Neck Stiffness

Clinical Overview

Neck stiffness (cervical rigidity) refers to reduced range of motion in the cervical spine, typically due to pain, muscle spasm, inflammation, or structural injury. It is a common post-traumatic finding but also an important clinical sign in non-traumatic neurological emergencies. In the context of fever and headache, neck stiffness (nuchal rigidity) is a cardinal sign of meningeal irritation, as seen in meningitis.

Common Causes

  • Muscle strain
  • Whiplash injury
  • Cervical spine fracture or dislocation
  • Cervical disc prolapse
  • Ligament injury
  • Meningitis (nuchal rigidity)
  • Cervical spondylosis
  • Arthritis

Investigations

  • Cervical Spine X-ray (AP, lateral, odontoid views)
  • CT Cervical Spine (mandatory post-trauma if fracture suspected)
  • MRI Cervical Spine (for disc, cord, and ligamentous assessment)
  • Neurological examination

🔴 RED FLAGS — Seek Emergency Care Immediately

• Limb weakness or paralysis

• Numbness in hands or feet

• Difficulty walking or balance problems

• Bladder or bowel dysfunction

• High-velocity trauma mechanism

• Fever with neck stiffness (possible meningitis — emergency)
Keywords

What conditions can lead to spinal cord compression?

This could be due to any of the following:

  1. Herniated disc — when the soft center of a spinal disc pushes out and presses on the spinal cord or nerves.
  2. Spinal stenosis — narrowing of the spinal canal, usually due to aging or arthritis.
  3. Tumors — either benign or malignant growths pressing against the spinal cord.
  4. Trauma or injury — fractures or dislocations that impinge on the spinal cord.
     
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