Diagnosis
The diagnosis of a stiff neck is mainly made by the typical symptoms. Usually the family doctor or an orthopedist is the right contact person. It may be possible to consult doctors from other specialties (e.g. neurology, internist, rheumatologist).
A physical examination in conjunction with the patient’s medical history (anamnesis) usually provides information about the extent of the symptoms. In particular, the physique, the mobility of the head, muscle strength and pain in the shoulder and neck area are examined. The cause of the stiff neck must be determined in order to initiate the appropriate therapy.
In some cases, for example after an accident, in the case of chronic pain that increases at night or when there are doubts about the harmlessness of the complaints, imaging procedures such as x-rays or magnetic resonance imaging can facilitate the diagnosis. However, it is not always the possibly visible signs of wear and tear on the spine that are the cause of neck pain. Possibly, examinations of the vessels in the neck (duplex sonography), blood tests or examinations by a neurologist or psychiatrist may also be considered.
The first aid for a stiff neck is always warmth. Whether with a hot-water bottle, soft red light or a warm grain pillow, the painful and stiff neck should first be warmed up properly. The heat increases the blood circulation in the aching muscles and thus promotes the healing process of smaller injuries.
It also relieves the pain, which is very important to prevent the pain-related relieving posture, which usually worsens rather than improves the discomfort of the stiff neck. A pleasantly warm bath can also help to relax the muscles and often has the additional positive effect of reducing stress, which is also a common cause of stiff neck. Basically, the stiff neck should only be moved carefully and not jerkily.
Light movement exercises in the sense of turning the head and stretching the lateral neck muscles are also recommended. Bed rest, on the other hand, is not recommended; it rather prolongs the duration of the pain. As much movement as possible is important, everyday life should be continued as well as possible, only heavy physical work and jerky movements should be avoided.
Nor should any attempt be made to “give yourself a break” or to move your head back and forth in circles. This often worsens the symptoms. Gentle massages can also loosen the muscles and promote blood circulation.
A professional masseur or physiotherapist can usually help to relieve severe pain. In persistent cases, relaxing and anti-inflammatory drugs for the stiff neck, as well as physiotherapy and heat treatments can be prescribed if the symptoms do not disappear by themselves within a few days. Medications can also be injected into the muscle or irritated joints.After a simple whiplash injury or to immobilize certain types of instability in the cervical spine (e.g. inflammation of vertebrae), a cervical tie (cervical support) can be useful for immobilization and stabilization. Other procedures such as acupuncture can also provide relief in some cases. Chiropractic or manual therapy is rarely used on the cervical spine, as it can lead to serious complications, including stroke.
