck muscles.

The neck also includes the trachea, throat, and associated structures, such as the thyroid cartilage (Adam’s apple) and the thyroid gland. A stiff neck can be due to diseases, disorders and conditions of these structures, as well as the muscles, tendons and ligaments of the neck. A stiff neck can also be caused by conditions of the shoulders and head, such as poor posture and tension headaches, respectively.

A stiff neck may indicate a serious condition, such as arthritis or spinal stenosis. Seek prompt medical care if you have unexplained or persistent neck stiffness, or if you are otherwise concerned about your symptoms .

A stiff neck can also be associated with serious and life-threatening conditions, such as heart attack, meningitis, or neck fracture. Seek immediate medical care (call 911) if you, or someone you are with, have neck stiffness after neck injury or trauma, or numbness, inability to move any part of your body, chest pain, shortness of breath, or neck stiffness with fever or headache.

What other symptoms might occur with a stiff neck?

A stiff neck may occur by itself or it may be accompanied by other symptoms, which vary depending on the underlying cause, your medical history, and other factors. Additional symptoms that may occur with a stiff neck include:

  • Difficulty turning your head

  • Difficulty opening or closing the mouth

  • Headache

  • Irritability

  • Pain down your shoulders or arms

  • Sleep disturbances

    Serious symptoms that might indicate a life-threatening condition

    In some cases, neck stiffness or pain may occur with other symptoms that might indicate a serious or life-threatening condition, such as meningitis, heart attack, or spinal trauma, which should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have a stiff neck or neck discomfort with any of these symptoms:

    What causes a stiff neck?

    A stiff neck may be caused by conditions that originate in the neck itself, or by diseases and conditions of related areas, such as the shoulders, jaw, head, or upper arms. A stiff neck is often caused by factors that cause a strain of the neck or shoulder muscles, such as sleeping in awkward positions, poor posture, or strenuous activities.

    The levator scapulae muscle is located at the back and side of the neck and connects the neck to the shoulder. As a result of its position and the forces acting upon it, this muscle is easily strained.

    Neck stiffness and discomfort can also be caused by diseases, disorders and conditions of any of the structures that make up the neck, such as the cervical spine and spinal cord, nerves, intervertebral discs, muscles, ligaments, tendons, thyroid gland, trachea, and throat. Referred pain from disorders within the chest or abdomen can also generate neck stiffness.

    Musculoskeletal causes of neck stiffness

    A stiff neck may be due to muscle strains, ligament sprains, and other musculoskeletal problems. Causes include:

    • Activities involving repeated side-to-side turning of the head

    • Cervical spine fracture or spinal cord trauma

    • Excessive stress or tension

    • Holding the neck in an abnormal position or immobile for long periods

    • Injuries, falls, or other trauma, such as a motor vehicle accident or sports injury

    • Osteoarthritis (type of arthritis characterized by degeneration of the cartilage and bone in the joints) and rheumatoid arthritis (chronic autoimmune disease characterized by joint inflammation)

    • Poor posture

    • Sleeping or resting in an awkward position

    • Spinal degeneration (spondylosis, a degenerative disc disease)

    • Spinal stenosis (narrowing of the spinal canal causing pressure on the spinal cord or nerves), which can be caused by a herniated disc in the neck and other conditions

    • Whiplash (cervical sprain or strain, neck hyperextension followed by hyperflexion)

    Diseases and conditions that can cause a stiff neck

    Diseases or conditions that can affect the neck include:

    • Arthritis

    • Brain aneurysm (cerebral aneurysm, a bulging of the wall of a brain artery)

    • Cancer, including spinal tumors and multiple myeloma (blood cancer)

    • Carotid artery dissection

    • Fibromyalgia (chronic condition that causes pain, stiffness and tenderness)

    • Headache such as migraine

    • Heart attack

    • Infections such as influenza (flu), cervical spine infection, or meningitis (a serious bacterial infection of the membranes surrounding the brain and spinal cord)

    • Osteomyelitis (infection or inflammation of the spinal bones)

    • Referred pain from diaphragm, gallbladder, or stomach conditions

    • Temporal arteritis (Giant cell arteritis)

    • Temporomandibular joint pain

    • Thyroiditis

    Questions for diagnosing the cause of a stiff neck

    To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your stiff neck including:

    • In what part of the neck do you feel stiffness?

    • When did the symptoms start?

    • Have you experienced any recent trauma or injury, such as a sports injury or motor vehicle accident?

    • Are you experiencing any other symptoms, such as fever, headache or numbness?

    What are the potential complications of a stiff neck?

    Neck stiffness due to overuse or minor strains usually responds to home treatments, such as rest, ice, and over-the-counter anti-inflammatory medications. However, in some cases, neck stiffness may become a chronic condition and affect your daily life. Over time, neck stiffness can lead to complications including:

    • Absenteeism from work or school

    • Adverse effects of treatment

    • Chronic pain

    • Disability

    • Paralysis

    • Poor quality of life

    • Spread of cancer

    • Spread of infection

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    Medical Reviewer: William C. Lloyd III, MD, FACS
    Last Review Date: 2021 Jan 2
    THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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