A stiff neck refers to a tightness or rigidity in the muscles supporting the neck. Nuchal rigidity refers to a stiffness that prevents bending of the neck and limits movement of the neck. Neck stiffness can be simply a mild discomfort and slight problem in moving the neck. Or it can be severe pain and the inability to move or bend the neck at all.
The muscles and bones of the neck have to support the weight of the head and every turn the head makes. Neck stiffness can occur by itself or with neck pain. Neck pain may come from any structure of the neck. This includes the vertebrae and muscles of the upper back, the blood vessels of the neck, and lymph nodes in the neck.
Any type of injury or illness can result in a stiff neck. A person with a stiff neck may move the neck more slowly and carefully. This can lead to painful muscles spasms. Neck stiffness can also lead to strained ligaments and pain that travels from the neck into the back and arms.
The cause of neck stiffness can vary greatly. Some of the causes of neck stiffness include:
Symptoms of neck stiffness can vary greatly. Symptoms may be mild, causing a slight problem in moving or turning the head and neck. Or the symptoms may be severe, causing great difficulty in moving, turning, or bending the neck.
If the neck stiffness is due to a major injury or head trauma or if there is severe nuchal rigidity, emergency treatment may be needed.
The healthcare provider will want to know more about the person's symptoms, such as:
In diagnosing a stiff neck and its causes, a healthcare provider will obtain a medical history and a history of the events leading up to the neck stiffness. A physical exam will be done to diagnose the underlying cause. If a person has been injured, the healthcare provider will be careful during the examination so as to avoid further injury.
If it is possible that the person has meningitis or a subarachnoid hemorrhage, emergency care is needed because these conditions are life-threatening. X-rays, blood tests, spinal taps, and possibly CT scans or magnetic resonance imaging (MRI) may need to be done to evaluate the possible cause of the stiff neck.
Some ways to prevent neck stiffness include the following:
Many causes of stiff neck are not preventable.
The long-term effects of a stiff neck depend on the underlying cause. For example, a person who received a minor whiplash from a car accident may recover completely without any further effects. Torticollis may cause a person to suffer lifelong pain and a decreased ability to move about. A person with meningitis may recover from the infection, may suffer lifelong limitation in movement, or may die from the infection.
The cause of the stiff neck will determine if others are at risk. A person who has injured his neck is not contagious. A person with an infection, such as meningitis, may be contagious to others.
Treatment for stiff neck depends on the underlying cause.
Side effects to treatment depend on the treatment used. Antibiotics can cause stomach upset, rash, allergic reactions, or other side effects. Surgery poses a risk of bleeding, infection, paralysis, or allergic reaction to the anesthesia.
A person who feels fine after treatment may not need any further care. A person who underwent surgery may need close monitoring and physical therapy. A person who has meningitis may need intensive care for many weeks.
A person recovering from a stiff neck may need no further monitoring. A person who received intensive treatment and is recovering from a serious illness, such as meningitis, may need close monitoring. A person recovering from a major trauma or injury may need close monitoring to evaluate treatment and physical therapy to aid recovery. Any new or worsening symptoms should be reported to the healthcare provider.
Author:Eileen McLaughlin, RN, BSN
Date Written:
Editor:Smith, Mary Ellen, BS
Edit Date:08/09/00
Reviewer:Gail Hendrickson, RN, BS
Date Reviewed:07/05/01
Professional Guide to Signs and Symptoms, Springhouse, 1997.
Mayo Clinic Family Health Book, David E. Larson, 1996