Neck Pain and Stiffness: Causes and Treatment Options

Neck stiffness and back problems?

Hello, Director Wang.
I am from Keelung.
In March, after a haircut, I experienced an accident during a massage by the barber, resulting in neck and shoulder pain.
Since then, up until October, I initially had numbness in my hands, specifically in my index and ring fingers, as well as in my feet.
However, after June, the numbness has mostly subsided, but the shoulder and neck pain remains persistent.
I wake up every day with a stiff neck, which is quite severe.
When I look up, I feel a sensation of tightness in the back of my neck, as if it is being pushed upwards.

I then went to Cathay General Hospital for out-of-pocket physical therapy, undergoing three sessions over three weeks.
The physical therapist mentioned that there doesn't seem to be any significant issues, but I could opt for more detailed examinations.
I was instructed to practice chin tucks and shoulder shrugs daily, which has helped me manage the symptoms better.

In September, I had an examination at the Neurology Department of National Taiwan University Hospital, where nerve conduction studies and evoked potential tests were normal.
X-rays of the cervical spine were taken in AP, lateral, and both oblique views, and the doctor concluded that my cervical spine looks good and there is no need for concern.

Currently, my symptoms include frequent episodes of waking up with a stiff neck and the sensation of my neck being pushed upwards when I look up.
I would like to ask if these symptoms are likely to improve over time or if I should seek further medical attention.
I have seen online videos suggesting that the feeling of upward pressure in the back of the neck could indicate cervical spine dislocation.
Is this true? I am quite worried, especially since I am preparing for the college entrance exam and will soon be enlisting in the military.

Additionally, my neck and upper back occasionally make sounds, and sometimes when I tuck my chin, I hear popping noises.
The physical therapist and neurologist both said there is no major concern, but I am quite anxious about it and would appreciate your clarification.
Are there any methods to alleviate the stiffness? Thank you very much.

A-Ming, 20~29 year old female. Ask Date: 2018/10/08

Dr. Wang Zhaomin reply Rehabilitation

The initial symptoms may be caused by nerve irritation, which can improve after treatment, and since X-rays show no significant lesions, there should be no major skeletal issues.
Currently, the symptoms may be related to lifestyle and common postures, as prolonged reading with the head down while preparing for exams can easily lead to shoulder and neck discomfort.
It is recommended to continue the exercises taught by the therapist to strengthen the shoulder and neck muscles, which should gradually improve the symptoms.
If the symptoms persist, further examinations may be necessary.
Regarding the popping sounds, if they occur naturally, they generally are not a cause for concern; however, it is not advisable to intentionally create popping sounds, as long-term irritation and wear on the shoulder and neck joints can be detrimental to health.
To alleviate neck stiffness, attention should be paid to daily posture, training the shoulder and neck muscles, and selecting an appropriate pillow with the right firmness and height to provide adequate support for the head and neck, which should help improve the condition.

Reply Date: 2018/10/08

More Info

Neck pain and stiffness can be quite debilitating and often stem from various causes, including muscle strain, poor posture, and underlying medical conditions. Based on your description, it seems that your neck pain and associated symptoms have persisted for several months, which can be concerning.
Initially, it’s important to understand that neck pain can arise from several factors. In your case, the incident following a haircut where you received a massage may have triggered muscle tension or strain. This is common, especially if the massage was vigorous or if you were in an awkward position during the treatment. The subsequent symptoms of arm and leg numbness could indicate nerve involvement, but since you mentioned that these symptoms have largely resolved, it suggests that the initial irritation may have subsided.

The sensation of stiffness and the feeling of your neck "locking" when you look up can be attributed to muscle tightness and possibly cervical spine issues. The cervical spine consists of vertebrae that can become misaligned or strained due to poor posture, repetitive movements, or trauma. The fact that your imaging studies (X-rays) showed no significant abnormalities is reassuring, indicating that there are likely no major structural issues at play.

You mentioned that physical therapy has been somewhat beneficial, which is a positive sign. Physical therapy can help strengthen the muscles around the neck, improve flexibility, and promote better posture, all of which can alleviate pain. The exercises you are doing, such as chin tucks and shoulder shrugs, are excellent for maintaining neck health. Consistency is key, and it may take time to see significant improvements.

Regarding your concern about the popping or cracking sounds in your neck, this is often benign and can occur due to the movement of tendons or ligaments over bones or due to gas bubbles in the joint fluid. As long as these sounds are not accompanied by pain or discomfort, they are generally not a cause for concern.

As for the "pushing up" sensation in your neck when you look up, this could be related to muscle tightness or tension in the upper trapezius or other neck muscles. It’s not uncommon for individuals to experience a sensation of tightness or pressure in the neck, especially if they are under stress or have poor ergonomic setups at work or study.

In terms of treatment options, here are some recommendations:
1. Continue Physical Therapy: If you find it beneficial, continue with your physical therapy sessions. You might also consider discussing with your therapist about incorporating more specific exercises that target your symptoms.

2. Posture Awareness: Be mindful of your posture, especially when studying or using a computer. Ensure your workstation is ergonomically set up to reduce strain on your neck.

3. Heat and Cold Therapy: Applying heat can help relax tight muscles, while cold therapy can reduce inflammation. Alternating between the two may provide relief.

4. Regular Breaks: If you are studying for long periods, take regular breaks to stretch and move around. This can help prevent stiffness from developing.

5. Stress Management: Since stress can exacerbate muscle tension, consider incorporating relaxation techniques such as deep breathing, yoga, or meditation into your routine.

6. Consult a Specialist: If your symptoms persist or worsen, it may be worthwhile to consult a specialist, such as a neurologist or an orthopedic doctor, for further evaluation. They may recommend additional imaging studies or treatments.

In conclusion, while your symptoms may be concerning, they are often manageable with the right approach. It’s essential to remain proactive about your health, continue with your exercises, and seek further medical advice if necessary. Remember, recovery can take time, and it’s important to be patient with your body as it heals.

Similar Q&A

Understanding Neck Pain: Causes, Symptoms, and Treatment Options

Hello Doctor: I have been experiencing neck pain for the past six months, along with lower back pain, and sometimes upper back pain. There is a feeling of tightness and stiffness in my neck when I turn it, which is painful. I have received treatment in the neurology department at...

Dr. Ye Boshou reply Neurology
1. Neck stiffness is not a precursor to a stroke. 2. Possible. 3. No. 4. If there are still issues, you may visit the rehabilitation department for physical therapy.

Understanding Chronic Neck Stiffness: Causes and Solutions

Frequent neck stiffness and habitual head shaking can be caused by several factors, including muscle tension, poor posture, stress, or underlying medical conditions such as cervical spondylosis or myofascial pain syndrome. To address these issues, consider the following approache...

Dr. Li Zhiyao reply Internal Medicine
Stiffness in the neck may be caused by spinal issues, muscle problems, or even high blood pressure. Please pay attention to whether your blood pressure is elevated, if your pillow is unsuitable, or if you are using the computer excessively. It is recommended to consult with a reh...

Which Specialist Should You See for Neck Pain and Stiffness?

Hello, Doctor. I have been studying for a long time and sitting for extended periods. Over the past six months, I often feel a tightness in my cervical spine, and my neck feels somewhat stiff. Even during regular activities, I sometimes notice something unusual in my neck, and it...

Dr. Jiang Junyi reply Neurology
Hello: Based on your description, it may be necessary to consider cervical spine disorders. External factors such as traffic accidents, falls, head impacts against hard objects, or excessive force during cervical rotation can lead to cervical instability, dislocation, and cervica...

Understanding Neck, Shoulder, and Back Stiffness: Causes and Solutions

Hello Dr. Yeh, I often experience stiffness and discomfort in my neck, back, and shoulders, especially while driving or eating, but I do not have these symptoms when playing golf. An internist has examined me and found nothing unusual, and a physician has suggested that I see a ...

Dr. Ye Boshou reply Neurology
Mr. Wu, at the age of 62 and with this diagnosis, is likely suffering from cervical spondylosis. A neurological examination and X-ray imaging should be performed to confirm the diagnosis before proceeding with treatment.