Neck stiffness is a common condition that can vary in intensity, ranging from general soreness that mildly inhibits neck motions to sharp or burning pain that flares when attempting even slight head movements. Treating a stiff neck typically involves a combination of one or more of the following:

  • Short rest period and/or activity modification
  • Ice pack and/or heat therapy
  • Gentle stretching and massage
  • Over-the-counter pain medication

The vast majority of stiff necks are acute and result from some type of muscle strain or ligament sprain when the neck gets overused or overexerted. Recognizing which action or environmental factors contributed to the stiff neck can help develop a treatment strategy and reduce the risk for recurrence.

See Stiff Neck Causes, Symptoms, and Treatment

How Stiff Neck Causes Can Determine Treatments

While it is important to treat the pain and limited range of motion associated with a stiff neck, the problem might keep coming back if the initial cause is not addressed. Some common sources of neck stiffness include:

Sleeping in awkward positions

When waking up with a stiff neck, it makes sense to evaluate the sleeping environment, especially if the bed or pillow is unfamiliar or new. Some people find better support for the neck with larger pillows, while others might prefer smaller or no pillows. The same goes for the firmness of mattresses and pillows, as no particular level of firmness works best for everyone. Finding the right pillow and mattress for better sleep comfort may take some trial and error.

See Pillows and Positions for Easing Neck Pain Video

Poor posture

If neck stiffness and soreness tend to develop toward the end of the work day or during specific activities, such as while hunched over a computer screen for hours, it may be due to a combination of poor posture, inactivity, and muscles becoming weakened or tightened. Using better posture in the workplace, such as by sitting up straight when on the computer and regularly taking breaks to stretch the neck, may be key to preventing neck stiffness from returning.

See How Poor Posture Causes Neck Pain

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Overexertion or overuse

Lifting a heavy item or performing an unfamiliar task can increase the likelihood of the neck’s muscles and ligaments becoming injured due to overexertion or overuse, which can lead to pain and stiffness. When lifting or carrying a heavy item, it is important to keep the neck in a neutral position with the ears directly above the shoulders. If the head and shoulders are tilting at odd angles, such as leaning too far forward or to the side to maintain balance or momentum, the item is too heavy and the neck is at increased risk for becoming painful and stiff.

Direct trauma

A stiff neck that occurs after direct trauma or an accident may just be a muscle strain or ligament sprain, or it could also involve more significant damage to the cervical spine and other parts of the body. For a whiplash injury, which involves the head whipping back and forth, the neck pain and stiffness might not show up until hours later or even the next morning. Any neck pain or stiffness associated with a significant accident, such as a car crash or ladder fall, must be evaluated by a doctor.

See What Is Whiplash?

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If a stiff neck is accompanied by a severe headache, fever, dizziness, reduced coordination in the arms or legs, or other troubling symptoms, a serious underlying condition may be present that requires immediate medical attention.

See When Is a Stiff Neck Serious? and Understanding Neck Pain and Dizziness

Dr. Grant Cooper is a physiatrist with several years of clinical experience, specializing in the non-surgical treatment of spine, joint, and muscle pain. He is the Co-Founder and Co-Director of Princeton Spine and Joint Center and the Co-Director of the Interventional Spine Program.

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