Dr Tariq Jagnarine
Fam Med, Endocrinology/ Diabetes
A person’s neck may feel stiff due to overuse, injury, or sleeping in an unusual position. Stretching, using warm or cold packs, and medication may relieve it. However, in some cases, a person may need treatment for a more serious cause, such as meningitis. The neck contains muscles, tendons, ligaments, and bones. These work together to support the head and allow it to move in many directions. A stiff neck often occurs when one of the muscles becomes strained or tense. Stiffness can also develop if one or more of the vertebrae is injured. A stiff neck may become painful when a person tries to move their neck or head.
Usually, a stiff neck results from a minor injury or incident. People can often relieve the stiffness at home. In rare cases, however, it can be a sign of a serious illness that requires medical treatment.
Causes
Stiffness usually occurs when the neck muscles are overused, stretched too far, or strained. This can cause pain ranging from mild to severe that can make it difficult to move the head or use the neck muscles. The most common causes of a stiff neck include:
• Minor sprains and strains
• Sleeping in an awkward position
• Sitting or slouching for long periods, such as at a desk
• Looking down at an object (such as a cellphone) repeatedly
• Sustaining a sport injury
• Experiencing a fall
• Having tense muscles due to stress
• Whiplash
• Cervical spondylosis, or arthritis of the neck, can also cause neck pain and stiffness, which may improve when lying down
• Meningitis
Treatment
The best way to relieve a stiff neck depends on the cause. When the stiffness is minor, some of the following home treatments may help:
• Applying ice
Applying an ice pack may help reduce swelling and numb pain.
Using an ice pack can help relieve inflammation and swelling after a minor strain. The ice can have a numbing effect, temporarily relieving any pain.
This treatment is usually most effective within the first 48 hours of an injury, when there tends to be the most significant swelling.
Use a first aid ice pack or cover a bag of ice or frozen peas with a cloth to avoid frostbite. Apply the ice for up to 20 minutes at a time, taking 20 to 30-minute breaks.
• Applying heat
Some people alternate using ice and heat on a muscle strain. Using heating pads or taking a hot bath can help relax tense muscles and provide relief.
• Taking over-the-counter medicines
If applying ice, heat, or both does not relieve the pain of a stiff neck, taking nonsteroidal anti-inflammatory drugs (NSAIDs) may help. Some examples include ibuprofen and naproxen, which can reduce swelling and relieve pain. If a person has a health condition and is taking other medications, they should ask a doctor before using NSAIDs.
• Stretching
Stretch the neck muscles by gently and slowly moving the head from side to side. Roll the shoulders forward and backward. Stop if the stretches cause pain.
• Checking the sleeping environment
Sometimes, a mattress that is too firm or not supportive enough can cause neck pain. A pillow that is the incorrect size or firmness may also cause a stiff neck. The head, neck, and back should be in an aligned position during sleep. The pillows that a person uses should suit their sleeping position.
A firmer, larger pillow may work well for side sleepers. Back sleepers may need a flatter pillow that supports the head and neck without forcing them into a forward position.
• Paying attention to posture
Slouching can gradually pull the neck muscles and cause stiffness and pain. A person should focus on keeping the shoulders, neck, and back in a straight line throughout the day. Wearing a posture-correcting device may help, as can setting reminders and alarms on a cellphone or computer.
• See a dentist
Ongoing stiffness in the neck accompanied by a headache or jaw pain upon waking can be a sign of nighttime teeth grinding, or bruxism. A dentist can check the teeth for signs of wear from grinding, and they may look at the alignment of the jaw. Some people wear a custom-made teeth guard at night to protect the teeth from further damage. This may also alleviate pressure on the jaw and neck muscles.
• Getting a massage
A licensed massage therapist may help provide relief from tense, sore muscles. Although research has not yet proven that massage is effective, a study from 2014 found that massage did improve pain for people with neck arthritis. Other research published in the journal Complementary Therapies in Clinical Practice found that having a professional massage can help relieve stress, which may indirectly help with stiffness in the neck.
• Managing stress
There is no way to completely avoid stress. However, learning to manage it can reduce tension in the neck. People with high levels of chronic stress may wish to talk with a healthcare professional about healthful ways to manage stress.
Prevention
Looking down at a phone for too long can cause eye and neck strain.
• Some of the following measures can help prevent a stiff neck:
• Use an earpiece to talk on the phone. Avoid holding the phone between the shoulder and ear.
• Try not to look down at a cellphone or tablet for long periods. Hold the device at eye level whenever possible and take frequent breaks.
• Use proper ergonomics at work. This may include keeping the screen at eye level, keeping the feet flat on the floor, and making sure the arms are supported. Also, focus on keeping the head directly above the neck without craning it forward.
• Be mindful when carrying bags. Carrying a heavy purse or briefcase can put pressure on the shoulder and strain the muscles in the neck. Use rolling bags or backpacks whenever possible.
• Take breaks. Sitting or driving for long periods can strain the neck. Get up, walk, and stretch at least once per hour.
• Invest in a high-quality mattress and pillow that provide the correct amount of support.
• Regularly engage in stress-relieving activities. Some examples include listening to relaxing music, taking baths, practising meditation or deep breathing, and enjoying a class or favourite activity.
• See a healthcare provider as recommended. Talk with them about pain, stress levels, sleep quality, and overall well-being.
• Exercise regularly. Moving the body can help alleviate muscle tension and stiffness. Exercise is also a natural stress reliever. Low-impact activities such as walking, swimming, biking, or yoga may be helpful.
When to see a doctor
A stiff neck is generally not a cause for alarm. However, see a doctor if:
• The stiffness is accompanied by other symptoms, such as a fever, a headache, or irritability.
• The stiffness does not go away within a few days and after trying home treatments such as NSAIDs and gentle stretching.
• The pain is severe.
Causes
