A stiff neck is typically characterized by soreness and difficulty moving the neck, especially when trying to turn the head to the side. It may also be accompanied by a headache, neck pain, shoulder pain and/or arm pain. In order to look sideways or over the shoulder, an individual may need to turn the entire body instead of the stiff neck.
Most people are familiar with the pain and inconvenience of a stiff neck, whether it appeared upon waking up one morning or perhaps developed later in the day after some strenuous activity, such as moving furniture. In most cases, pain and stiffness go away naturally within a week. However, how an individual manages and cares for the stiff neck symptoms can affect pain levels, recovery time, and the likelihood of whether it will return. By far the most common cause of a stiff neck is a muscle strain or soft tissue sprain. In particular, the levator scapulae muscle is susceptible to injury. Located at the back and side of the neck, the levator scapulae muscle connects the neck’s cervical spine with the shoulder.
The levator scapulae muscle may be strained throughout the course of many common, everyday activities, such as:
Sleeping with the neck at an awkward position
Falling or sudden impact that pushes the head to the side, such as sports injuries
Turning the head side to side repeatedly during an activity, such as swimming the front crawl stroke
Slouching with poor posture while viewing the computer monitor or looking downward at a mobile phone for prolonged periods (sometimes referred to as “text neck”)
Experiencing excessive stress or anxiety, which can lead to tension in the neck
Holding the neck in an abnormal position for a long period, such as cradling a phone between the neck and shoulder
The cause of the stiff neck may be obvious if symptoms start right away, such as after falling during a sporting event. If a stiff neck seems to develop out of nowhere, however, it could be difficult to pinpoint the exact cause.
Sometimes neck stiffness is a reaction to an underlying disorder of the cervical spine, which helps support and move the neck in addition to protecting the spinal cord. Several examples of cervical spine disorders that can cause neck muscles to painfully spasm or tighten include:
Cervical herniated disc. The protective outer portion of a disc in the cervical spine breaks down, and the inner portion leaks out, causing compression and inflammation in nearby tissues.
Cervical degenerative disc disease. As discs lose hydration and height over time, pressure increases on nearby joints, nerves, and soft tissues, such as ligaments and muscles. This process can result in neck pain and stiffness.
Cervical osteoarthritis. Arthritic breakdown of the cervical facet joints between vertebral bones often occurs along with other degenerative conditions, such as spinal stenosis, and anatomical changes, such as bone spurs.
There are many different types of headaches, though the most common are migraine, cluster, and tension:
Tension headache:
A tension headache is a slow-building headache. Pain in the neck may often accompany a tension headache. Fatigue, stress, and muscle strain are often underlying causes of tension headaches. Tension headaches often cause a throbbing pain that affects both sides of the head. The pain may affect the back of the head and feel dull.
Migraine:
A headache of varying intensity, often accompanied by nausea and sensitivity to light and sound. The American Migraine Association notes that there are connections between neck pain and migraines. A migraine is the result of a neurological condition that affects the brain.
According to the American Migraine Foundation, when people experience a headache with neck pain, they are likely experiencing a cervicogenic headache. A cervicogenic headache is a pain that results from conditions that affect the neck or cervical spine and its supporting bone and tissue.
In addition to head pain, a person may experience symptoms such as:
a limited range of motion of their neck
a headache that worsens as a result of specific movements
increased headache pain due to pressure on the neck
pain that typically occurs on one side of the head
pain that starts in the back of the head or neck and travels to behind the eyes
Many people do not need to see their doctor for a headache. Often, taking OTC medications, such as ibuprofen or acetaminophen or applying hot packs to the neck is enough to stop the headache.
According to the National Headache Foundation, a person should see their healthcare provider if:
the headache does not go away or gets worse
OTC medications do not stop the pain
the characteristics of regular migraines or headaches change
they need pain relievers for headaches more than twice per week
the headache interferes with daily activities
sexual activity, coughing, sneezing, exercise or bending over trigger the headache
they develop nausea or dizziness
A person should seek emergency medical treatment if they experience the following symptoms with the headache:
headache or migraine is the worst it has ever been
loss of consciousness
vomiting that will not stop
loss of vision
pain lasting more than 72 hours
presence of unusual symptoms
an intense “thunderclap” sensation in their head
weakness or numbness of the face or arms
slurred speech
stiff neck and fever
Neck pain and headaches are often connected. Several types of headaches have links to neck pain, including some common ones, such as tension headaches and migraines. Sometimes, a person may have an underlying problem with the neck that can cause a headache.
People should see their doctor or another healthcare professional if they are not sure what is causing their headache and neck pain, treatments are not working, or they experience other symptoms alongside the pain.