Stiff neck (meningism)

The Stiff neck, also Meningism called, refers to a painful restriction or inability to move in the cervical spine. This is caused by reflex tension to protect important structures of the spinal cord and brain. If the neck stiffness occurs, a medical examination is essential, as the neck stiffness is a symptom (sign of illness).

What is a stiff neck?

Stiff neck This means that the person affected has considerable pain when moving the head. The mobility of the cervical spine is severely restricted or no longer possible. The patient is unable to move their chin towards their chest.

This is the main criterion for meningism. The medical term meningism was derived from meninges. Meninges are the membranes of the brain. However, a stiff neck is to be distinguished from pure neck pain or shoulder pain. However, tension usually occurs in connection with meningism.

causes

Various causes come with Meningism in question. Diseases of the meninges, bleeding in the brain, a sunstroke or a flu-like infection can be the cause of the stiff neck.

An infection from a tick bite can also cause neck stiffness. Bleeding in the brain, which is also the first symptom of a stiff neck, is particularly dangerous. Suppurated sinus infections or ulcerated tonsillitis can also be associated with stiff neck.

Illnesses or injuries to the cervical spine are also often coupled with a painful stiff neck. A migraine attack can also be the cause of the stiff neck.

Symptoms, ailments & signs

In the case of meningism, symptoms in the neck area first appear. Those affected complain of a stiff neck, accompanied by very severe pain, when trying to move their head towards the chest. For this reason, the sick people adopt a gentle posture, which in turn leads to painful tension in the neck muscles.

In addition, characteristic accompanying symptoms occur, but these do not necessarily have to occur in every patient. These side effects are called "meningonal syndrome". The most common symptoms are sudden nausea and even vomiting. Furthermore, extremely strong, cramp-like headaches can be observed in many sick people.

If the meningism has occurred due to an infection, for example with meningococci, it is not uncommon for a high fever to occur, which increases steadily. Symptoms such as photophobia or phonophobia are less common. With photophobia, those affected perceive any light sources as uncomfortable and painful. In some people, sensitivity to light can cause nausea and vomiting. If you see any of these signs, you should see a doctor right away as it is a serious condition.

Diagnosis & course

The diagnosis when the Stiff neck must be asked by a doctor. For the doctor, further diagnostic criteria are the occurrence of fever, visual disturbances and sensitivity to light. The doctor receives important information when interviewing the patient and during the first physical examination.

Certain tests enable the doctor to determine which meninges are diseased or irritated. Furthermore, blood tests and x-rays give the doctor initial clues as to the cause of the disease. Especially in combination with a high fever, a CSF puncture (lumbar puncture) is an important measure for doctors to be able to make a diagnosis.

Depending on the cause of the stiff neck, there is a different course. Meningism, which is caused by inflammation of the meninges or bleeding, can develop into a life-threatening disease and requires intensive medical care until the patient is stabilized.

The course can be very dramatic, as in addition to neck stiffness, significant headaches, visual disturbances, nausea, dizziness, light sensitivity and impaired consciousness can occur. These can lead to unconsciousness.

It is typical of meningism that the reflex tension is released in the coma. If the cause of the stiff neck is damage to the cervical spine, headaches, sometimes visual disturbances, as well as abnormal sensations and loss of strength in the arms are possible.

Complications

Apart from the typical pain relieving measures, which are effective almost on the entire body, there is no way for those affected to treat the stiff neck or make it more bearable. A medical research into the cause is necessary and the meningism and its cause are treated accordingly.

The stiff neck should not be attempted to be overcome by force. If a cerebral hemorrhage is the cause, further severe damage can result from further hemorrhage. Even a bacterial cause that triggers meningism can only be made worse by "straightening" the head, as purulent tissue is further distributed or cysts can tear open.

Since a stiff neck occurs for different reasons, an amateur treatment with home remedies is not advisable. Infections of the meninges - which mostly indicate diseases that require treatment - or cerebral hemorrhages are not infrequently the reason for the stiffening. Damage to the spine can also be the cause.

The list of accompanying symptoms that occur depending on the cause is long. Affected people can only take action in the case of neck tension, which occurs during the course of a flu-like infection, through heat, cold or massages. If in doubt, however, medical advice is always preferable.

When should you go to the doctor?

If the neck is stiff, it is not necessary to consult a doctor in all cases. Often the stiff neck occurs due to incorrect posture, one-sided stress and a lack of exercise. With light balancing movements and a supply of heat to the affected area, a significant alleviation of the symptoms or freedom from symptoms can be achieved without medical care. If you carry out independent sporting activities that do not cause overexertion and in which the muscles in the neck are gently loosened, an improvement in the state of health is often achieved. Often a self-initiated massage can bring about mobility of the shoulders, neck and neck.

If, despite all efforts, the symptoms continue unabated or if they increase in intensity, a doctor should be consulted. If the person concerned has a headache, deformed skeleton, persistently relieving posture or persistently crooked posture, a doctor should be consulted.

Consult a doctor if you experience discomfort while chewing, shortness of breath or changes in the complexion. Medical help should be sought as soon as the symptoms spread or the daily requirements can no longer be met due to the impairments. Repeated nausea and vomiting are further signs that need to be clarified by a doctor.

Treatment & Therapy

Treatment of the Meningism depends on the cause. Meningism, the cause of which is an inflammatory disease of the meninges, is treated with antibiotics and often with antiviral drugs. Intensive medical care is often required here, as there are significant complications during this illness, e.g. Epilepsy can occur.

If the stiff neck is caused by bleeding in the brain, it is imperative to clarify where exactly the bleeding is in the brain. The neurosurgeons must act very quickly here, as the bleeding can lead to damage to the brain that is no longer reversible. Furthermore, bleeding in the brain can quickly lead to breathing problems and death of the patient.

Especially with bacterial infections, such as purulent angina, the symptoms improve quickly with the administration of antibiotics, and the stiff neck disappears.

Neck stiffness caused by diseases of the cervical spine requires clarification as to which structures of the cervical spine are damaged. Depending on the results of this examination, targeted therapy in the form of medication and physiotherapy is then carried out. In the case of severe herniated discs, which can also be accompanied by a stiff neck, an operation is often necessary.

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Outlook & forecast

Meningism is caused by a potentially life threatening medical condition. The prognosis therefore depends primarily on what is causing the disease and how quickly the affected person is treated properly. Antibiotics must be used quickly, especially if the disease is of bacterial origin. Otherwise, if left untreated, it almost always ends fatally. With timely treatment, however, there is a good chance that patients will recover completely.

How high the chances of a full recovery are, however, depends on the type of pathogen and the general health of the person affected. Accordingly, the prognosis is sometimes less favorable for the elderly and for infants. Their immune system is usually not as efficient as in healthy adults. An illness caused by viruses is much less life-threatening.

Nevertheless, the prognosis also depends on the virus and the general physical condition. The first few days in particular are critical. If the sick person has survived this well, the chance of recovery is usually good. The disease then usually heals within several weeks without any consequential damage.

In rare cases, the condition can cause persistent neurological damage. These can be symptoms of paralysis, hearing damage or impairment of psyche or behavior. Complications and long-term damage usually occur when the disease also spreads to the brain.

prevention

A direct prevention of the Meningism can not. Certain vaccinations can reduce the risk of getting sick after a tick bite or of meningitis.

Damage to the cervical spine can be avoided through varied activities, gymnastics and lots of exercise. In order to prevent the vascular changes in the brain, which under certain circumstances can lead to life-threatening bleeding in the brain, it is important that high-fat foods, nicotine and obesity are avoided. It is also important to ensure that the blood pressure is not increased.

Regular preventive examinations make it very seldom possible to detect changes in the vessels, so that in individual cases meningism can be avoided through early treatment.

Aftercare

The extent to which follow-up care is necessary depends on the outcome of the initial therapy. As a rule, there are no consequential damages left if treatment is started in good time. Therefore, there is no reason for close follow-up examinations as we know from cancer treatments. A relapse cannot develop from the underlying disease. Few measures are suitable to prevent the stiff neck from recurring.

As part of the follow-up care, a doctor can reduce the risk of getting the disease again with certain vaccinations. Other forms of prevention, however, are the responsibility of the patient. A healthy lifestyle with plenty of exercise, a balanced diet and no addictive substance consumption is considered the best type of preventive aftercare.

Follow-up care pursues other goals if consequential damage remains from the initial treatment. Then it's about supporting everyday life and minimizing disadvantages. There should also be no new complications. The scope and type of aftercare depends on the individual complaints.

Aids can be prescribed for hearing impairments. Behavioral problems can be treated as part of psychotherapy. Neurological damage and paralysis can even lead to a lifelong need for help. Most of the patients with permanent impairments are also treated with medication.

You can do that yourself

If you have a stiff neck, your own behavior can help alleviate the symptoms and avoid dangers. It should also be noted that a natural straightening of the head can be dangerous due to the disease and must therefore be avoided. This also applies to intensive sporting activities, especially gymnastic exercises.

A rather restrained reaction to painful neck tension with warmth or cold as well as a light massage is helpful. A workplace design based on ergonomic aspects is also advantageous. The right choice of chair and table should be in the foreground when doing office work. Regular breaks with a little movement serve to avoid aggravating existing complaints by prolonged, unchanged sitting postures. When driving a car it should be noted that a sudden impact of the head and neck on the attached neck rest could be painful and dangerous. A properly adjusted, well-padded neck support is therefore recommended.

Unnecessary stress on the neck and spine area in everyday life should be avoided. This also includes incorrect posture, stress and drafts. With the selection of the right mattress and pillow, a sleep-free night can be promoted. If the stiff neck is accompanied by chronic pain, a patient attitude is required. Relaxation techniques can help you cope better with the illness.