Neck spasm is a painful and discomforting stiffness of the neck muscles. It is a highly disabling condition, which greatly prevents a person from leading a normal life. Neck spasm is seen either since childhood, in which case we call it torticollis, or in adulthood, where we call it trapezitis. Both these diseases have entirely different origins, but yet they cause the same symptom, a stiff and painful neck. Injury from road accidents can also lead to neck spasm from fracture of neck vertebrae or with a whiplash injury.
Although rest is thought to give pain relief, in a few people it may actually aggravate the pain and even lead to progression of the disease. The pain from a neck spasm is also felt in the arm and head, leading to the notion of a grave brain disease. It is this fear, which multiplies the severity of the neck spasm, causing an almost panic driven state of anxiety. Anxiety in itself is known to cause some degree of neck spasm. Thus, it is very much important, that we understand and locate the exact source of neck pain, to avoid the cascade of mental turmoil. The article on neck describes the structure and functions performed by the neck along with common diseases of neck.
Other Causes of Neck Spasm
Apart from orthopedic causes there are some diseases which also cause neck spasm as one of their symptom.
Meningitis is an infection of the coverings of the brain and spinal cord, which are called meninges. This infection can occur at any age and causes a reflex spasm of neck muscles to prevent the friction between the inflamed meninges. Neck spasm is one of the first signs of meningitis and is so severe that movements of the neck are completely restricted. The person also has high grade fever with chills, which remains throughout the day unrelieved by antipyretics. Children are more commonly affected by this infection, as the blood brain barrier (which normally regulates the transfer of products between nervous system and other parts of body) is not completely developed. In the elderly population, neck spasm may be the only symptom of meningitis as fever and other symptoms are mild and non-specific.
Hospital admission is necessary for the treatment of meningitis as several investigations (like CSF examination, blood counts, etc.) have to be done immediately and many vital parameters (heart rate, intracranial tension, body temperature, etc.) have to be monitered constantly. Intravenous antibiotics and antipyretics along with prevention of high intracranial tension is the primary treatment.
Tetanus is a life-threatening infection transmitted from open injuries sustained by rusted and metallic objects, which are contaminated with soil. Anerobic organisms from the clostridium group found in soil are responsible for this disease. These organisms secrete a toxin in the body which causes a severe spasm of skeletal muscles. The muscle spasm initially begins in the jaw (lock jaw) and neck muscles. Within a few hours the entire body is affected (Picture 1) by the toxin and death ensues because of inability to breath air (respiratory muscle spasm). After the spread of toxin to the entire body there is hardly any treatment which can effectively save a person. Thus, it is necessary to promptly seek medical care on seeing a severe neck spasm or inability to open the mouth.
Picture 1: Tetanus
(Source: Wikimedia Commons)
Treatment of tetanus is generally prevention of infection by vaccination. Any injury from a metallic object or near the foot which is bound to be contaminated by soil should be followed by anti-tetanus vaccination. The effect of a vaccine lasts for only 6 months and after subsequent injuries there should be repeat vaccination.
Thus, we now know that neck spasm can range from a simple muscle strain to a life-threatening tetanus. If the characteristics of each disease condition are carefully understood, then it becomes fairly easy to differentiate between them and seek appropriate medical help in the nick of time.