Stiffneck

Stiffneck is a common term for neck stiffness, a condition in which the neck muscles feel tight and movement of the head is limited. It is usually caused by muscle strain or overuse, such as sleeping in an awkward position, poor posture, or repetitive activities. Less commonly, stiffness can arise from degenerative changes in the cervical spine, inflammatory conditions, or neck injuries (for example whiplash). In rare cases, neck stiffness may indicate a serious problem such as meningitis or spinal cord pathology, especially when accompanied by fever, severe headache, confusion, or neurological symptoms.

Signs and symptoms typically include neck pain or ache, a reduced ability to turn or tilt the head, muscle tightness or spasms, and sometimes headaches or pain radiating to the shoulders or upper back. Red flags that warrant urgent medical evaluation include fever with neck stiffness, severe or increasing pain after trauma, numbness or weakness in the arms or legs, loss of bladder or bowel control, and signs of confusion or poor balance.

Diagnosis is usually clinical, based on history and physical examination. Red flags or persistent symptoms may prompt imaging (such as X-ray or MRI) or other tests to rule out serious causes. In the absence of red flags, most stiffneck cases are managed without imaging.

Management focuses on self-care and conservative treatment: heat or cold application, gentle neck stretches and posture changes, ergonomic adjustments, and over-the-counter pain relievers such as NSAIDs or acetaminophen as directed. Physical therapy may help, and symptoms typically improve within days to weeks. Seek medical care if symptoms persist beyond a few weeks, worsen, or are associated with alarming signs. Prevention includes regular neck and upper back exercises, good posture, and ergonomic work habits.