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Stiff Neck

Most of us experience a stiff neck during our lifetime.

There are many (and I mean many) causes of a stiff neck but as a physiotherapist there’s a few that really stand out.

These are the types of stiff neck I see in clinic most regularly.

Stiff neck from overworked neck muscles, cervical joints or a combo of both.

Often a stiff neck will present on it’s own, and then other times there are a few other symptoms as well.

  • Sensation of tightness or tension along the shoulder up through to the neck
  • Burning sensation around the neck and shoulders 
  • Headache
  • Catching pain during neck movement
  • Reduced shoulder range of movement

Let’s go deeper and investigate what causes a stiff neck and how we can fix them.

What Causes a Stiff Neck

Overload

If you overload your neck with sustained stress it can become stiff. 

Common patterns are people who work long hours at a desk

Those spending a lot of time on overhead activities where you’re looking up. 

Painting a ceiling is a prime example.

Consistent overload of your neck muscles in high loading or a stationary position can lead to neck stiffness.

So what can you do about it?

Think of how your arms felt sore and stiff after that first time you went to the gym.

As you get stronger the soreness and tightness reduces and the threshold to tolerate load also increases. 

Similarly, if you have a stiff neck, studies have found that strengthening of the neck muscles reduces neck stiffness

Another solution is simply movement.

Our bodies love moving and bending.

The last time you slept with your shoulder overhead, you woke up with a stiff shoulder right? 

Motion is lotion for our joints so moving our neck regularly helps keep it lubricated and reduces the chance it gets stiff.

Sprain or Strain

Neck stiffness can also develop following acute neck sprain or strain. 

You might be surprised to learn that a strain can still happen in a low loading situation. 

Something as simple as sleeping in an awkward position.

I’ve seen plenty of people with a stiff neck and severe neck pain with muscle spasms from sleeping with their head at a weird angle for them.

In most of these cases, physiotherapy can provide instantaneous relief for neck stiffness. 

Different management is required if your neck sprain or strain due to heavy loading. 

The shoulder muscles which connect into the neck need to be assessed and strengthened if lifting awkward or unaccustomed loads strain them. 

Structures

Our joints change as we age, this is normal.

The disc and facet joints that make up our vertebral column and facilitate movement of our spine are constantly changing. 

They can lose a little bit of hydration (less slippery) and flatten out. 

There can also be some osteoarthritis changes including bone spurs and cartilage damage.

With these very normal changes happening we can lose some of our end-range movement of our neck.

An example of this is reducing the ability of our head to turn on our shoulders. 

If you’re getting a few more decades under your belt, you might find it harder to “head check” in the car to see that blind spot if your neck end-range of motion is reduced.

You might also feel an occasional jamming sensation.

While such structural changes are not modifiable, engaging in regular range of motion and resistance exercises can help maintain your neck mobility. 

Moving on to the other end of the spectrum, there are some of us with hypermobile joints.

Hypermobile joints are able to move more than the average, and even these can feel stiff!

How? 

With hypermobile joints, your muscles that control neck movement actually have to work harder to provide support to the neck. 

The result is overloaded neck muscles which feel stiff and tight. 

In clinic when I measure the range of movement available of people who complain of neck stiffness, they are often normal. 

And if you have hypermobile joints the range is often more. 

The reality is that the sensation of having a stiff neck is due to overloading rather than true shortening of the neck muscles. 

What Can You Do To Fix a Stiff Neck

Well, if your stiff neck symptom pattern fits well with the above, you will benefit from neck exercises. 

comic strip showing how a giraffe has a strong neck that does not get sore like a human neck

You can book an appointment here with our neck-spert physiotherapists to workout what is the best exercise to relieve your neck stiffness. 

A few words of caution:

Any neck stiffness due to high impact trauma, or accompanied by unexplained dizziness, visual changes, fainting spells, fevers, nausea, fatigue, coordination issues, changes in mental state may indicate a serious underlying pathology and would require immediate medical attention.

This article is general advice only and not individual clinical advice. You should always consult your physiotherapist or doctor before commencing any treatment.

References

Andersen, H., Ge, H. Y., Arendt-Nielsen, L., Danneskiold-Samsøe, B., & Graven-Nielsen, T. (2010). Increased trapezius pain sensitivity is not associated with increased tissue hardness. The journal of Pain, 11(5), 491-499.

Andersen, L. L., Andersen, C. H., Skotte, J. H., Suetta, C., Søgaard, K., Saltin, B., & Sjøgaard, G. (2014). High-intensity strength training improves function of chronically painful muscles: case-control and RCT studies. BioMed research international, 2014.

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