A stiff neck may last a few days or even weeks but it usually heals quickly because of the durability of the cervical spine. Sometimes, something as simple as sleeping wrong can cause a stiff neck and occasionally a stiff neck can have more serious implications.

These are the usual culprits that can lead to a stiff neck:

Muscle Strain or Sprain

The levator scapula muscle running the length of the back and side of the neck connects the cervical spine to the shoulder and is controlled by the third and forth cervical nerves. A muscle sprain or strain particularly to this area can lead to a stiff neck.  You can strain this muscle while doing many everyday activities, such as:

  • Sleeping without proper support from a pillow and in a poor posture can stretch this muscle unnecessarily.
  • Any repetitive activity that involves turning the head from side to side, as in swimming, can result in stiff neck.
  • Poor posture that tilts the head, like when cradling the phone between the neck and shoulder, or viewing the computer monitor for long hours which contracts the neck muscle.
  • Stress that causes tension knots in the neck.

Cervical Spine Disorders

The cervical spine consists of the spinal cord, vertebrae, and discs of the upper part of your neck. When any part of the cervical spine becomes misaligned, it will cause pain and stiffness to the neck. The stiffness in the neck can be an indicator of an underlying disorder such as:

Facet joint disorders- occur when the facet joints at the back of the spinal structure that help with movement wear out because of osteoarthritis.

Herniated Disc- is a serious condition that can cause terrible irritation and pain to the nerve roots in the disc of your neck and pain along your arms too.

Cervical osteoarthritis- can cause muscle spasm and neck stiffness from blocked nerve pathways in the cervical spine.

Meningitis / Infection

Bacterial infection in the fluid membrane of the brain and spinal cord causes inflammation and stiffening of the neck along with a high fever, headache and nausea. Seek immediate medical attention if you notice any such symptoms as it is an indication of meningitis. Other rare but serious infections can also cause stiff neck symptoms, such as meningococcal disease or vertebral osteomyelitis, that occur in the cervical spine and vertebral body.  When you have a stiff neck, fever, feel nauseous and are sensitive to light then it can also be a sign of a common viral infection, like the flu.


Neck injuries from an accident, sports mishap or falls where your head has being jerked around violently may result in muscle injuries, sprains, and perhaps even strains on the ligaments in your neck. The main symptom of these injuries is neck stiffness and pain.


Osteoarthritis is daily wear and tear of your neck joints with age, which often lead to stiffness and limiting neck movement.  While RA is an autoimmune disorder that can affect your neck joints along the upper part of your neck resulting in severe neck pain and stiffness. Sometimes arthritis also leads to your spinal canal narrowing down which results in a pinched nerve causing radiating pain down your arms, legs and neck stiffness.

Stiff Neck Treatments

If the stiff neck symptoms persist for more than a week then you may need medical attention and especially if there are also other symptoms mentioned above. Your physician may order an X-ray or computed tomography (CT) scan along with a physical examination to diagnose the cause of your stiff neck. Your treatment will depend on what is causing it but generally in case of the more common strained neck muscles, initial treatment will include:

  • Non-steroidal anti-inflammatory drugs or NSAIDs to relieve pain
  • Ice on the stiff neck for the first 48 to 72 hours to reduce inflammation, then switch to using a heat wrap or heat pad or even consider taking a hot shower to soothe your muscles
  • To rest your neck muscles, you may have to wear a cervical collar.
  • Limit physical activities that can strain your neck
  • Seek help from physical therapist.
  • Get a neck and shoulder massage.
  • Practice simple neck stretching exercises like slowly moving your head up and down and side to side.
  • Sleep on a firm mattress with a neck pillow for proper support.
  • If your stiff neck gets worse let your doctor know because you may need more specialized care to relieve your symptoms.

The Illinois Bone & Joint Institute has more than 90 orthopedic physicians, and 20 locations throughout Chicago. We’re here to help you move better so you can live better.