Skip to Main Content
Make an Appointment

Stiff Neck

A stiff neck happens when muscles of the neck are strained or tense. It can sometimes be remedied at home, but when that fails, medical treatments are also available.

Stiff Neck

Conventional wisdom states that stiff neck symptoms can be treatable with nonsurgical remedies. However, not all stiff neck symptoms are benign, and leaving the stiff neck untreated can lead to a limited range of motion that can affect your overall health and quality of life. A stiff neck can cause pain, tightness, popping, and clicking noises and sensations and affect daily activities. A detailed examination of stiff neck symptoms can determine the exact condition affecting the stiffness of one’s neck.

Where Does the Neck Hurt?

  • Neck stiffness can occur at the base of the head, down to the shoulders. This can be associated with pain, crunching noises or popping sensations and may have some sharp pain associated with it.
  • Neck stiffness can cause pain extending down into the arms and may be associated with numbness, tingling or some weakness.
  • There can just be some focal localized points of pain anywhere along the neck column, back of the neck muscles, upper, lower and middle trap muscles between the shoulder blades or in the scalene muscles

Types of Neck Pain

  • Neck pain can be described as soreness or an aching sensation.
  • Someone can have spasms or sudden powerful tightening or twitching of the neck muscles.
  • You can develop dull headache-type pain or pain that radiates up around the base of the skull to the top of the head and sometimes to the front of the head.
  • May be a deep, sharp or stabbing sensation.
  • Severe pain with tingling sensations that may or may not radiate into the shoulders or down the arms or to the fingers.
  • Painful muscles and neck areas that are tender to the touch.

Common Causes Of Neck Pain

A thorough musculoskeletal physician will take symptoms, history of neck pain, stiffness, and associated symptoms and put them together to have a differential diagnosis to determine the exact cause of neck pain.

Poor Posture and Ergonomics

With the overuse of cell phones, tablets, and computers, there is an epidemic of poor posture and spinal misalignment. Posture is key to keeping healthy muscles, bones and joints, and discs for the spine. Prolonged looking down at digital devices can compromise muscles and normal spinal curves that can lead to problems. Also, poor ergonomic positions for certain occupations or activities where you are in a prolonged, awkward position can lead to wear and tear as well.

Teeth Grinding

Teeth grinding can be both a cause of neck pain and stiffness and a result of neck pain and stiffness. If one grinds one’s teeth, the facial muscles work harder and can tighten which can pull on the neck, causing head and neck and shoulder problems, Also, upper neck instability or misalignment can cause compensation of the jaw muscles that will lead to nerve irritation and teeth grinding.


Symptoms of arthritis include painful joints that can radiate pain in the upper, middle, or lower neck between the shoulder blades and upper neck areas. Arthritis develops with continued instability, poor posture, poor alignment, and wear and tear. The cartilage in the joints can become inflamed causing pain and stiffness and causing the joint to enlarge.

Cervical Disc Injury

The neck is composed of 7 building blocks called vertebral bodies and the surface between those building blocks are discs. The discs serve as important shock absorbers of the neck but these can be injured with continued wear and tear, poor posture, poor alignment and trauma. Injury to the disc can lead to pain directly in the disc that can radiate into the neck in between the shoulder blades or it can cause disk bulging, which can irritate the nearby nerves causing numbness, tingling, weakness down the shoulder and arm.

Cervical Nerve Injury

At each level of the neck, nerves exit the spine. They control movements of the neck, shoulders, arms, and fingers. Disc bulges and arthritis cause joints to increase in size. Ligament laxity, bulging facets getting enlarged or hypertrophied, disc bulges, etc. can cause less space around the nerves, which is referred to in medical terms as Stenosis.

Spinal Injuries

Spinal cord injuries can be serious and usually result from accidents, but trauma can come up insidiously like in the form of severe stenosis or less space around the nerves or a collection of fluid around the nerves, such as a syrinx. Typically, these result in severe significant weakness in the arms, even possibly the legs. If really severe, this can cause bowel or bladder issues, trouble breathing, or extreme pain. Additionally, other spinal injuries would be things such as fractures. They can occur from trauma or from osteoporosis, and these would need to be diagnosed and treated immediately.


Meningitis is a rare form of neck stiffness and pain. This is caused by infection, which can be viral, bacterial, fungal or parasitic. Bacterial meningitis is most common and is typically combated with vaccinations. If this is unrecognized, this can be fatal within a few days. Viral meningitis mostly resolves on its own, while fungal and parasitic infections can be severe, but they are much rarer. Symptoms usually include fever, stiff neck, headache, possible seizures, difficulty breathing, increased sleepiness, light sensitivity, and decreased appetite.

Home Remedies You Can Try

  • Relative rest can be tried to see if there is a muscle problem that goes away on its own.
  • Heat can be tried to relax the muscles and ease pain by using a heating pad or infrared heating pad.
  • Ice or cryotherapy may help soreness or swelling.
  • Doing some gentle stretching and light neck or upper back exercises may help.
  • Massage could potentially be beneficial to relax tight muscles.
  • Sometimes over-the-counter pain relievers such as Tylenol can be used.
  • Other pain relievers are nonsteroidal anti-inflammatory drugs or NSAIDs to reduce pain and inflammation.

How Stress Management Can Relieve Neck Pain

Stress can cause neck stiffness. Muscle tightness, which can pull on the neck and affect neck posture can cause headaches. Released stress hormones can make you more prone to inflammation and pain. So managing stress either with relaxation techniques, breathing techniques, or manual therapy such as massage can be very helpful.

When To See Your Doctor

It is best to see your doctor if some of your home remedies are not alleviating neck pain and it continues to persist or get worse.  You should see your doctor if you are having pain, numbness, tingling, or weakness going down any extremity, if that is coming along very rapidly and not going away with any positions, maneuvers, or modalities, then you want to see your doctor right away.

Conventional Medical Advice On Stiff Neck

The traditional medicine approach to stiff neck symptoms might not be adequate for proper diagnosis and treatment. The traditional techniques include maybe doing a brief history, trying some medicines or home therapies. If that does not work, doing some specialized physical therapy may be helpful. All these are great, but if these things fail, the next typical steps may be steroid-type injections to help the pain, which can potentially help, but also can potentially make things worse and do not address the underlying issue.

Some nerve blocks and procedures can be done as both diagnostic tools and as a precursor to burn the nerves that can alleviate pain in the joint, but again have the sequelae of the consequences of burning nerves like making muscles weak. And then when these things fail, typically the only other solution offered is surgery — or just deal with it if no surgeon wants to operate.

However, there is a whole field of regenerative medicine or interventional orthopedics that can fill in the gaps for when physical therapy and home remedies are not enough and you do not quite need surgery. These techniques can include prolotherapy, PRP, or bone marrow concentrate containing stem cells, all of which are tools that can be injected precisely to stimulate your body’s own natural healing of certain areas.

Also, a proper diagnostic workup including a thorough history, thorough hands-on physical exam, perhaps ultrasound, perhaps MRI or imaging modality, perhaps several different diagnostic blocks with just local anesthetic to make sure you have made an adequate diagnosis.

How To Get A Proper Diagnosis

At the Centeno-Schultz Clinic, our diagnostic process consists of an hour-long evaluation in which we take a detailed history, a very thorough physical exam, ultrasound when appropriate, and reviewing of cervical x-rays that may include flexion/extension x-rays, a digital motion x-ray, and a cervical MRI. Most of the time with this information, we can have a firm diagnosis and develop a treatment plan. When the diagnosis is still not honed in, we can perhaps try some diagnostic blocks to further hone a diagnosis.

What Happens When Left Untreated

So when neck symptoms go untreated, these can lead to more serious problems, continued pain, worsening function for the patient. Sometimes things can progress overtime where the only solution may be surgery. If things go too far and then surgery was required but ignored, then it can cause some permanent deformity or permanent nerve-type injuries.

Latest Advances In Treating Stiff Neck

At the Centeno-Schultz Clinic, we have developed state-of-the-art treatments for chronic stiff neck. These include:

  1. Prolotherapy injection, which is slightly irritating solution that can be injected into tendons and ligaments to help stimulate the body’s own repair mechanisms and has low risk and good evidence that they can help with neck instability.
  2. PRP or platelet-rich plasma is a growth factor cocktail obtained from the blood. Blood can be taken, processed so that the platelets are isolated, concentrated for various formulations and can be injected into tendons, ligaments inside the joints, discs or around nerves with specialized platelet growth factors to help to repair those areas.
  3. Bone marrow concentrate containing stem cells is the most powerful injection solution we can offer that is required for more severe cases, which can be injected into severely arthritic joints, disc tears, injured tendons, and ligaments with partial tears. The results of these techniques are tracked patients in the registry, which shows positive outcomes and pain, function and patient reported percentage improvement.

Do Not Miss What Your Body Is Telling You

If you have neck stiffness that is not going away with simple things or you are getting more concerning symptoms such as numbness, tingling, weakness, or radiation down the arm, then you need to get evaluated by a physician right away. The doctors at the Centeno-Schultz Clinic are experts in the diagnosis and treating musculoskeletal and orthopedic problems and in particular stiff neck, chronic stiff neck, and neck problems. We can offer a full diagnostic workup and develop a personalized specific treatment plan to help the pain by promoting your own body’s ability to heal itself without the use of drugs and surgeries so a more natural solution. You do not have to endure your neck pain for too long. Make an appointment with us today.

Common Conditions Associated With Stiff Neck

Atlantoaxial Instability (AAI)

Instability simply means that bones move around too much, usually due to damaged ligaments. In the spine, this can cause nerves to get banged into and joints to get damaged. In the craniocervical junction, instability can cause the upper cervical spinal nerves to get irritated, leading to headaches. In addition, the C0-C1 and C1-C2 facet joints can also get damaged. In addition, there are other nerves that exit the skull here that can get irritated, like the vagus nerve, which can cause rapid heart rate. What’s the Difference Between CCI and AAI? CCI refers to instability in any part of the craniocervical junction…

Read More About Atlantoaxial Instability (AAI)

Cervical Medullary Syndrome

Cervical Medullary Syndrome is a clinical condition that occurs as a result of inflammation, deformity, or compression of the lower part of the brain. Symptoms can be extensive with fluctuating severity based upon the extent of the underlying injury. For example, mild irritation of the brainstem may cause only mild, intermittent symptoms. The upper cervical spine and brain are complex with multiple structures.  These structures reside within the skull and protective confines of the cervical spine.  Neither expands to accommodate inflammation, injury, and disease.  Rather the delicate tissues of the brain and spinal cord are irritated or compressed.   The 4 major conditions that cause cervical medullary syndrome are… 

Read More About Cervical Medullary Syndrome

Cervical Radiculopathy

Common Cervical Radiculopathy symptoms include neck pain, arm pain, shoulder pain radiating down arm to fingers, numbness, tingling, and weakness. Cervical Radiculopathy is a clinical condition in which a nerve or nerves in your neck become irritated or compressed. It is also known as ” a pinched nerve,” The causes are discussed below. It can affect individuals of any age with peak prominence between ages 40-50 years of age. Cervical Radiculopathy is due to spinal nerve inflammation, irritation, or compression. The most common causes of Cervical Radiculopathy are: Disc Injury – The disc is an important shock absorber. Unfortunately, it is susceptible to injury.

Read More About Cervical Radiculopathy

Craniocervical Instability

Craniocervical Instability is a medical condition characterized by injury and instability of the ligaments that hold your head onto the neck. Common symptoms of Cranial Cervical Instability include a painful, heavy head, headache, rapid heart rate, brain fog, neck pain, visual problems, dizziness, and chronic fatigue.CCI or neck ligament laxity treatment options depend upon the severity of the instability and clinical symptoms. When appropriate, conservative care should always be the first-line treatment. Craniocervical Instability Surgery is often recommended when conservative care fails. This involves a fusion of the head to the neck which is a major surgery that is associated with significant risks and complications…

Read More About Craniocervical Instability

Ehlers-Danlos Syndrome (EDS)

Disorders that affect and weaken the connective tissues such as tendons and ligaments. It is a hereditary disorder which means you are born with it.  EDS has many different signs and symptoms which can vary significantly depending upon the type of EDS and its severity.   It most commonly affects the skin, joints, and blood vessels.  Joints are typically hypermobile with excessive joint range of motion because of a defect in collagen formation. In most cases Ehlers-Danlos syndrome is inherited. That is to say that you are born with it. The two main ways EDS is inherited are: autosomal dominant inheritance and autosomal recessive inheritance…

Read More About Ehlers-Danlos Syndrome (EDS)

Facet Joint Syndrome

Injury or inflammation of the cervical facet can led to neck, shoulder and headache pain – called “cervical facet syndrome.” Cervical facet syndrome largely involves a joint in the posterior aspect of the cervical spine. It functions to provide stability and guide motion. cervical facet joint injection for cervical facet syndrome Cervical facet pain is common in patients who have sustained a whiplash injury, trauma to the neck or undergone cervical fusion. Physical examination is typically significant for restriction in range of motion along with pain. Each joint has a distinct referral pattern illustrated below. The Centeno-Schultz Clinic are experts at diagnosing and treating cervical facet dysfunction. Injury to the joint is not commonly detected by conventional radiographic studies.

Read More About Facet Joint Syndrome

Loss of Cervical Lordosis

Normal neck curve? All of us, at one time or another, have probably been told to stand or sit up straight. The primary structure that allows us to follow that wise advice and demonstrate good posture is our spine. Likewise, when our posture is poor, this puts strain and pressure on the spine and supporting structures and can create problems down the road. This emphasis on a straight posture may, understandably, make you envision your spine, which stretches from the base of your skull all the way down to your pelvis, as straight. However, if you could stand sideways in front of a mirror and see all the way through to the spine, a normal spine would have three gentle counterbalancing curves. If there is too much curve at any point or not enough, this can be a problem.

Read More About Loss of Cervical Lordosis

Pinched Nerves in the Back

We talk a lot about leg pain stemming from a pinched or irritated nerve in the lower back. And, indeed, that’s what our physicians are traditionally taught in medical school—a pinched nerve in the lumbar spine typically presents as a symptom in the leg. However, what if you have some butt pain but no pain or other symptoms in the leg? Does this mean it couldn’t be a pinched nerve? Not so fast. Turns out a pinched low back nerve doesn’t always have to be accompanied by leg symptoms. Let’s start by taking a look at how the back is structured.

Read More About Pinched Nerves in the Back

Thoracic Outlet Syndrome

The thoracic outlet is an area around the collar bone where the nerves that come from your neck meet up with the blood vessels from your heart and together supply the entire upper extremity (shoulder and arm). These blood vessels (subclavian artery and vein) and nerves (brachial plexus) travel from the base of your neck to your armpit (axilla) and are considered the “thoracic outlet”. Now that you know what the thoracic outlet is, what is thoracic outlet syndrome? Simply listening to a patient’s history and completing a physical examination is all that is needed to diagnose TOS. But more involved imaging such as X-rays…

Read More About Thoracic Outlet Syndrome


The temporomandibular joint (TMJ) is the joint connection between your jaw and your skull. If you run your fingers along either side of your jaw line toward your ears, you can actually feel where the jaw bone ends and the skull bone begins. If you open and close your mouth, the difference between the two is dramatic as the jaw bone moves, thanks to the TMJ joint, while the skull bone remains stable. The TMJ and any of its surrounding structures can become painful and inflamed, and this can become so bad that it can prevent patients from even being able to move their jaw bone to chew.

Read More About TMJ
Show More

FREE eBook Download (Click the Book Cover)

Ready to get help for your Stiff Neck?

Get Help