The neck is one of the most flexible parts of the human body allowing the head to move in many directions. It is highly muscular part of the body with only the vertebrae at the back providing stability. When the neck flexibility decreases, we often call it a stiff neck. Usually there is pain which worsens with moving the head and neck. Neck stiffness affects almost every person at some time or the other in their life. In most instance it is acute and passes in a few days with minimal treatment. Chronic cases need proper diagnostic investigation and medical treatment as there may be serious underlying muscular, joint and bone problems.
Stiff Neck Treatment
Treating a stiff neck should be left to the health care professionals. Even though a deep tissue massage may not require a medical background, you can at times do more damage than good by attempting to treat a stiff neck. Your family doctor, orthopedist, physical therapist or chiropractor may utilize one or more of the following measures after examining and investigating your neck stiffness.
- Anti-inflammatory drugs to reduce pain and inflammation.
- Muscle relaxants to ease the muscle spasm.
- Analgesics for pain relief.
- Hot or cold therapy.
- Interferential current, TENS and other forms of electrotherapy.
- Massage, muscle stretching, trigger point therapy and spinal manipulation.
- Acupuncture or dry needling.
- Strapping and the use of a cervical brace/neck collar.
A health care professional will determine the most appropriate course of treatment depending on your individual condition. However, there are several measures that you can undertake to ease the pain and stiffness.
Causes of Neck Stiffness
It is important to understand the possible causes of a stiff neck before taking any measures to ease it. Neck stiffness is a symptom of some underlying problem involving the muscles of the neck and upper back or its tendons, the ligaments, bones or the joints of the neck. Most acute cases of a stiff neck usually involve the muscles, its tendons or the ligaments. Chronic conditions tend to involve the joints or bones (vertebrae).
Common causes of a stiff neck include :
- “Sleeping badly” is a common way that people describe sleeping in an awkward or incorrect position.
- Looking downwards for long periods of time typically when reading a book resting on a desk, using a computer or laptop.
- Holding your head in one position for a prolonged period of time like when watching TV, working or undertaking other activities.
- Stress which causes a person to tense up the neck, back and shoulder muscles unconsciously over a long period of time.
- Exercise or other physical activities which a person is not accustomed to and usually involving the upper limbs or upper body.
More serious causes of a stiff neck that occur less frequently need to be investigated immediately and the appropriate medical treatment needs to be commenced at the earliest. These causes may include :
- Whiplash where the ligaments of the neck and spine are sprained.
- Ruptured intervertebral (IV) discs between the spinal bones.
- Dislocation of the vertebrae.
- Fracture of the verterbral bones.
- Osteoarthritis of the neck vertebrae (cervical vertebrae).
- Meningitis where the inner lining around the spinal cord and brain (meninges) are inflamed.
Drugs and Rubs
There is a wide range of medication and topical applications that can be helpful for neck stiffness. Most are non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and diclofenac. Ibuprofen is more easily sourced as it is sold over-the-counter without a prescription. When used in conjunction with another widely available OTC medication, acetaminophen, it is very effective for relieving pain and inflammation. An intramuscular injection is often more effective but should only be done by a medical doctor.
OTC topical applications that are rubbed on the skin usually contain menthol or camphor. These substances are counter-irritants which cause an intense burning or cooling sensation on the skin. It is more of a distraction to the pain rather than having an actual therapeutic effect. Some gels, ointments and creams contain salicylates or diclofenac which can help with both pain and inflammation.
A soft collar that is designed to fit around the neck can be very helpful in the short term. These collars minimize movement of the neck, provide support and also assists with correcting the posture. In the short term, the benefits of using a soft collar for acute neck stiffness makes it a viable option. However, prolonged use of a neck collar can be detrimental as it may weaken the neck muscles. Solid neck braces should not be used for a stiff neck unless specifically prescribed by a medical professional.
Heat and Ice
Both heat and cold therapy can be helpful in easing a stiff neck. Initially cold therapy may be advisable for the first 48 to 72 hours by using ice packs over the painful area. Never apply ice directly onto the bare skin. After this period, heat can be applied to the painful area by using a heat pad or hot water bottle. Even a hot shower can be helpful. If either ice or heat exacerbate the pain and stiffness, it should be discontinued immediately.
Mattress and Pillows
Sleeping on an ergonomically-designed mattress and suitable pillow is advisable if you are experiencing repeated episodes of neck stiffness. Avoid sleeping on two or three pillows. The spine should be straight when lying on your side during sleep. Similarly your mattress and pillow should ensure that the natural curvatures of the spine are maintained and supported when you lie on your back. It may be worth considering replacing your mattress and buying an ergonomically-designed pillow if you are experiencing neck stiffness upon awaking from sleep.
A good posture can go a long way in preventing musculoskeletal problems involving the neck and back. However, modern life is such that this is not always possible. Keeping the head in one position for prolonged periods while you are sitting at a desk or standing over a counter while you work is one of the major contributers to neck stiffness and pain. You should maintain a good posture while walking, standing and sitting in keeping with the natural curvatures of the spine (neutral spine). It is important to get the advice of a physical therapist or chiropractor about the proper posture and make a concerted effort to correct your posture if necessary.
Neck Exercise Video
Neck stretching exercise can help with improving mobility, easing muscle spasm and preventing neck pain. It should be done on a daily basis as a means of preventing neck stiffness but can also be done gently once stiffness arises. Never force any stretching exercises beyond the range of motion that you can manage. The neck exercise video below is a comprehensive guide on the correct way of stretching the neck muscles. Always consult with your doctor, physical therapist or chiropractor before commencing with exercises for musculoskeletal problems.
Article reviewed by Dr. Greg. Last updated on February 15, 2013