Stiff neck pain headache

When Is a Stiff Neck Serious?

A stiff neck can be annoying, but it is usually not cause for panic. In rare cases, however, it could signal the need for a prompt medical evaluation. This page contains some ways to know when a stiff neck might be a symptom of a serious underlying medical condition.

See All About Neck Pain


If neck pain becomes chronic, it’s likely that some form of medical treatment or guidance is needed to alleviate the pain. See Diagnosing Neck Pain

Red Flag Symptoms That Can Accompany a Stiff Neck

If a stiff neck is the result of a condition other than a strain or sprain, oftentimes other symptoms will also be present. In such cases, typically at least one other symptom will develop with or before the stiff, painful neck occurs.1

See Neck Strain: Causes and Remedies


Below are “red flag” symptoms that could indicate a potentially serious underlying medical condition is causing the stiff neck:

  • Fever, which likely signals an infection is being fought
  • Headache, especially if it seems different from previous headaches in terms of duration, intensity, or accompanying symptoms
  • Nausea or vomiting
  • Fatigue or unexplained drowsiness
  • Change in mental state, which could include confusion or mood swings
  • Coordination issues, such as dizziness or problems walking or writing
  • Weight loss that is not part of a diet change

See Understanding Neck Pain and Dizziness

These symptoms should motivate the individual to seek immediate medical attention, but they do not necessarily mean a serious condition or medical emergency is present.

See When Neck Cracking Needs Medical Attention

In This Article:

  • Stiff Neck Causes, Symptoms, and Treatment
  • Treatment for a Stiff Neck
  • When Is a Stiff Neck Serious?
  • Video: What Causes a Stiff Neck?

Most Common Serious Condition with Stiff Neck

Meningitis—which in its most dangerous form is a bacterial infection that causes the protective membranes of the brain and spinal cord to be inflamed—is the most common serious condition associated with a stiff neck.

See Spinal Cord Anatomy in the Neck

According to the Centers for Disease Control and Prevention (CDC), a fever, headache, and stiff neck (inability to flex the neck forward, also called nuchal rigidity) are typically early symptoms of bacterial meningitis.FOOT|1] When any two of these symptoms are present together, they should be immediately checked out by a doctor.

See When Neck Stiffness May Mean Meningitis

Meningitis symptoms usually develop within a few days of exposure, and the individual’s condition could worsen gradually or rapidly. Early treatment for meningitis is critical for having a good outcome. Delayed treatment could result in poor outcomes, such as hearing loss, brain damage, or even death.

It should be noted that a stiff neck is not always present with meningitis, and other symptoms could include nausea, heightened sensitivity to light or loud noises, or confusion, among others.


Meningitis is a bacterial infection that causes the protective membranes of the brain and spinal cord to become inflamed.

Others Serious Conditions with Stiff Neck

Other conditions that would rarely cause stiff neck but require immediate medical attention include:

  • Infection. While meningitis is the most common infection that could cause a stiff neck, numerous other infections could also result in a painful stiff neck.
  • See Osteomyelitis, a Spinal Infection

  • Tumor. A brain tumor, especially if it is located in the cerebellum, can cause a stiff neck. A tumor in the cervical spine, such as from cancer, could also cause the neck to become sore and/or stiff.
  • See Types of Spinal Tumors

  • Cervical dystonia. This neurological disorder, also known as a form of torticollis, can cause neck muscles to spasm uncontrollably. The head could be turned or stuck in various positions outside of normal alignment.

    See Understanding Neck Spasms


This is not a complete list, as many conditions could cause the neck tissues to swell or spasm, resulting in painful, restricted movement.

See What Causes Neck Spasms?

Stiff Neck: A Look At Possible Causes

Your neck feels tight and tense, and it’s uncomfortable, maybe even impossible, to move it from side to side or up and down. And a stiff neck often seems to linger on and on.

Most often, a stiff neck is caused by strain on the soft tissues of your neck, but it can be a symptom of many problems and shouldn’t be ignored.

Causes of Stiff Neck

A stiff neck may be the result of:

  • Injury. If you had an accident that caused your head to jerk around violently, you may have injured the muscles and perhaps the ligaments in your neck, which can lead to stiffness. Neck injuries may result from mishaps as wide-ranging as automobile accidents, a collision or hit sustained while playing contact sports, and falls.
  • Osteoarthritis. This is a condition that results from wear and tear of your joints and often occurs with age. It can lead to stiffness and limited movement in various joints, including your neck.
  • Rheumatoid arthritis. This autoimmune disorder affects your joints, and it can damage those in your neck. This damage can result in severe neck pain and stiffness, usually in the upper part of your neck.
  • Pinched nerve. A pinched nerve may be due to arthritis, the narrowing of your spinal canal, or a herniated disk. If you have a pinched nerve, you may experience neck stiffness that sometimes radiates into your arms and maybe your legs.
  • Emotional stress. When you’re under stress, your muscles can become tense. A stiff neck is often an early signal that you are feeling stressed.
  • Fibromyalgia. This disorder is associated with painful, achy muscles and joints. Muscles may contract, resulting in a stiff neck.
  • Muscle spasm. A muscle spasm occurs when your nerves send messages to your muscles that cause them to contract. A muscle spasm in your neck can result in a stiff neck.
  • Meningitis. Meningitis is a serious, potentially life-threatening infection of the fluid that surrounds your brain and spinal cord. Along with fever and a headache, a stiff neck is a common symptom of meningitis.
  • Other infections. In addition to fever, vomiting, and sensitivity to light, a stiff neck can be a sign of a simple viral infection, such as the flu

Is your workout giving you a stiff neck?

Try these quick fixes to stay active and avoid neck pain.

Updated: December 15, 2019Published: September, 2017

Physical activity is important to feeling great and staying healthy. But the wrong execution of a particular move, such as a golf swing or swimming stroke, may wind up causing neck pain. “Often people don’t realize their activity is to blame,” says Emily Roy, a physical therapist with the Sports Medicine Center at Harvard-affiliated Massachusetts General Hospital.

Neck pain after working out: What goes wrong

Neck pain may result from overuse of muscles in the neck and shoulder (many shoulder muscles also attach to the neck), strain on the joints in the neck, or a pinched nerve in the neck or shoulder area.

Roy says one of the biggest contributors to neck pain is poor posture during an activity. “Instead of pulling the chin down for a neutral posture, some people keep the chin forward and shoulders slouched. That makes the chin stick out and creates tension in the neck and surrounding muscles,” Roy explains.

The trapezius muscle takes the brunt of that stress. It’s a large diamond-shaped muscle that starts at the base of the skull, widens at the shoulders, and reaches halfway down the back.

“It’s a dull, achy pain,” Roy says. “Or you may get headaches from the muscles at the base of the skull. In the extended neck position, they tighten and get irritated.”

Avoiding neck pain

Here are some ways in which common activities lead to neck pain, and quick fixes to counteract bad form.

Cycling. Leaning over to reach the handlebars of a road or mountain bike can cause you to round your back and hunch your shoulders up to your ears.

Quick fix: Bring your shoulder blades down and back as you lean forward. “It’s a subtle motion while still leaning forward. Get your shoulders away from your ears, slightly arch your back, and stick out your chest,” Roy explains.

Gardening. Crouching and looking down, reaching very far and lifting heavy objects all stretch your neck in a way that strains neck muscles.

Quick fix: Pull your chin back as you look down; take frequent breaks; stay close to the area you are working in; use your leg muscles to help lift heavy objects.

Swimming. When doing the crawl, always turning your head to the same side to breathe builds muscles on one side of the neck and shortens muscles on the other side; doing the breaststroke may strain neck muscles.

Quick fix: Alternate swimming strokes (crawl, breaststroke) periodically; when doing the crawl, alternate the breathing side occasionally.

Golf. Extending the neck while you swing causes tension; carrying a golf bag on the same side all the time leads to uneven muscles and pain.

Quick fix: Bring your chin toward your neck as you look down at the ball so your neck is not extended; alternate shoulder sides when you carry a golf bag.

Yoga. Looking up when doing a “downward dog” position can extend the neck; turning your neck too far when looking behind you can stress the neck joints.

Quick fix: Keep your chin toward your neck for a neutral position; limit how far you turn your head.

Move of the month

Neck stretching: Side-bending range of motion

  • Face forward and let your head bend slowly to the side.
  • Hold three seconds and repeat on the other side.
  • Repeat 10 times.
  • Do this exercise slowly and gently.
  • For an additional stretch, when your head is bent to the side, let it roll slowly forward about 45 degrees and hold it there for three seconds.

Neck pain relief and prevention

Gentle stretches may help relieve your neck pain (see “Move of the month”). “Slowly tip the head to the side — ear to shoulder — then do the same on the other side. But don’t do this if it increases pain,” warns Roy.

Remember that using the proper form during physical activity prevents neck pain— so does strengthening the neck, shoulder, and core muscles.

For more ideas, you can check out the Harvard Special Health Report Neck Pain (

Image: © Goodluz/Getty Images

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

When does a headache need to be seen at the hospital?


As a neurosurgeon, I encounter a lot of people who are concerned with ruptured brain aneurysms (blood vessel blisters). Ruptured brain aneurysms typically present with severe headache. I am incessantly asked, “When is a headache more than just a headache? When should I go to the hospital?”

A headache is considered to be pain located anywhere in the region of the upper neck or head. It is one of the most common locations of pain in the human body and can have many difference causes. There are three major categories of headaches which include primary headaches, secondary headaches, and cranial neuralgias which can be associated with facial pain.

  • Primary headaches include tension, migraine, and cluster headaches.
  • Secondary headaches are those due to something affecting the underlying structure of the head and neck. Causes include bleeding in the brain, tumors, meningitis, and encephalitis.
  • The third type of headaches which involve neuralgias and facial pain are usually caused by inflammation of the nerves in the head and neck.

Tension headaches are the most common type of primary headache and are more common in women than men. Their cause is unknown but thought to be due to the contraction of the muscles covering the skull. Tension headaches usually occur because of physical or emotional stress placed on the body. Symptoms of a tension headache include pain which is described as “tightness” that begins in the back of the head and upper neck. It is usually mild in intensity, bilateral and not associated with vomiting or sensitivity to light. Usually, these headaches do not impair function.

Migraine headaches are the second most common type of primary headache and are also more common in women than men. They are associated with unilateral headache, nausea, vomiting, and sensitivity to light.

Cluster headaches are rare primary headaches and occur more commonly in men than women. The cause of cluster headaches is unknown. They tend to run in families, which suggest genetics may play a role. They may be triggered by changes in sleep pattern and by certain medications. Symptoms of a cluster headache include unilateral pain in the face and head that is sharp in quality and very short in duration. The pain is usually excruciating and the eyes and nose may become watery.

Secondary headaches include causes such as head and neck trauma, blood vessel problems in the head and neck (ruptured brain aneurysms fall into this category), non-blood vessel problems in the brain, medications, infection, and changes in the body’s normal environment, problems with the structures of the head, and psychiatric disorders.

Headaches are treated differently depending on the type, cause, and nature of the headache.

Tension headaches are usually treated successfully with medications such as aspirin, ibuprofen, acetaminophen and naproxen. If these fail, supportive treatments should be sought out such as massage, biofeedback, and stress management. If mild, migraine headaches are usually first treated with non-steroidal anti-inflammatory agents or NSAIDs. The drugs of choice for migraines are considered to be triptans such as Imitrex, Maxalt, Amerge, Zomig, Axert, Frova, Relpax, and Treximet. Some other medications used include ergots, anit-nausea medications, butalbital combinations, and opiates. Cluster headaches are usually treated with inhalation of high concentration of oxygen, injection of triptan medications, injection of lidocaine, ergotamines, and caffeine. Preventative medications include calcium channel blockers, prednisone, lithium, and valproic acid.

When should a headache be treated?

A patient should seek medical care it for a headache when it is considered the “worst headache of his/her life,” different than a usual headache, starts suddenly or is aggravated by physical exertion. Medical care should also be sought if the headache is associated with nausea and vomiting, fever, stiff neck, seizures, trauma, changes in vision, changes in speech, changes in behavior, weakness, is getting worse, and/or is disabling.

Why should a headache be treated?

A headache should be treated because it may be caused by something serious or be associated with a worsening condition and if left untreated may even lead to death. Headaches should also be treated so that it does not become disabling and impair normal function. Overtreatment should be avoided due to the fact that some medications, once stopped, may cause rebound headaches. So, to answer my simple original question, “When is a headache more than just a headache?” with a simple answer; any headache that presents with neurological deficits and is different than a usual type of headache that you suffer, requires medical attention.

Chaim Colen is a neurosurgeon. He can be reached on Twitter @MyNeurosurgeon.

Image credit: .com


A stiff neck may last a few days or even weeks but it usually heals quickly because of the durability of the cervical spine. Sometimes, something as simple as sleeping wrong can cause a stiff neck and occasionally a stiff neck can have more serious implications.

These are the usual culprits that can lead to a stiff neck:

Muscle Strain or Sprain

The levator scapula muscle running the length of the back and side of the neck connects the cervical spine to the shoulder and is controlled by the third and forth cervical nerves. A muscle sprain or strain particularly to this area can lead to a stiff neck. You can strain this muscle while doing many everyday activities, such as:

  • Sleeping without proper support from a pillow and in a poor posture can stretch this muscle unnecessarily.
  • Any repetitive activity that involves turning the head from side to side, as in swimming, can result in stiff neck.
  • Poor posture that tilts the head, like when cradling the phone between the neck and shoulder, or viewing the computer monitor for long hours which contracts the neck muscle.
  • Stress that causes tension knots in the neck.

Cervical Spine Disorders

The cervical spine consists of the spinal cord, vertebrae, and discs of the upper part of your neck. When any part of the cervical spine becomes misaligned, it will cause pain and stiffness to the neck. The stiffness in the neck can be an indicator of an underlying disorder such as:

Facet joint disorders- occur when the facet joints at the back of the spinal structure that help with movement wear out because of osteoarthritis.

Herniated Disc- is a serious condition that can cause terrible irritation and pain to the nerve roots in the disc of your neck and pain along your arms too.

Cervical osteoarthritis- can cause muscle spasm and neck stiffness from blocked nerve pathways in the cervical spine.

Meningitis / Infection

Bacterial infection in the fluid membrane of the brain and spinal cord causes inflammation and stiffening of the neck along with a high fever, headache and nausea. Seek immediate medical attention if you notice any such symptoms as it is an indication of meningitis. Other rare but serious infections can also cause stiff neck symptoms, such as meningococcal disease or vertebral osteomyelitis, that occur in the cervical spine and vertebral body. When you have a stiff neck, fever, feel nauseous and are sensitive to light then it can also be a sign of a common viral infection, like the flu.


Neck injuries from an accident, sports mishap or falls where your head has being jerked around violently may result in muscle injuries, sprains, and perhaps even strains on the ligaments in your neck. The main symptom of these injuries is neck stiffness and pain.


Osteoarthritis is daily wear and tear of your neck joints with age, which often lead to stiffness and limiting neck movement. While RA is an autoimmune disorder that can affect your neck joints along the upper part of your neck resulting in severe neck pain and stiffness. Sometimes arthritis also leads to your spinal canal narrowing down which results in a pinched nerve causing radiating pain down your arms, legs and neck stiffness.

Stiff Neck Treatments

If the stiff neck symptoms persist for more than a week then you may need medical attention and especially if there are also other symptoms mentioned above. Your physician may order an X-ray or computed tomography (CT) scan along with a physical examination to diagnose the cause of your stiff neck. Your treatment will depend on what is causing it but generally in case of the more common strained neck muscles, initial treatment will include:

  • Non-steroidal anti-inflammatory drugs or NSAIDs to relieve pain
  • Ice on the stiff neck for the first 48 to 72 hours to reduce inflammation, then switch to using a heat wrap or heat pad or even consider taking a hot shower to soothe your muscles
  • To rest your neck muscles, you may have to wear a cervical collar.
  • Limit physical activities that can strain your neck
  • Seek help from physical therapist.
  • Get a neck and shoulder massage.
  • Practice simple neck stretching exercises like slowly moving your head up and down and side to side.
  • Sleep on a firm mattress with a neck pillow for proper support.
  • If your stiff neck gets worse let your doctor know because you may need more specialized care to relieve your symptoms.

The Illinois Bone & Joint Institute has more than 90 orthopedic physicians, and 20 locations throughout Chicago. We’re here to help you move better so you can live better.

Causes of meningitis

Meningitis is caused by a bacteria or virus getting into the spinal fluid of the brain and spinal cord, usually through the bloodstream. The bacteria or virus then infects the meninges, a delicate membrane around the brain and spinal cord.

Meningitis might happen during or after a viral infection like a cold. In other cases, your child might be well and get meningitis.

Children under two months have the highest risk of developing bacterial meningitis. Children are less likely to get bacterial meningitis as they get older.

Meningitis is a medical emergency and needs immediate treatment. If you think your child might have meningitis, take him straight to the nearest hospital emergency department.

Meningitis symptoms

Older children might complain of feeling generally unwell. They might have nausea, fever and tiredness. They might avoid eating.

Later symptoms include headache, a sore and stiff neck, vomiting and seizures. Children might not be able to look at bright light.

There might also be a rash that doesn’t disappear if you press a glass on it. This rash happens with meningitis caused by the bacteria meningococcus. This condition is known as meningococcal meningitis.

In younger children and babies, meningitis is very hard to diagnose on symptoms alone. This is because younger children can’t tell you that they have a headache or a sore neck. They might be off their food, irritable, low on energy and drowsy. They might also have a fever, vomiting or a bulging fontanelle (the soft spot on top of a baby’s skull).

If your very young child is unwell for no obvious reason, doctors will check for meningitis.

When to see a doctor about meningitis symptoms

You should see your GP if your child:

  • has an unexplained fever and is generally unwell
  • complains of a persistent headache or sore neck
  • says bright light hurts her eyes.

If you think your child has meningitis, he must see a doctor as soon as possible. If you’re in any doubt, take your child to the emergency department at your nearest hospital.

Tests for meningitis

If the doctors at the hospital think there’s a possibility of meningitis, they’ll do blood tests and a lumbar puncture on your child to confirm the diagnosis and work out which bacteria or virus has caused the infection.

If your child is very unwell, the doctors will start antibiotic treatment for meningitis directly into a vein through a drip before they do the lumbar puncture.

Treatment for meningitis

If your child has bacterial meningitis, at first she’ll need to stay in hospital for treatment with antibiotics given directly into one of her veins. After this, she’ll take the antibiotics by mouth. Treatment can last up to 21 days.

Children with bacterial meningitis usually make a complete recovery if it’s diagnosed early and treatment starts straight away.

If diagnosis and treatment are delayed, there’s a greater chance of permanent problems like hearing impairment, intellectual disability, epilepsy and movement disorders.

There’s no specific treatment if your doctor diagnoses viral meningitis, but treating the symptoms is very important. This means you’ll need to get your child to drink lots of fluids and take paracetamol to keep him comfortable and help keep his fever under control.

Most children with viral meningitis recover completely.

Prevention of meningitis

Immunisation protects your child from some of the bacteria that cause meningitis, including Haemophilus influenzae, pneumococcus and meningococcus.

Depending on the bacteria causing the meningitis, family and others in close contact with your child might need to take antibiotics to stop the disease from spreading.

3 Reasons You May Have a Stiff Neck

When you have a stiff neck, the soreness and restricted range of motion can make routine activities difficult. Symptoms typically last from just a day or two to a couple of weeks, and may be accompanied by a headache, shoulder pain, and/or pain that radiates down your arm. Occasionally when the underlying cause is more serious, the symptoms can last for weeks, months or years. Here are some potential causes of stiff neck, and when it may be something more serious.

See When Is a Stiff Neck Serious?


A stiff neck is commonly caused by a neck muscle strain or soft tissue sprain.
Watch: Neck Strains and Sprains Video


1. Muscle strain

Any activity that places your neck in an awkward position for an extended amount of time could cause neck muscles to become fatigued and spasm. For example, holding your phone against your shoulder while you talk, sleeping with your neck at an awkward angle, carrying a heavy bag on one shoulder, or having to look too far downward or upward to view your computer screen or a TV can all cause neck stiffness.

See Stiff Neck Remedies Based on Cause

Another cause of neck strain is known as text neck, which is neck pain and stiffness caused by spending more and more time looking down at smartphones and tablets.

See How Does Text Neck Cause Pain?

2. Cervical spine disorders

The cervical spine encompasses all of the discs, bones, joints, muscles, and nerves in your neck. Your spinal cord also runs through the center of the vertebrae (bones) in your cervical spine.

Watch: Cervical Spine Anatomy Video

Any one or combination of these parts of your cervical spine may become worn down over time or injured, causing neck stiffness, pain, and/or possible neurological problems. Some cervical spine disorders that commonly occur include:

  • Cervical osteoarthritis. Over time, the facet joints in the back of your spine can become arthritic and painful. The facet arthritis, also known as spondylosis, can also encroach on your spinal nerve roots and possibly into the spinal cord area. This may develop in conjunction with various types of spinal degeneration, such as degenerative disc disease, so you may hear your doctor refer to both conditions. Symptoms may include neck pain and stiffness as well as referral pain patterns which refer to pain and stiffness in the shoulder and scapular area. If the spinal nerve roots are involved symptoms may include arm pain and/or tingling, numbness, and possibly difficulty walking if the spinal cord is involved.

    See Facet Joint Disorders and Back Pain

  • Cervical disc problems. Spinal discs are soft tissue structures that provide cushioning between each vertebra of your spine. Over time, one or more discs in your neck may herniate or degenerate. Like cervical facet arthritis, cervical degenerative disc disease (DDD) may also cause cervical pain and stiffness and is more likely in turn to irritate nerve roots, causing pain and/or tingling, numbness, and possibly difficulty walking if the spinal cord is involved.

    See All About Spinal Disc Problems


Cervical spine disorders must be diagnosed and treated by a qualified health professional. Even if you feel your symptoms are mild, it is a good idea to seek treatment. The right exercise program can go a long way in alleviating neck pain and stiffness or preventing it from getting worse.

See Treatment for a Stiff Neck


A cervical herniated disc, cervical degenerative disc disease, cervical osteoarthritis and cervical spinal stenosis may each cause symptoms of neck stiffness, pain, and/or possible neurological problems.

3. Infection

A stiff neck caused by an infection is rare compared to the other causes above, but it is a serious medical condition. For example, meningitis can cause a stiff neck by infecting and inflaming the meninges, which are the protective membranes surrounding the spinal cord and brain. If you experience fever, headache, nausea, vomiting, or other signs of an infection along with your stiff neck, seek medical attention immediately.

See Osteomyelitis, a Spinal Infection

Learn more:

Neck Strain: Causes and Remedies

How Does Text Neck Cause Pain?

How to Prevent and Treat a Stiff Neck: Remedies and Exercises

If you have a painful, stiff neck, you can try several remedies to reduce the pain and lessen the stiffness. Many of these remedies can also be used for prevention.

Apply heat or ice

Apply ice for 20 minutes a few times a day to help relieve neck inflammation. You can also alternate between applying ice and heat. Taking a warm bath or shower or using a heating pad may also help.

Take OTC pain relievers

Over-the-counter pain relievers like the following can help reduce the pain:

  • ibuprofen (Motrin, Advil)
  • naproxen sodium (Aleve)
  • acetaminophen (Tylenol)

Stretch but avoid sudden movements

Stretching can help relieve the pain and stiffness, and prevent it in the future. It’s important to stretch gently and slowly. Sudden movements can cause more inflammation, pain, and a more serious injury. Apply a heating pad or take a warm shower before stretching.

Stretches include:

  • Roll your shoulders backward and then forward in a circle.
  • Press your shoulder blades together and hold the position for a few seconds, then repeat.
  • Slowly turn your head from side to side.

Get a massage

Massage by a trained practitioner can help to loosen and stretch your neck and back muscles.

Try acupuncture

Acupuncture involves inserting needles into specific pressure points on your body. While more scientific research is needed to identify proven benefits, acupuncture has been practiced for thousands of years in Eastern medicine. Visit only a certified practitioner with sterile needles.

Consider chiropractic care

A licensed chiropractor can manipulate muscles and joints to provide pain relief. This type of therapy can be uncomfortable or painful to some. You can discuss your comfort with a doctor.

Limit physical activity

If your neck stiffness and pain started after performing physical activity, you should limit that activity until the stiffness resolves. However, you should limit heavy lifting and activities that may aggravate your neck muscles any time you have neck pain.

Reduce stress

Stress can cause you to tense the muscles in your neck. Reducing stress can help treat and prevent neck pain and stiffness. You may choose to reduce stress in a variety of ways, including:

  • listening to music
  • meditation
  • taking a vacation or break, even if it’s just for a few hours away from the office or a stressful environment
  • doing something you enjoy

Exercise regularly

Exercise can help strengthen your muscles to prevent injuries. Exercise can also help you to improve your posture to relieve and prevent neck stiffness. It’s also a great way to relieve stress that may be causing your stiff neck.

Adjust your sleep environment

Adjusting your sleep environment can help relieve a stiff neck. Ways to change your sleep environment include:

  • getting a firmer mattress
  • using a neck pillow
  • sleeping only on your back or side
  • relaxing before going to sleep
  • wearing a mouth guard if you’re grinding your teeth at night

What causes neck pain and stiffness?

Seven bones called vertebrae are connected by spongy shock-absorbing ‘discs’, with a network of muscles and tough connective tissue supporting them. The spinal cord runs through a canal protected on all sides by bone. Damage or strain to any one of these can cause pain.

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What are the symptoms of neck pain?

Pain – obviously! This often starts in the neck and spreads to one or both shoulders (sometimes further down the arm), or up to the back of your head. Your neck and shoulders may feel stiff. Pins and needles are common and usually not a worrying sign, but these need to be checked out as they suggest a nerve emerging from your spine may be caught or irritated. The pain usually improves after a few days and goes within weeks.

Do I need tests?

As long as you don’t have any of the ‘red flags’ below you’re unlikely to need tests and may not even need to see a doctor. X-rays and scans aren’t recommended except in special circumstances as they don’t change treatment options.

Red flags – when should you worry?

Most neck pain doesn’t mean there’s a serious problem to worry about. However, you should always get your symptoms checked out if:

  • It’s connected with numbness, weakness or persistent pins and needles in your arm.
  • You’ve had any trauma such as a whiplash injury.
  • You feel generally unwell, especially with weight loss or fever.
  • The pain keeps getting worse rather than better.
  • The neck bones (rather than muscles on either side) are very tender.
  • You also develop weakness in your legs or problems with passing urine.
  • You have other medical problems such as a history of a recent accident, cancer or rheumatoid arthritis.

Treating neck pain

Keep moving

When you first get neck pain, it may be very painful to move and you’ll need to rest in a neutral postion for a couple of days. After that, as long as you don’t have the ‘red flags’ above, it’s important to keep moving your neck to stop it stiffening up (which is why neck collars or braces aren’t recommended unless your doctor says so). Turn your head gently in all directions every few hours, trying to increase the range of motion gradually. Avoid prolonged sitting but keep up your normal activities as much as possible.

Medication and self-care

Painkillers like paracetamol or anti-inflammatory painkillers like ibuprofen (which also comes in a gel from your pharmacist) will help, and your doctor may recommend a short course of muscle relaxants if there’s a lot of muscle spasm. A heat pad or pack over aching muscles may also help.

Wry neck – not a cause for a wry smile

The medical term for this is ‘torticollis’, when the neck gets stuck with your head twisted to one side. It may be due to strain of the muscles or ligaments of the neck, making the muscles go into spasm. Sleeping in a draught or an uncomfortable position may bring it on. It’s often very painful in the muscles on one side but usually settles within a few days. In the meantime, painkillers will help.

Avoiding neck pain – dos and don’ts

You can’t always avoid neck pain, but simple day-to-day precautions can reduce your risk of suffering.


  • Turn your chair to face your computer directly and adjust your chair so the screen is at eye level.
  • Stretch regularly if you’re working at a desk or driving long distances.
  • Keep your head back over your spine rather than hunched forwards.
  • Consider Pilates, yoga or the Alexander technique (many councils have lists of local classes for all ages and abilities!).


  • Sleep on your stomach. If possible, sleep on your back.
  • Use a very firm or high pillow – it should support the natural curve of your neck.
  • Tuck your phone under your chin by hunching your shoulders up.

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