Stiff neck

Almost every adult over 30 has had one in their life stiff neck and the related tension pains. The cause for this is usually an incorrect posture combined with insufficient movement and in most cases can be remedied by the patient himself. However, in the event of severe, long-lasting pain, nausea or high fever, the advice of a doctor should be sought.

What is a stiff neck?

Doctors speak of a stiff neck when painful blockages in the lower, back of the neck impair the head's freedom of movement. Turning or tilting the head is associated with mild to severe pain, which can also continue over the shoulder blades and into the upper arms.

In contrast to a stiff neck, the diagnosis of a stiff neck is made when the lateral neck muscles are not affected by the blockages and can be contracted normally or painlessly.

causes

The main cause of a stiff neck is tension in the muscles (muscle tension), which, when sitting or lying down incorrectly, leads to so-called muscular imbalances (incorrect loads). Anyone who spends too much time in an unhealthy position in front of the computer screen or at a work surface that is too low, taking too few breaks in between and also not doing any relaxation exercises, will sooner or later be plagued by complaints in the neck.

The muscles that are unilaterally stressed over a long period of time harden and tense because they are no longer sufficiently loosened. Stress or psychological problems can also be the cause of a stiff neck when you literally “carry a heavy load on your shoulders”. In sensitive people, cold or drafts can also trigger the neck stiffness, which however then disappears by itself after one or two days.

In the case of poorly trained or not warmed up neck muscles that are suddenly used, muscle strains can also occur, which cause pain similar to tension. In rare cases, serious diseases such as osteoarthritis of the spine or meningitis can lead to a stiff neck.

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Diseases with this symptom

• migraine
• Whiplash
• Meningism

• Meningitis
• disc prolapse
• Scoliosis

• arthrosis
• Spondylosis
• Muscle hardening

Diagnosis & course

The first symptoms of a stiff neck are pain in the neck and upper back, and a blockage in the lower neck area, which can make turning and tilting the head almost impossible. This can be accompanied by headaches and pain when moving the shoulders and arms.

The reasons for the stiff neck can usually be clarified in the questioning by the doctor. When the patient describes his professional and private everyday life, in most cases the risks for tense neck muscles become apparent and the triggers can be clearly narrowed down. The possible reasons for the stiff neck can be verified by palpating and listening to the neck and upper back. X-rays, ultrasound, CT or MRI are used to rule out osteoarthritis or a herniated disc in the cervical spine or to confirm the suspicion.

The diagnosis of meningitis can also be considered based on initial indications from imaging procedures. This is confirmed by certain movement tests and using blood counts or examinations of the spinal fluid.

Complications

A stiff neck can have several causes. The causes each have different complications. A typical stiff neck occurs when the meninges are inflamed (meningitis). Due to the anatomical proximity, the inflammation can spread to the brain (encephalitis), leading to headaches, sensitivity to light and clouding of consciousness, but also to paralysis and epileptic seizures.

In addition to the brain, the inflammation can also spread to the spinal cord (myelitis) and accordingly lead to paralysis and sensitivity disorders. The inflammation can cause pus to build up in the brain, leading to an abscess. In addition, due to meningitis, there may be a disruption of the CSF circulation, so that there is an increase in intracranial pressure.

In the worst cases, this can lead to vital centers being trapped in the elongated marrow, leading to respiratory arrest and thus death. There is also an increased risk that blood clots will form in the veins of the brain and thus lead to symptoms of failure similar to encephalitis.

In the worst cases, the pathogen can release toxins into the blood or spread itself through the blood, causing sepsis. This is a life-threatening condition that can turn into shock. As a result, vital organs are no longer adequately supplied with blood and it is not uncommon for the patient to die.

When should you go to the doctor?

A stiff neck is usually harmless and can be treated yourself with protection, warmth and light massages. If these measures have no effect or if pain or other accompanying symptoms occur, the complaints should be clarified by a doctor or chiropractor. This also applies if the stiffening persists for several weeks and has a negative effect on general well-being and functionality in everyday life. A doctor's visit is particularly urgent if the stiff neck is accompanied by numbness or movement disorders.

Then there may be a serious nerve disease that needs to be treated immediately. Concomitant symptoms such as fever and night sweats indicate an infection or a tumor in the neck area. If there are also headaches and dizziness, the doctor must rule out serious causes such as meningitis or cerebral haemorrhage. A stiff neck after an accident or fall must always be treated medically. If you suspect drafts or tension as the cause, you should also consult a specialist to avoid aggravating the symptoms. In the event of lumbago, it is advisable to go to the emergency room.

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Treatment & Therapy

Even if the body reacts with as little movement as possible in order to avoid pain when the neck is stiff, resting and standing still is exactly the wrong approach. The most effective immediate measures against a stiff neck are warmth and exercise. When the muscle warms up, it relaxes and the pain subsides.

If the stiff neck is chronic and therefore neither targeted stretching and loosening exercises nor repeated heat treatments have any effect, medical massages and physiotherapy are used. To relieve acute pain, pain relievers are administered or local anesthetics are injected directly into the tense muscles. Aside from conventional medical measures, naturopathic therapies can also be used to treat a stiff neck. Particularly with acupuncture from traditional Chinese medicine or progressive muscle relaxation, considerable success can be achieved in relieving tension.

The latter method is mainly used when psychological problems are also a possible cause of the painful neck. However, if the cause of the stiff neck is not muscle tension, but rather a herniated disc or osteoarthritis of the cervical spine, surgery is usually the only possible successful treatment option. In rare cases, a stiff neck is a sign of meningitis or blood poisoning, which must be treated with antibiotics.

Outlook & forecast

A stiff neck is extremely uncomfortable because it hurts extremely and makes you immobile. Most of the sick feel the impulse to move as little as possible. However, this is not advisable. It is almost always muscle tension that causes a stiff neck. Exercise and warmth are ideal for relieving acute pain and loosening tense muscles.

The tension results from degenerative changes in the intervertebral discs of the cervical spine, which result in shortened muscles. Therefore, long periods of sitting at the computer are “poison” for the neck and shoulder muscles. If the affected person is exposed to drafts, severe pain occurs in the neck and shoulder area. Uncomfortable lying down can also cause tension, for example from incorrect pillows or mattresses. Muscle strains from "cold" muscles, on the other hand, rarely occur.

Acute pain is treated with warmth, movement protects against future diseases, because it strengthens bones and tendons and makes muscles more flexible. Exercise also reduces pain. Twenty minutes of swimming, walking or cycling is enough for prevention.

If the neck does not move even after three days, an orthopedic surgeon must rule out other causes. If the symptoms are the result of an accident, immediate medical help is necessary.

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prevention

The therapy form "movement" can also be used as prophylaxis for a stiff neck. With regular exercise, ideally light endurance training with targeted relaxation and stretching exercises, the muscles are not given a chance to cramp from the start and the pain does not become so severe or it does not occur at all. If stress is the cause of unbearable pain in the neck, learning relaxation techniques, such as meditation or autogenic training, can help prevent it.

You can do that yourself

When self-treating a stiff neck, a distinction should be made between the cause: the tension is caused by physical or emotional overload. Usually, the symptoms hide overexcited nerves and tense muscles. Taking a pain reliever in low doses brings immediate relief from the symptoms. It is also recommended to take active anti-inflammatory drugs.

The trace element selenium is recommended for consumption in alternative medicine. It lowers inflammatory processes in the body. Alternatively, heat applications are very beneficial in self-treatment. Red light lamps or ointments also bring relief. Physical treatment is also possible. Simple massage movements can be done by yourself. In most cases, incorporating a nap in the stressful everyday life also provides significant relief. It should be remembered that behind the stiff neck and the associated tension, it is precisely this lack of rest phases that is hidden.

Depressive moods and pain rotate in a cycle. The body and soul can be strengthened through long walks, listening to music, and breathing exercises. Registering for a yoga or tai chi class creates space for a break and strengthens the entire body. The workplace should also be checked, drafts and moisture are to be avoided, a seat that is suitable for the spine is beneficial. Physiotherapists can analyze bad posture and offer sitting training.