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Stiff Neck Injury Explained

A stiff neck is an extremely common symptom, which may be caused by a variety of neck conditions. The symptoms of neck pain and stiffness, which decreases neck movement, can be secondary to several problems, such as a Disc Prolapse (Slipped Disc), a facet joint problem, an undiagnosed Cervical Fracture (Broken Neck), or another neck problem.

The stiff neck is usually caused by muscle spasm in the neck muscles. This spasm can cause neck pain in addition to any underlying neck problem. In infants a stiff neck is called 'Congenital Muscular Torticollis', which is an inherited disorder of the neck muscles. In adults, muscle spasm in the neck, leading to a stiff neck, is usually a protective mechanism which is secondary to an underlying neck problem. This is referred to as 'Acute Torticollis' or 'Wry Neck'.

The muscles surrounding the neck can become imbalanced, where some become weak and long whilst others overly active and tight. This “upper cross syndrome” was first described by Dr Vladimir Janda who identified patterns of dysfunction in both the upper and lower spine. In regards to the neck, Upper Cross Syndrome usually involves over activity in the Pectoralis muscles of the chest and the Upper Trapezius and Levator Scapula muscles behind the neck. This is often caused by posture either at work, with prolonged sitting, driving or now with looking down at mobile phone screens the symptoms can be exacerbated. The tightness in the mentioned muscles causes the opposite muscles (antagonists) to become stretched and weakened (inhibited). So the muscles at the front of the neck such as the Scalenes, Sternocleidomastoid along with the Lower Trapezius muscles and Rhomboids behind the shoulder blade can become quite dormant, causing a forward head posture.

Stiff Neck Signs & Symptoms

In most cases of Acute Torticollis or Wry Neck, the person wakes up with the painful stiff neck, although occasionally the neck may become stuck following a sudden movement. The head will be held to one side and the neck is too painful to move. Attempting to move the neck will usually make the neck pain worse. In some cases, the pain will radiate up the neck or down to the shoulder area. There may be painful spasm in the neck muscles.

Stiff Neck Treatment

Because the cause of Acute Torticollis is not known for sure, it is important to rule out injury to the discs in the neck or degenerative conditions of the neck. To do this is it best to see a doctor and, if necessary, a referral will be made to a specialist. Once it has been established with investigations, such as an x-ray and MRI scan of the neck, that there is no serious underlying problem, the stiff neck can be referred for treatment with a Chartered Physiotherapist. A Physiotherapy appointment can help address any muscular imbalances around the neck and upper spine and identify postural habits that could be leading to the symptoms.

No treatment, particularly manual treatment and manipulations should be started before the cause of the stiff neck has been established.

Gentle massage and mobilisations by a Chartered Physiotherapist are effective forms of treatment for a stiff neck. This involves the physiotherapist gently applying pressure to each vertebra in the neck in order to loosen them and allow a greater range of movement. Exercises to maintain range of movement and strength in the muscles surrounding the neck can also be prescribed alongside any postural advice that will help reduce the symptoms and future episodes of neck pain. Another helpful treatment is the use of a Heat Pack. Heat Packs have the effect of relaxing the muscles that had previously been in spasm. Gentle stretching exercises can also be beneficial in alleviating muscle spasm in the neck.

Stiff Neck Prevention

Obviously, with Congenital Muscular Torticoliis there is no prevention strategy. In Acute Torticollis, good posture, particularly keeping the neck in supported position when working, can help to prevent a stiff neck. This is because the neck stiffness and protective muscle spasm is usually as a result of an underlying neck problem. Good posture can help to avoid these conditions such as Arthritis of the neck and disc problems. In people who already have neck problems, lying down in bed may aggravate their neck pain and lead to more neck muscle spasm. This in turn can lead to more neck pain and further spasm. Sleeping with only one pillow can help alleviate a poor overnight posture and in turn can lead to reduced neck pain and spasm. A supporting Neck Pain Pillow can be effective at providing support for the head and neck, which prevents this vicious cycle from developing.

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