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:
Resting for one or two days will allow any injured tissue in the neck to begin to heal, which in turn will help relieve stiffness and possible muscle spasm. However, it is recommended to limit rest to one or two days, as too much inactivity can lead to a weakening of the muscles, and weak muscles have to struggle to adequately support the neck and head.
As soon as tolerated, it is a good idea to gently stretch the neck. Stretching, as tolerated, will help ease the stiffness and restore the neck to a more natural range of motion. For many, it is a good idea to learn appropriate stretches with the help of a physical therapist or other qualified health professional.
See Neck Stretches
Heat and Ice Packs
Cold therapy/ice packs help relieve most types of neck stiffness by reducing local inflammation. Applying heat to the neck can spur blood flow, which fosters a better healing environment. Often patients use ice, but some prefer heat. Both may be used alternately.
Many over-the-counter and prescription medications are available. NSAIDs, which work by reducing inflammation, are often a first line of treatment for neck stiffness and soreness. Common types of NSAIDs are ibuprofen (e.g. Advil, Motrin) and naproxen (e.g. Naprosyn). Even nonprescription medications have risks, possible side effects and drug (or food or supplement) interactions, so be sure to discuss any medications with a pharmacist or doctor.
Low-Impact Aerobic Exercise
In addition to stretching, any form of low-impact aerobic exercise, such as walking, is often helpful in relieving any type of stiffness. Even if walking doesn't directly involve the neck, it helps circulate oxygen to the soft tissues throughout the spine, which in turn promotes healing.
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It is advisable for patients to seek a diagnosis from their primary care physician, chiropractor, or a spine specialist (such as a physiatrist) to determine the underlying cause of their neck symptoms. Especially if neck stiffness persists after a few days or a week, if it seems to be getting worse, and/or if it is accompanied by other troubling symptoms, it is a good idea to seek a medical diagnosis and treatment.
Immediate medical attention is recommended if neck stiffness is noted after a traumatic injury, or if there are additional concerning symptoms, such as a high fever.
For more information on persistent neck pain, see Chronic Neck Pain: What Condition Is Causing My Neck Pain?