A stiff neck is typically characterized by soreness and difficulty moving the neck, especially when trying to turn the head to the side. It may also be accompanied by a headache, neck pain, shoulder pain and/or arm pain. In order to look sideways or over the shoulder, an individual may need to turn the entire body instead of the stiff neck.
Most people are familiar with the pain and inconvenience of a stiff neck, whether it appeared upon waking up one morning or perhaps developed later in the day after some strenuous activity, such as moving furniture. In most cases, pain and stiffness go away naturally within a week. However, how an individual manages and cares for the stiff neck symptoms can affect pain levels, recovery time, and the likelihood of whether it will return.
Common Causes of Stiff Neck
By far the most common cause of a stiff neck is a muscle strain or soft tissue sprain. In particular, the levator scapulae muscle is susceptible to injury. Located at the back and side of the neck, the levator scapulae muscle connects the neck’s cervical spine with the shoulder. This muscle is controlled by the third and fourth cervical nerves (C3, C4).
The levator scapulae muscle may be strained throughout the course of many common, everyday activities, such as:
- Sleeping with the neck at an awkward position
- Falling or sudden impact that pushes the head to the side, such as sports injuries
- Turning the head side to side repeatedly during an activity, such as swimming the front crawl stroke
- Slouching with poor posture while viewing the computer monitor or looking downward at a mobile phone for prolonged periods (sometimes referred to as "text neck")
- Experiencing excessive stress or anxiety, 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
The cause of the stiff neck may be obvious if symptoms start right away, such as after falling during a sporting event. If a stiff neck seems to develop out of nowhere, however, it could be difficult to pinpoint the exact cause.
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Uncommon Causes of Stiff Neck
Sometimes neck stiffness is a reaction to an underlying disorder of the cervical spine, which helps support and move the neck in addition to protecting the spinal cord. Several examples of cervical spine disorders that can cause neck muscles to painfully spasm or tighten include:
- Cervical herniated disc. The protective outer portion of a disc in the cervical spine breaks down, and the inner portion leaks out, causing compression and inflammation in nearby tissues.
- Cervical degenerative disc disease. As discs lose hydration and height over time, pressure increases on nearby joints, nerves, and soft tissues, such as ligaments and muscles. This process can result in neck pain and stiffness.
- Cervical osteoarthritis. Arthritic breakdown of the cervical facet joints between vertebral bones often occurs along with other degenerative conditions, such as spinal stenosis, and anatomical changes, such as bone spurs.
This is not a complete list of conditions that can cause a stiff neck. While rare, several other possibilities exist, such as an infection or tumor.
Stiff Neck Symptoms
A stiff neck can vary in intensity, ranging anywhere from an annoying discomfort to extremely painful, sharp, and limiting. Typically, attempting to turn a stiff neck to a particular side or direction will eventually result in so much pain that the motion must be stopped.
The amount of reduction in neck motion can affect the individual’s activity levels. For example, if the head cannot be significantly turned in one direction without excruciating pain, driving will likely need to be avoided until symptoms improve.1
Dos and Don’ts for a Stiff Neck
Oftentimes, taking it easy for a day or two is all that is needed to give the neck’s soft tissues a chance to heal. In cases where pain is significant, an individual may want to use an over-the-counter pain medication or apply ice and/or heat therapy.
Wearing a cervical collar to immobilize a stiff neck is not advised. Rather, an individual with a stiff neck should try to stick to normal activity levels if possible, especially after the first day or two.
When to See a Doctor for a Stiff Neck
If a stiff neck has not shown improvement after a week, it should be checked by a doctor. Also, regardless of how long it has lasted, a stiff neck accompanied by any red flag symptoms—such as a fever, headache, nausea or vomiting, or unexplained sleepiness—should be seen by a medical professional immediately.