How to Treat a Stiff Neck?

Written by Leon Mao
Physiotherapist, University of Melbourne
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on May 16, 2022

Man sitting on the edge of his bed holding his stiff neck

A stiff neck can affect everyday life. Specifically, a stiff neck describes the inability to fully move the neck. This can gradually develop over time or suddenly appear. Along with back pain, the Australian Institute of Health and Welfare notes that 4 million Australians experience neck pain.[1]

There are many reasons for experiencing a stiff neck. The neck is made up of many structures that can cause neck discomfort, including injuries to the ligament, muscles, joints and bone.

Fortunately, there are several home treatments that are readily available to help you get rid of your stiff neck. Additionally, physiotherapy can also help with a range of neck pain conditions if symptoms keep persisting. This article will go through the causes of neck stiffness, home treatments, prevention and when you should seek treatment.

Causes of a Stiff Neck

There are several conditions that cause a stiff neck. Some develop over time while others can occur suddenly. Detailed below are common conditions that can cause a stiff neck.

1. Arthritis

Arthritis describes inflammation and pain which occurs between the joints of the cervical spine (neck) which are also known as the facet joints. Over time, the smooth cartilage begins to break down between these joints which can lead to neck stiffness. There are various types of arthritis, including osteoarthritis, rheumatoid arthritis and psoriatic arthritis.

2. Spinal Conditions

There are certain spinal conditions in the neck which can lead to stiffness and pain. Examples of spinal conditions include ankylosing spondylitis, spondylolisthesis, and bulging discs. These types of spinal conditions can develop over time or due to a physical injury.

For example, spondylolisthesis occurs when the vertebrae (spinal bones) gradually slip out of place over time. On the other hand, some disc injuries are caused by sudden traumatic accidents, such as car accidents and falls. Injuries to these structures lead to neck pain, inflammation and stiffness.

3. Muscle Tightness

Tightness of the muscles around the neck can cause neck pain and stiffness. Causes of neck muscle tightness include poor posture, sitting for long periods and repetitive use (e.g. gym, sports). As the muscles shorten, they restrict the ability to move the neck properly. Common muscles around the neck that are affected, include the upper trapezius, levator scapulae and the splenius capitis.

4. Neck Sprain (also known as a Cervical Sprain or Whiplash)

Sprains are tearing injuries of the ligament(s). Ligaments are bands of tissue which connect bones together across joints. These injuries occur when the ligaments overstretch and/or tear. One of the typical types of neck sprains is whiplash. This is a condition where the head suddenly cocks back and forth due to trauma, such as a fall or car accident. Stress through the neck causes damage to the ligaments surrounding the neck.

5. Acute Wry Neck (also known as Torticollis)

Acute wry neck is a condition that can cause sudden episodes of neck pain and stiffness. Often, this is caused by the neck muscles suddenly contracting which causes the head to become stuck in a twisted position. These conditions can suddenly develop for several reasons, including stress, sudden movements and fatigue. Compared to general muscle tightness, a wry neck can often lead to sharp and sudden restrictions of neck movement.

How to Get Rid of Neck Stiffness at Home

Neck stiffness can be limiting. Being unable to fully move the neck can lead to problems driving, shopping or even walking. However, there are treatments at home that can help restore neck movement and get rid of symptoms.

1. Heat, Ice or Combination Therapy

Heat and/or ice treatment can be used to help ease neck pain. They can be used separately or together depending on the cause of the neck stiffness.

Ice therapy can be used by applying ice gel packs, frozen vegetables or freezer bags filled with ice. Lowering the temperature around the neck helps reduce it’s sensitivity to pain

On the other hand, heat therapy is used to help improve blood flow around the neck to help with recovery and healing. Heat packs and hot water bottles are some typical ways heat therapy is delivered.

To prevent damage to the skin, towels should be wrapped around the packs as a protective layer. Treatments can be applied for 10-15 minutes at a time for 3-4 sessions a day.

2. Gentle Movements and Stretches

To avoid the neck from stiffening up, incorporate gentle movement and stretches into your daily routine. Loosening up tightened structures, such as muscle and ligaments can help you slowly regain neck movement.

3. Avoiding Aggravating Activities

Certain movements or activities (e.g. lifting weights, desk work) can stiffen the neck further. Temporarily or reducing these types of activities can help ease any discomfort or stress through the neck. Allowing this to happen allows the neck time to recover and heal. For certain conditions, avoiding these activities should only be a short-term solution until the movement begins to return.

4. Over-The-Counter Pain Relief Medications

Over-the-counter medications that help relieve pain, such as paracetamol (e.g. Panadol) or ibuprofen (e.g. Nurofen) can also be used. By reducing discomfort, the neck is able to move more freely before feeling any restrictions. For medical advice or prescription drugs, please consult your doctor.

Preventing a Stiff Neck

Prevention is better than cure. Avoiding a stiff neck is no exception. Through consistent and safe lifestyle and habitual changes, there is a lower chance of experiencing neck stiffness. Below are some strategies that you can start today to reduce the risk of getting a stiff neck.

1. Monitor Your Posture

Another risk for developing a stiff neck is posture. Having a hunched or forward head posture increases the weight of the head onto the neck by up to 21kg.[2] Over time, this added stress can cause muscle tightness, joint problems and neck pain. A major culprit of poor posture is phone use which should be constantly monitored to prevent the constant stress through the neck. Spending less time on the phone or having a more upright posture is advised.

2. Taking Regular Breaks During Work

On top of posture, taking regular work breaks throughout the day is also advised for reducing neck stiffness. Research has shown that even taking regular 30 second breaks throughout the day helps prevent a painful and stiff neck by 61%.[3] Breaks do not have to be long, but can help take the stress of the neck effectively. They can even help clear the mind and increase productivity during busy days.

3. Exercise

Exercises, such as strengthening and stretching activities can help ease pain and prevent neck stiffness. By conditioning the muscles around the neck, it will be able to better deal with the demands of everyday life, such as office work and our use of technology. In fact, it only takes 6 weeks of specific exercise to reduce pain and disability caused by the neck.[4]

4. Finding a Suitable Pillow

Having a good night’s rest can help rejuvenate the body, clear the mind and assist with neck health. Using the right pillow can improve support and alignment for the neck. Research indicates that between 61-77% of people find that pillows reduce neck discomfort.[5] Choosing a suitable pillow depends on several factors, including your typical sleeping position (e.g. lying on your back or side), preferred firmness and its height.

When to Seek Physiotherapy

While some types of neck stiffness will disappear shortly or ease with home treatments, others may require some professional help. Physiotherapists regularly see patients with painful and stiff necks.

They offer a range of science-based treatments to help with short-term and long-term neck stiffness. Additionally, they will also use physical tests and, if necessary, imaging investigations (e.g. x-rays, MRIs) to assist with diagnosis.

Physiotherapists also regularly work with other healthcare professionals, such as doctors, surgeons and specialists to help patients achieve the best outcomes.

Below are several signs of when to seek physiotherapy to help get rid of a stiff neck:

  • If your neck stiffness does not improve

  • You are getting pain, numbness or pins and needles down the arm, hands and/or fingers

  • You are getting headaches alongside your neck stiffness

  • If you suspect your neck stiffness is related to poor posture or ergonomics at work

  • If you are getting symptoms after an incident (e.g. car accident, fall). Severe symptoms, such as extreme neck pain, neck instability, crunching sounds in the neck, loss of consciousness and paralysis may require a visit to your GP and/or imaging.

Key takeaways

Due to the inactive and technology-filled lifestyles of Australians, many people are experiencing stiff necks. There are many reasons for getting a stiff neck, such as muscle tightness, spinal conditions and poor posture.

However, there are certain treatments and prevention plans that can help with neck stiffness. Examples include heat and ice therapies, exercise and scheduling work breaks.

For some, neck pain and stiffness can become disabling. Eventually this can lead to troubles concentrating at work, driving and even socialising. Seeking professional help, such as physiotherapy, can guide you in the right direction and help you resume a normal daily routine.

Written by Leon Mao
Physiotherapist, University of Melbourne
Published on May 16, 2022
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on May 16, 2022
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Last medically reviewed on May 16, 2022
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