A stiff neck, also known as meningism, describes a painful movement restriction or inability to move the cervical spine. This is caused by a reflex contraction to protect important structures of the spinal cord and brain. When stiff neck occurs, a medical examination is absolutely necessary, since stiff neck is a symptom (sign of disease).
What is a stiff neck?
A stiff neck means that the person concerned has considerable pain when moving their head. The mobility of the cervical spine is severely restricted or no longer possible. The patient is unable to move the chin towards the chest. See psyknowhow for Lateral Midface Fracture Explained.
This is the main criterion for meningism. The medical term meningism was derived from meninges. Meninges are the lining of the brain. However, a stiff neck is to be distinguished from pure neck pain or shoulder pain. However, tension usually occurs in connection with meningism.
There are various causes of meningism. Diseases of the meninges, bleeding in the brain, sunstroke or a cold can be the cause of stiff neck.
Infection from a tick bite can also lead to stiff neck. Bleeding in the brain is particularly dangerous, and the first sign of the disease is a stiff neck. A blocked sinus infection or tonsillitis can also be associated with a stiff neck.
Diseases or injuries to the cervical spine are also often coupled with a painful stiff neck. A migraine attack can also be the cause of a stiff neck.
Symptoms, Ailments & Signs
In the case of meningism, symptoms first appear in the neck area. Those affected complain of a stiff neck, accompanied by very severe pain, when trying to move their head towards the chest. For this reason, the sick people adopt a relieving posture, which in turn leads to painful tension in the neck muscles.
In addition, characteristic accompanying symptoms occur, which, however, do not necessarily have to occur in every patient. These side effects are called “meningonal syndrome”. Sudden nausea and even vomiting occur most frequently. Furthermore, extremely severe, spasmodic headaches can be observed in many sufferers.
If the meningism is due to an infection, for example with meningococci, it is not uncommon for a high fever to occur, which is constantly increasing. Symptoms such as photophobia or phonophobia occur less frequently. With photophobia, those affected perceive any light source as unpleasant and painful. In some people, sensitivity to light can cause nausea and vomiting. If you have any of these signs, you should see a doctor immediately as this is a serious condition.
Diagnosis & History
The diagnosis when stiff neck occurs must be made by a doctor. For the doctor, further diagnostic criteria are the occurrence of fever, blurred vision and sensitivity to light. The doctor receives important information when questioning the patient and during the first physical examination.
Certain tests enable the doctor to determine which meninges are diseased or irritated. Furthermore, blood tests and X-rays give the doctor initial indications of the cause of the disease. Especially in combination with a high fever, a liquor puncture (lumbar puncture) is an important measure for doctors to be able to make a diagnosis.
Depending on the cause of the stiff neck, there is a different course. Meningism, which is caused by inflammation of the meninges or bleeding, can develop into a life-threatening disease and requires intensive medical care until the patient is stable.
The course can be very dramatic, since in addition to stiff neck, significant headaches, visual disturbances, nausea, dizziness, sensitivity to light and disturbances of consciousness can occur. These can lead to unconsciousness.
It is typical of meningism that the reflex tensions are released in the coma. If the cause of the stiff neck is damage to the cervical spine, headaches, partial visual disturbances, as well as paraesthesia and loss of strength in the arms are possible.
Apart from the typical pain-relieving measures that are effective almost all over the body, there is no way for those affected to treat stiff neck or make it more bearable. A medical investigation of the causes is necessary and the meningism and its cause are then treated accordingly.
A stiff neck should never be attempted to be overcome by force. In the case of a cerebral hemorrhage as the cause, further serious damage can result from further bleeding. Even a bacterial cause as the trigger of meningism can only be aggravated by “straightening” the head, since purulent tissue is spread further or cysts can rupture.
Since a stiff neck occurs for different reasons, an amateur treatment with home remedies is not recommended. It is not uncommon for infections of the meninges – which usually indicate diseases that require treatment – or cerebral hemorrhages to be the reason for the stiffening. Damage to the spine can also be the cause.
The list of accompanying symptoms that occur depending on the cause is long. Those affected can only use heat, cold or massages to treat neck tension that occurs during the course of a flu-like infection. When in doubt, however, medical advice is always preferable.
When should you go to the doctor?
Neck stiffness does not always require medical attention. Neck stiffness often occurs due to incorrect posture, one-sided strain and a lack of exercise. Slight compensatory movements and application of heat to the affected area can significantly alleviate the symptoms or eliminate them without medical care. If you take responsibility for sporting activities that do not cause overexertion and where the muscles in the neck are gently relaxed, an improvement in your state of health is often achieved. A self-initiated massage can often bring about mobility in the shoulders, neck and neck.
If, despite your best efforts, the symptoms persist or increase in intensity, you should see a doctor. A doctor should be consulted in the event of headaches, a deformity of the skeleton, a persistent relieving posture of the body or a permanent crooked posture by the person concerned.
If you experience discomfort when chewing, shortness of breath or changes in the complexion, you should consult a doctor. Medical help should be sought as soon as the symptoms that have arisen spread or the daily requirements can no longer be met due to the impairments. Repeated nausea and recurring vomiting are further signs that need to be clarified by a doctor.
Treatment & Therapy
Treatment for meningism depends on the cause. Meningism, which is caused by an inflammatory disease of the meninges, is treated with antibiotics and often also with antiviral drugs. Intensive medical care is often required here, since considerable complications, such as epilepsy, can occur during this illness.
If the stiff neck is caused by bleeding in the brain, it is imperative to find out exactly where the bleeding is in the brain. The neurosurgeons have to act very quickly here, since the bleeding can cause damage to the brain that is no longer reversible. Furthermore, bleeding in the brain can quickly lead to breathing problems and the death of the patient.
Especially with bacterial infections, such as purulent angina, the symptoms improve quite quickly with the administration of antibiotics, and the stiff neck disappears.
Stiff neck, which occurs due to diseases of the cervical spine, requires clarification as to which structures of the cervical spine are damaged. Depending on the result of this examination, a targeted therapy in the form of medication and physiotherapy is then carried out. In the case of severe herniated discs, which can also be accompanied by neck stiffness, an operation is often necessary.
Outlook & Forecast
Meningism is caused by a potentially life-threatening condition. The prognosis therefore depends primarily on what causes the disease and how quickly those affected are treated professionally. If the disease is of bacterial origin in particular, it must be treated quickly with antibiotics. Otherwise, if left untreated, it almost always ends fatally. With timely treatment, however, there is a good chance that the patient will recover completely.
However, how high the chances of a full recovery are depends on the type of pathogen and the general state of health of the person affected. Accordingly, a prognosis is sometimes less favorable for the elderly and for infants. Their immune system is usually not as efficient as in healthy adults. A disease caused by a virus is significantly less life-threatening.
Nevertheless, the prognosis also depends on the respective virus and the general physical condition. The first few days in particular are critical. However, if the patient has survived this well, the chance of recovery is usually good. The disease then usually heals within several weeks without any consequential damage.
In rare cases, the condition can cause permanent neurological damage. This can be symptoms of paralysis, hearing damage or mental or behavioral impairments. Complications and long-term damage usually occur when the disease also spreads to the brain.
There is no direct prevention of meningism. Certain vaccinations can reduce the risk of becoming ill after a tick bite or of meningitis.
Damage to the cervical spine can be avoided through varied activities, gymnastics and lots of exercise. In order to prevent vascular changes in the brain, which can lead to life-threatening bleeding in the brain, it is important to avoid high-fat food, nicotine and being overweight. It is also important to ensure that the blood pressure is not elevated.
It is very rarely possible to detect changes in the vessels through regular check-ups, so that in individual cases meningism can be avoided through early treatment.
The extent to which follow-up care is necessary depends on the outcome of the initial therapy. As a rule, no consequential damage remains if treatment is started in good time. Therefore, there is no reason for close follow-up controls as is known from cancer treatments. A recurrence cannot develop from the underlying disease. To prevent a recurrence of stiff neck, only a few measures are suitable.
As part of the follow-up care, a doctor can reduce the risk of recurrence with certain vaccinations. However, other forms of prevention are the responsibility of the patient. A healthy lifestyle with lots of exercise, a balanced diet and not consuming addictive substances is the best form of preventive aftercare.
Follow-up care pursues other goals if consequential damage from the initial treatment remains. Then it’s about supporting everyday life and minimizing disadvantages. Also, no new complications should arise. The extent and type of aftercare depends on the individual complaints.
Aids can be prescribed for hearing damage. Behavioral problems can be treated with psychotherapy. Neurological damage and paralysis can even lead to lifelong dependency. Most patients with permanent impairments are also treated with medication.
You can do that yourself
Your own behavior can help to alleviate the symptoms and avoid danger in the case of stiff neck. It should also be noted that a natural straightening of the head can be dangerous due to the disease and must therefore be avoided. This also applies to intensive sporting activities, especially gymnastic exercises.
A rather restrained reaction to painful neck tension with heat or cold and a light massage is helpful. A workplace design based on ergonomic aspects is also advantageous. The focus should be on the right choice of chair and table when doing office work. Regular breaks with a little movement serve to prevent existing complaints from being aggravated by prolonged, unchanged sitting postures. When driving a car, it is important to note that a sudden impact of the head and neck on the attached neck brace could be painful and dangerous. A correctly adjusted, well-padded neck support is therefore recommended.
Unnecessary strain on the neck and spine area in everyday life should be avoided. This also includes incorrect posture, stress and draughts. Choosing the right mattress and pillow can promote a night’s sleep that is as pain-free as possible. If the stiff neck is accompanied by chronic pain, a patient attitude is required. Relaxation techniques can help to better deal with the mental illness.