Nobody wants their day ruined by a stiff neck. The sharp, nagging pain from completing simple tasks, like checking a rearview mirror or speaking to a colleague, can frustrate the calmest of people.
While a stiff neck can develop out of the blue, it can be weeks or months in the making, often by someone’s own doing.
“As a society, we look down a lot,” says Deirdre Rodericks, MD, a Mass General Brigham sports medicine specialist. “We look down at our phones and computers. Even though we can bend our necks for an entire day, it doesn't mean we should.”
She explains why the neck stiffens and suggests ways to relieve the pain.
Carrying the head is no easy task. The head weighs approximately 12 pounds, and the neck serves as its balance beam.
Several tendons and muscles hold the head above the body. They stabilize the neck while allowing it to move side-to-side and up-and-down.
Poor posture, however, can make the head feel much heavier. Leaning too far forward leaves muscles behind the neck with more weight to carry. While those muscles can handle added weight for a short amount of time, they can easily strain after a few hours.
Dr. Rodericks compares the strain on the neck to carrying a bowling ball.
“It’s much easier to hold a bowling ball closer to one’s chest than to keep the ball extended in front of you with one arm,” she says. “The arm will strain after a few minutes. You don’t want to keep your head craned forward for that same reason. Those muscles behind the neck are holding on for dear life.”
Muscles and tendons strain when asked to do too much. Overuse and the natural wear-and-tear of aging are a few of the most common causes of a stiff neck.
Located at the top of the spine, the neck consists of several bones, called vertebrae. Fluid-filled discs separate these bones. These discs cushion the vertebrae to lessen the load on the joints (where two bones come together) during head movement. They also allow space for nerves to exit the spinal cord.
As people age, those discs lose their cushion. The fluid in the discs turn stale, like jelly inside a weeks-old donut.
“The neck wants the figurative jelly donuts between the vertebrae to stay smooth and fresh,” says Dr. Rodericks. “When the jelly dries out, those bones have no cushion left. That’s when they start to grind against each other.”
The condition, known as arthritis, makes it difficult to twist the head back and forth. Without enough cushion, the bones can rub together or cause a pinched nerve.
Major life events can lead to poor posture, which strains muscles in the neck. Life events that typically lead to a stiff neck include:
Those who sleep facedown tend to experience more neck pain than those who sleep on their back or side. Sleeping facedown forces someone to keep their head turned sideways so they don’t suffocate into their pillow. Locking the head sideways forces neck muscles into a strained position, possibly disrupting high-quality sleep.
People carry stress and anxiety in different parts of their body. Just as someone might grind their teeth, others might hike up their shoulders, tightening the muscles behind their neck. When those muscles stay clenched for several days in the leadup to a deadline or presentation, they begin to strain.
A stiff neck can linger for months due to whiplash. This occurs when the head suddenly, and often violently, moves back and forth, straining ligaments inside the neck. Whiplash commonly occurs during car accidents, or from falling and hitting one’s head.
The best intervention is prevention. Practicing a strong posture allows a stiff neck to heal. However, correcting posture takes time.
Dr. Rodericks recommends:
Keep computer screens at a height where the head will not need to lean forward. Adjust the height of the keyboard so the shoulders will not need to hike up to type.
Either at home or in the office, Dr. Rodericks recommends using:
Keep the spine and neck as straight as possible when sleeping. Laying front-side-up creates a gap between the neck and mattress. While the head rests on a pillow and the back lays flat, the neck sinks downward. Without support, the neck must hoist itself up to stay in line with the spine. Sleeping sideways puts the neck in a similar position.
To correct the gap, Dr. Rodericks suggests:
Dr. Rodericks suggests three simple exercises for improving posture. Practice holding the positions of each exercise for 30 seconds.
For those who need immediate relief, patients can try several short-term remedies.
A masseur or a massage gun can release knots, or muscle tension. Still, Dr. Rodericks warns patients not to rely on them as a sole treatment option for neck stiffness.
“If you’re going to keep sitting in awkward positions, massages aren’t going to do you any good long-term,” she adds. “You need to fix the aggravation and the imbalance in the muscles.”
A licensed chiropractor can ease sore muscles by performing gentle releases on joints. That said, avoid high-speed adjustments, like sudden cracks, to the neck. High-speed cracks can compress arteries in the neck and, in some cases, trigger a stroke.
Several over-the-counter medications and consumer goods can treat symptoms from home.
If a stiff neck refuses to go away after several weeks or months, see a doctor for further evaluation. In rare cases, a stiff neck can signal a much more serious condition.
Meningitis, a life-threatening infection, makes it painful to move the neck. The condition swells the protective lining of the brain and spinal cord. It can permanently disable patients if left untreated.
Seek immediate care for a stiff neck accompanied by:
A stiff neck can also signal a nerve injury. Visit an emergency room if a stiff neck includes sudden:
Adjusting daily routines can help keep neck health front-of-mind. Dr. Rodericks encourages patients to regularly practice straightening their neck and back throughout the day.
“Sometimes I’ll tell people to set an alarm on their phones for every hour,” says Dr. Roderick. “No matter where they are — work, at home, on the train — it can be a friendly reminder to stand up straight and correct their posture.”
Pausing work to go for a walk, or simply building in a few minutes to stand up and stretch in the morning or afternoon, can give the neck a much-needed break from bending over a desk all day.
And, at the end of the day, those few minutes might just save someone a few weeks’ worth of pain.