Got a stiff neck? Almost all of us have experienced a stiff neck at some point in our lives. In fact, experts estimate that 66% of us have. As Dr. Allan Binder with Lister Hospital in Hertfordshire, England, reports "about two thirds of the population [has] neck pain at some time in their lives". Those of us who are in our 40's and 50's are the most vulnerable to experiencing stiff necks. Indeed, second only to back pain, "neck pain is the most frequent musculoskeletal cause of consultation in primary care worldwide." Where does a stiff neck come from and what can we do to avoid it? Are there any natural remedies for a stiff neck? And when does a stiff neck indicate a serious medical condition?
Why is it the neck that becomes stiff so often. The answer lies in the basic job of the neck -- to hold up your head. The head is heavy relative to the neck. Although estimates vary, the human head weighs from 8 to 10 pounds. You've heard the old saying goes "heavy is the head that wears the crown". Well, we should not only pity the head that wears the heavy crown of daily worries --we should also pity the poor neck that has to hold up that burdened head.
The neck is a complicated place, so that stiffness and pain can arise from problems in muscles, nerves, vertebrae, the cushioning between the vertebrae, or any combination thereof. The National Institutes of Health reports that the most common cause of neck trouble comes from muscle strain or tension, and that "usually, everyday activities are to blame."
Poor posture on the computer, while watching TV or reading, or sleeping in an unnatural position may be at the root of neck stiffness, which can be worked on with small changes of your body's position. There are, however, several less direct -- and oftentimes better hidden -- causes of neck stiffness resulting from diseases or traumatic events. Here is a Top 10 list of the lesser-known causes of neck stiffness and pain:
1. Herniated disk. The human spinal column forms to protect nerves travelling from the brain down the back. The bones composing this column are separated by disks, which cushion the spine and allow for bending and reaching movements. A herniated disk, also known as a slipped disk, happens when either all or part of a disk in the spine weakens or moves out of place, putting pressure on surrounding nerves. While the lower back hosts the majority of slipped disks, it can also happen higher up, in the neck.
The U.S. National Library of Medicine posts that herniated disks are most common in middle-aged and older men, often after strenuous activity. The resulting neck pain could feel like a tingling, a dull ache, or a burning pain, with various levels of severity.
Pain from a herniated disk in the neck may move as far as the shoulders, upper arm and forearm and the fingers. The pain could last from weeks to months, with treatment strategies ranging from medication and physical therapy, to lifestyle changes such as diet and exercise, to steroid injections or surgery.
2. Spinal Stenosis. Cervical spinal stenosis (CSS) is the narrowing of space in the cervical spine (also known as the spinal canal), usually because of the degeneration of vertebrae and intervertebral discs, occurring most often in adults over the age of 60.
With age, disks lose water content and thus "some of their ability to act like shock absorbers. This change in disk size affects alignments and increases the likelihood of bone spur formation, both of which could affect nearby nerves and create pain in the neck and other areas.
Besides neck pain and stiffness, symptoms include loss of balance and weakness or numbness in the shoulders, arms and hands. Treatment varies from a cocktail of physical therapy and medications, to laser surgery, to spinal implant devices.
3. Osteomyelitis. Osteomyelitis is a bone infection (either acute or chronic) caused most commonly by bacteria, and sometimes by fungi. This infection spreads from other parts of the body, such as infected skin, muscles, or tendons, or sometimes it arises after bone surgery.
Osteomyelitis generally affects the long bones of children, and the feet, hips and spine of adults - people who have had their spleen removed are at a particularly high risk. In addition to bone pain (in the neck, lower parts of the spine, or wherever the infection occurs), symptoms include fever, local swelling and chills.
Dr. KC Prasad and other researchers with the Department of Otolaryngology at the Kasturba Medical College in India, reports that "dealing with osteomyelitis in head and neck bones is not the same as in other bones of the body due to the nature of the bones, complex anatomy of the region, and esthetics." However, after a study in 2007, Prasad and his team concluded that "treatment can be conservative resection," that is, surgical removal of the infected part of the bone in the neck.
4. Osteoperosis. Osteoporosis is the most common type of bone disease - experts predict that 1 out of 5 American women over 50 have osteoporosis. This disease is the thinning of bone tissue and density over time, either because the body fails to form enough new bone, too much old bone is reabsorbed by the body, or both.
Osteoporosis is most common in women over 50 because of a drop in estrogen during menopause, and men over the age of 70 because of a drop in testosterone. Symptoms only appear late in the disease, including bone pain, loss of height over time, stooped posture (also known as kyphosis or "dowager's hump), and neck pain from fractures in spinal bones.
Just this year, in 2011, Dr. Nimit Taechakraichana from the Department of Obstetrics and Gynecology at Chulalongkorn University in Thailand , emphasizes that postmenopausal women may feel neck pain due to the kyphosis that "requires the patient to hyperextend the neck."
Dr. Taechakraichana notes the "universal recommendation" against osteoporosis as maximizing bone mass during young adulthood - yet this is hardly helpful to those already affected. Dr. Taechakraichana offers more realistic options to those who already suffer osteoporosis: biphosphonates, drugs that may help with bone remodeling. However, this research is fresh out of the lab and may not be available until further testing.
5. Whiplash. Whiplash, the infamous possibility after a car crash, is injury to soft tissue in the neck, which may also include damage to joints, discs, ligaments, cervical muscles, and nerve roots. The National Institute of Neurological Disorders and Stroke explains that in addition to neck pain and/or stiffness, symptoms of whiplash might include headache, dizziness, and even some cognitive impairment such as loss of memory and concentration, and depression.
However, The National Institute of Neurological Disorders and Stroke also has some good news: "The neck and head pain clears within a few days or weeks. Most patients recover within 3 months after the injury" - though there may be vestiges of neck pain and headaches. Treatment options include pain medications, antidepressants, and a cervical collar that is generally worn for two to three weeks, along with muscle-targeted exercises.
A 2012 study from a team of researchers from several universities including the University of Duisburg-Essen in Germany has found that a form of yoga known as "lyengar yoga" is superior to home-based exercise in improving neck pain. The study . The study found that yoga improves "the functional status of neck muscles".
6. Fibromyalgia. Fibromyalgia is long-term pain in various areas of the body, with tenderness in the joints, muscles, tendons and soft tissues. Areas of pain are called "tender points," and a frequent tender point is in the soft tissues on the back of the neck that ranges from mild (perhaps felt as a general stiffness) to severe. Though the National Institutes of Health label the disease as "common," (and it is most common in women between the ages of 20 and 50), its direct causes are unknown. Possible triggers include emotional trauma and sleep disturbances. In addition to pain, symptoms include memory and concentration problems, fatigue, depression and numbness in the hands and feet.
Treatment options for fibromyalgia include physical therapy, fitness programs and stress-relief methods, all intended to relieve symptoms. Occasionally antidepressants or muscle relaxants are prescribed to improve sleep and decrease pain.
7. Lyme disease. Humans become infected with the bacteria causing Lyme disease through bites of infected black-legged ticks. The Centers for Disease Control and Prevention warns that while ticks can attach to any part of the body, they are most often found in hidden areas, such as the groin, armpits and scalp, and that the tick must be attached to the skin for 36 to 48 hours before transmitting Lyme disease. If one of these little buggers has managed to hide on you or a loved one long enough, symptoms of Lyme disease include an expanding red rash, fever, heart palpitations, shooting pain and neck stiffness, caused by swelling of the spinal cord.
The Centers for Disease Control and Prevention recommend that prevention is "the best defense against Lyme disease." Prevention methods include avoiding bushy areas (by staying in the middle of a trail, for example), using repellent, washing soon after being out of doors, and performing a tick search - not forgetting those "hidden" areas that ticks prefer. If you think you may already have Lyme disease, antibiotics are usually successful.
Neurological diseases (Reasons 8-10 below). In 2001, Drs Rachel Straussberg, Liora Harel and Jacob Amir with the Schneider Children's Medical Center of Israel and Tel Aviv University, published a report based on evidence that "stiff neck and torticollis are significant signs of neurological disease." (Torticollis - sometimes inherited and sometimes acquired from injury to the nervous system -- is a condition in which the neck is twisted so that the head appears to be tipped to one side). Symptoms of stiff neck, these experts report, are "often associated with meningitis, subarachnoid hemorrhage, and posterior fossa tumor." Explanations of these three conditions follow: