One morning, you wake up to find that you cannot turn your neck to one side without experiencing pain or resistance. This type of neck stiffness is often related to sleeping in an awkward position, poor posture or sitting without considering proper body alignment. These factors can place uneven strain on your neck muscles, causing you to feel sudden stiffness.

However, a stiff neck may be related to osteoarthritis, especially if you feel numbness or tingling in your shoulders or down your arms. It can also be a warning sign of meningitis, a potentially fatal infection that requires immediate medical attention.

If you’re looking to determine the cause of stiff neck muscles, here’s what you should consider.

Structure of the Neck

The neck is a relatively complex and vulnerable area. It includes your first seven vertebrae, called the cervical spine. There is a disc between each vertebra that acts like a shock absorber and these are supported by 20 neck muscles, plus ligaments that allow for range of movement.

Eight pairs of nerves also help you move your neck, shoulders, arms and hands. For this reason, a compressed nerve in the neck may present as pain in one of these other areas. Stiffness may be attributed to an injured or damaged vertebra, muscle strain or nervous system issue.

Sources of a Stiff Neck

The first signs of a stiff neck often include pain, tenseness and tenderness. Especially when you first wake up in the morning, you may notice limited range of motion in this area along with shoulder or upper back pain.

Although a stiff neck is often temporary and goes away within a few days, symptoms that persist or return periodically require medical intervention. The issue may be attributed to one of the following conditions.

STRAINED OR TORN MUSCLES AND LIGAMENTS

Considered an overuse injury, small tears result from repeatedly sitting or standing in a way that stretches, bends or places additional strain on these soft tissues. Common scenarios include:

• Scrolling on a smartphone or tablet for hours at a time
• Sitting hunched over a laptop for several hours a day
• Reading in bed
• Sleeping in a position that puts pressure on the neck area
• “Tech neck” or routinely looking down at an electronic device
• Poor ergonomics on the job placing strain on the neck and upper back
• A sports injury
• Stress causing your muscles to tense up
• A fall
• Slouching as you sit or stand

WORN JOINTS

With age, joints experience a greater degree of wear. This progressive development can emerge as bone spurs and osteoarthritis that reduce range of motion, contribute to stiffness and cause pain.

Degeneration in this area may lead to cervical stenosis, a condition in which a narrowed spinal cord constricts the nerves passing through the neck and back. Cervical stenosis develops when the discs supporting the spine’s vertebrae dry out and lose their absorptive properties.

The bones may develop a thicker texture and potentially develop bone spurs. These two factors enclose the nerves passing through this area to the point where the growths put regular pressure on the nerve roots. Long term, surgery may be required to correct this condition.

NERVE COMPRESSION

In terms of your neck and spine, nerve compression frequently goes hand-in-hand with worn joints. Degeneration may contribute to a herniated or “slipped” disc that compresses a nerve passing through the neck area. You may experience a slipped disc and, subsequently, a compressed nerve and stiff neck due to whiplash, poor posture, osteoarthritis or age-related changes. The condition may also coincide with the development of bone spurs and cervical stenosis.

Understand that nerve compression may feel like a stiff neck at first but if the condition goes untreated, you may start to feel numbness or pain in other parts of your body. Organs and their respective systems also may not function as optimally as they should.

INJURY OR TRAUMA

Stiff neck may be a sudden development in response to a:

• Fall
• Sports injury
• Car accident

Particularly, a rear-end collision resulting in whiplash often leads to a stiff neck. In all cases, a sudden impact forces the neck, head and related muscles and ligaments into an unnatural position. The sharp force places strain on this area, stretching and potentially tearing the soft tissues.

Beyond sudden injuries, other trauma leading to a stiff neck include:

• Arthritis, characterized by inflammation. Sources range from an autoimmune disease like rheumatoid arthritis to excessive joint wear brought on by an incident or poor posture.
• Cervical spondylosis, a form of arthritis affecting the neck area. This condition may be accompanied by balance issues, weakness in the arms or legs and numbness that spreads down the arms and hands.

MENINGITIS

This condition causes inflammation around the brain and spinal cord, brought on by infection. As this condition results from exposure to a virus, fungus or bacteria, you may also experience nausea, vomiting, sudden fatigue, a rash, decreased appetite, confusion and light sensitivity.

Meningitis can quickly become fatal if not treated in time. Should you notice this combination of symptoms, seek medical attention right away. Treatment involves using corticosteroids to reduce inflammation and fluids through an IV.

Treatment for a Stiff Neck

When you wake up with a stiff neck, alternating heat and ice can make the muscles more limber and help manage inflammation. You may be advised to rest and watch your posture and form.

If your symptoms persist, schedule a doctor’s appointment. They may order imaging tests to identify the source of your pain – for instance, torn muscles, a slipped disc, arthritis or structural issues. Electromyography (EMG) may be requested to determine if you have a pinched nerve and how it’s affecting the rest of your body.

Treatment can vary and encompasses a combination of the following:

• Taking over-the-counter pain relievers.
• Avoiding or limiting the activity causing neck strain.
• Physical therapy treatment to improve how you position your neck, head and spine, strengthen your core muscles to improve posture and help you manage or decrease age-related wear and tear.
• Making lifestyle changes – for example, taking breaks on the job, getting more exercise and not looking down at a smartphone, tablet or laptop for hours at a time.
• Ergonomic adjustments to your workspace, including screens at eye level, keeping your wrists flat when typing and your feet flat on the floor.
• Considering where and how you sleep. Your mattress and pillow may not be providing your neck, head and back with the support they need. You may also want to sleep with a pillow below your thighs or neck.

We suggest working with a Physical Therapist to help recover from a neck injury or to simply improve your posture.