Stiff neck - treatments and causes

Stiff neck - treatments and causes

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Stiff neck - pain in the neck

A stiff neck and corresponding neck pain are a widespread complaint that is usually due to incorrect posture, for example when working on a PC or sleeping with a pillow that is too thick. For some people, even slight drafts on the neck cause complaints. In rare cases, however, the stiff neck can also be associated with serious illnesses such as life-threatening meningitis (meningitis). Therefore, if in doubt, a medical check should be carried out urgently.

Neck stiffness - a brief overview

A stiffened neck is often the result of cramped neck muscles and is often based on monotonous, heavy or incorrect stress. In rare cases, neck stiffness can also be a symptom of a more serious illness. Here is a brief overview of the symptoms:

  • symptom: Restricted movement of the head, painful blockages in the back of the neck and neck, stiff neck, neck problems, neck pain, sometimes radiating pain in the shoulder and arms.
  • Possible causes: Muscle tension in the neck area (very common), incorrect loading, signs of wear, cervical spine syndrome, meningitis, rheumatism, tumors, infectious diseases, blood poisoning, sunstroke, sinus thrombosis, ankylosing spondylitis.
  • Risk factors: Sitting for long periods, lifting and carrying heavy loads frequently, drafts, stress, emotional problems, incorrect posture, incorrect loading, lack of exercise.
  • treatment: Depending on the cause - medical massages, physiotherapy, pain relieving medication; surgery may be necessary in the case of severe wear; antibiotics can be administered for bacterial infectious diseases.
  • Naturopathy: Acupuncture, osteopathy, chiropractic, Rolfing, progressive muscle relaxation, autogenic training, homeopathy.


A stiff neck describes an impaired movement of the head, which is caused by painful blockages in the neck area. A stiff neck should be differentiated from the broader term “stiff neck”, which also includes restrictions on movement that originate from the lateral neck muscles. With a stiff neck, the origin of the symptoms is limited to the back of the neck.


A stiff neck shows up as a painful blockage in the back of the neck. The normal mobility of the head is significantly restricted. With the so-called functional causes, this usually only affects certain movements, such as turning to the right or tilting the head forward. However, if the neck stiffness is based on diseases such as meningitis, the mobility of the neck can be temporarily completely lost.

The pain often radiates to the shoulders and arms with a stiff neck, so that accompanying shoulder blade pain and upper arm pain are not uncommon. Depending on the triggers, the symptoms can occur in acute form but also as chronic neck stiffness. Furthermore, depending on the causes of the stiff neck, numerous different accompanying symptoms can be observed, which can range from sensory disturbances such as tingling in the limbs, numbness in the head or regular falling asleep of the hands to massive headaches, back pain and symptoms of paralysis. If the affected person shows a high fever, this should be seen as a warning signal for a serious illness and a doctor should be consulted as soon as possible.

Other symptoms that can occur in connection with a stiff neck are then described in more detail in the context of the respective causes.

Warning: With these symptoms immediately to the doctor

In most cases, a stiff neck is harmless and easy to treat. Chronic neck pain often indicates, for example, poor posture or a malformation in the area of ​​the spine and thoracic skeleton. Sometimes, however, a stiff neck can also indicate serious illnesses such as meningitis, rheumatism, tumors, infectious diseases or ankylosing spondylitis. Especially if the neck pain lasts longer than three months, there can be serious illnesses behind it. However, if one or more of the following symptoms occur in addition to the stiffness of the neck, medical help should be sought immediately:

  • The stiff neck occurs after a car accident or fall.
  • There is also a fever.
  • Affected people lose body weight for inexplicable reasons.
  • There was already a tumor in the past.
  • There are also gait disorders or difficulty walking.
  • Severe nerve pain occurs in the arms or legs.

Risk factors

There are numerous factors that favor the occurrence of neck stiffness. Those who often suffer from a stiff neck should avoid the following points if possible:

  • Sitting times too long,
  • heavy or incorrect lifting and carrying of loads,
  • sit in the breeze,
  • too much stress,
  • emotional problems.


With the possible triggers for a stiff neck, a distinction must first be made between functional or mechanical complaints and organic causes. Muscle problems, such as neck tension, play an outstanding role in the functional causes. They are particularly common for stiff neck. They are usually based on recurring incorrect loads, so-called muscular imbalances. Working on the computer, but also assembly line production are mentioned here as corresponding risk factors.

Incorrect loading

The monotonous load on certain muscles means that they harden over time and remain in a permanent state of contraction. Their opponents are also increasingly stressed by the constant move and may also begin to harden. Normal movements can only be carried out with considerable pain or no longer at all. The hardened muscles may also press on the surrounding connective tissue structures (fascia), blood vessels and nerves, which can lead to further complaints. Often, those affected suffer from the sensation disorders already mentioned and a severe headache at the back of the head.

Cervical spine syndrome

The stiff neck can also be due to functional impairments or diseases of the cervical spine. For example, osteoarthritis of the cervical spine or head joints should be mentioned here. This wear and tear leads to damage to the joint structures and corresponding restrictions in mobility. Accompanying this can also include neck pain, headache at the back of the head and pain in the shoulders and arms. The same applies to a herniated disc in the area of ​​the cervical spine. This rather rare form of a herniated disc is also often associated with massive back pain. Paralysis in the arm area can also be due to a herniated disc in the cervical spine. Such degenerative changes and signs of wear are summarized under the key term cervical spine syndrome (cervical spine syndrome).

Diseases as the cause

So-called meningism is a special form of a stiff neck. This describes a cramped complete neck stiffness in certain diseases, such as meningitis (meningitis). Accompanying symptoms like nausea and vomiting, headache, high fever, dizziness, poor circulation and impaired consciousness up to loss of consciousness can be observed. Meningism can also result from blood poisoning (sepsis), an acute sunstroke, a so-called sinus thrombosis or a tumor of the meninges.

Psyche as the cause

In addition to the functional and organic causes that can cause a stiff neck, psychological stress often also plays a role in the symptoms. For example, it is assumed that extreme stress, burnout (depression) or depression in some patients manifest themselves in tension in the neck muscles and a correspondingly increased susceptibility to a stiff neck.


Based on a thorough medical history at the beginning of the examination, the possible causes of the complaints can often be clearly narrowed down. A physical examination, with palpation and listening to the neck area, allows further conclusions to be drawn about the trigger of the neck stiffness. In order to determine a herniated disc or arthrosis of the cervical vertebrae, imaging procedures such as X-rays, ultrasound, computed tomography and magnetic resonance imaging are required in case of doubt. These can also provide evidence of a possible meningitis. Meningism can also usually be determined using certain movement tests (positive Bruderzinski, Kernig and Lasègue signs). Blood tests can also be used to determine and determine (viral or bacterial) meningitis, but it may be necessary to take a sample of the cerebrospinal fluid (brain spinal fluid) to confirm the diagnosis. Possible blood poisoning can be identified relatively easily on the basis of the blood picture.

Treatment options

For the functional or mechanical causes of a stiff neck, therapy based on medical massages, physiotherapy and possibly pain relieving medication is usually provided. Local anesthetic injection may also be considered. In the case of a herniated disc, the treatment options mentioned are sometimes unsuccessful and in case of doubt, surgery remains the last option for successful therapy.

With meningism or the treatment of its causes, drug therapy is usually in the foreground. For example, bacterial meningitis and blood poisoning are usually treated with high-dose antibiotics. In the case of sinus thrombosis, anticoagulant and blood-thinning preparations are administered. Viral meningitis can hardly be treated with medication, or not at all, due to the lack of effective medication. If the stiff neck is due to a tumor of the meninges, the treatment options are also clearly limited and in the end, radiation and / or chemotherapy remain the only options for therapy.

Naturopathy on a stiff neck

Naturopathy usually has little to counter the causes of meningism, but it does offer promising treatment options for the functional or mechanical causes of a stiff neck. For example, acupuncture as a method of traditional Chinese medicine (TCM) is today in many cases part of the "normal" treatment catalog for a stiff neck. Manual procedures such as osteopathy, chiropractic and Rolfing are now often part of the treatment of functional complaints in the neck area. The stress distribution and overall statics of the organism play a special role in the context of these procedures, which is why accompanying impairments, such as low back pain, hip pain or chest pain, are also taken into account in the diagnosis and treatment.

In order to relieve the neck muscles of any tension that may be present, naturopathy occasionally uses the so-called progressive muscle relaxation, which, in addition to relaxing the muscles, is also said to have a positive effect on the psyche. This is particularly appropriate if a connection between neck stiffness and psychological stress is suspected. Here, learning relaxation techniques (autogenic training) can contribute to coping with stress and in this way reduce the risk of a stiff neck.

Homeopathic remedies and Schüßler salts are used as part of naturopathic treatment for muscle tension, but also for inflammatory processes that may be present in the organism. In addition, the acid-base balance in natural medicine is attributed to a special effect on the muscles and therefore attempts to remedy any acidity that may be present.

Tips for preventing neck stiffness

Since cramped neck muscles are one of the most common but avoidable causes of neck stiffness, small changes in everyday life can often make a big difference. The following eight tips can help prevent stiff neck and neck pain. If there is still no improvement, a doctor should be consulted urgently.

  1. Change seating position: If you stay in the same position for too long, you tend to contract the muscles. You should get up once an hour, move around a little and do light exercises like shoulder circles.
  2. Massages: Painful areas on the neck can often be massaged away. To do this, use your fingers to find the painful point in the muscles and work with circular movements under light pressure.
  3. Anoint: Circulation-promoting ointments with natural ingredients such as comfrey or eucalyptus can help to relieve pain and relax.
  4. coping with stress: Methods for reducing stress can often also alleviate or eliminate painful tension. Proven relaxation methods include, for example, autogenic training, yoga, tai chi, meditation and progressive muscle relaxation.
  5. Heat treatment: A warm bath, a cherry stone pillow, a hot water bottle or a red light lamp provide soothing warmth that has a relaxing and antispasmodic effect. Caution: If inflammatory processes are the cause, heat is counterproductive.
  6. Avoid drafts: Especially in the car, on the train, in air-conditioned rooms or when sitting by the open window, the neck muscle cools down quickly. A scarf or bandana can protect against drafts.
  7. Keep your head moving: The neck muscles should be stretched regularly so that they do not cramp. To do this, often look back and left over your shoulder, move your head up and down and tilt to both sides.
  8. Ensure good sleeping conditions: If you often wake up in the morning with a stiff neck, you may have the wrong pillow, the wrong mattress or the wrong slatted frame. In the specialist shop you can get advice on ergonomic alternatives.

(fp, vb; update on January 30, 2019)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters, Dr. med. Andreas Schilling


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Video: 7 60 Second Stretches to Cure a Stiff Neck NOW-Pain Relief Exercises (January 2023).