• Friday May 29,2020

Neck stiffness (meningism)

The neck stiffness, also called meningism, denotes a painful restriction of movement or immobilization of the cervical spine. This is caused by a reflex tension to protect important structures of the spinal cord and the brain. When the neck stiffness is a medical examination is absolutely necessary because the neck stiffness is a symptom (disease sign).

What is a neck stiffness?

Neck pain is usually the most obvious symptom of severe neck stiffness.

Neck stiffness means that the affected person has considerable pain during head movements. The mobility of the cervical spine is severely limited or no longer possible. The patient is unable to move his chin toward the chest.

This is the main criterion for meningism. The medical term Meningismus was derived from Meningen. Meninges are the brain membranes. However, a neck stiffness is to be distinguished from pure neck pain or shoulder pain. However, tension usually occurs in connection with meningism.


Various causes come into question in meningism. For example, diseases of the meninges, bleeding in the brain, a sunstroke or a flu-like infection may be the cause of neck stiffness.

An infection by a tick bite can lead to neck stiffness. Especially dangerous are bleeding in the brain, which is also the first symptom of neck stiffness. Suppurative sinusitis or suppurative tonsillitis may also be associated with neck stiffness.

Diseases or injuries to the cervical spine are also often coupled with a painful neck stiffness. A migraine attack can also be the cause of neck stiffness.

Symptoms, complaints & signs

In meningitis, complaints of the neck occur first. The sufferers complain of a neck stiffness, accompanied by very severe pain, in an attempt to move the head towards the chest. For this reason, the diseased persons assume a restraint, which in turn leads to painful tension of the neck muscles.

In addition, characteristic concomitant symptoms occur, but these do not necessarily occur in every patient. These side effects are called "meningonal syndrome". Most commonly, there is a sudden onset of nausea, even vomiting. Furthermore, extremely strong, spasmodic headaches can be seen in many patients.

For example, if meningitis due to infection with meningococci has occurred, it is not uncommon to experience high fever, which is steadily increasing. Less common are symptoms such as photophobia or phonophobia. In photophobia, those affected find any light source unpleasant and painful. In some people, sensitivity to light can cause nausea and vomiting. For all these signs, seek medical attention immediately as it is a serious condition.

Diagnosis & History

The diagnosis of neck stiffness must be made by a doctor. For the doctor, further diagnostic criteria are the occurrence of fever, visual disturbances and photosensitivity. The doctor receives important information when questioning the patient and the first physical examination.

Through certain tests it is possible for the doctor to determine which meninges are affected or irritated. Furthermore, blood tests and x-ray examinations give the doctor first indications of the cause of the disease. Especially in combination with high fever, a CSF (lumbar puncture) is an important measure for the doctors to make a diagnosis.

Depending on the cause of the neck stiffness results in a different course. Meningism, which is caused by inflammation of the brain lining or bleeding, can develop into a life-threatening disease and requires intensive care until stabilization of the patient.

The course may be very dramatic, as in addition to neck stiffness, you may experience significant headaches, blurred vision, nausea, dizziness, photosensitivity, and loss of consciousness. These can lead to unconsciousness.

Typical of meningism is that the reflex tensions dissolve in a coma. If the cause of the neck stiffness is damage to the cervical spine, headaches, partial visual disturbances, as well as discomfort and loss of strength in the arms are possible.


Apart from the typical pain-relieving measures, which are effective almost on the entire body, there is no possibility for those concerned to treat the neck stiffness or to make it bearable. Thus, a medical cause research is necessary and then meningism is then treated together with its cause.

The neck stiffness should not be attempted to overcome by force. Thus, in the case of a cerebral hemorrhage cause more serious damage caused by further hemorrhages. Also, a bacterial cause as a trigger of meningism can only be worsened by a "tilting" of the head, as purulent tissue is so spread or can rupture cysts.

Since a neck stiffness occurs on different occasions, amateur treatment with home remedies is not recommended. For example, infections of the meninges - which mostly indicate illnesses requiring treatment - or brain haemorrhages are the reason for the stiffening. In addition, damage to the spine can also be the cause.

The list of concomitant symptoms that are cause-dependent is long. Patients can only be active in the case of neck tension, which occurs in the course of a flu infection, through heat, cold or massage. In case of doubt, however, medical advice is always preferable.

When should you go to the doctor?

With stiffness of the neck, a doctor may not be consulted in all cases. The neck stiffness often occurs due to a faulty posture, a one-sided load and a lack of exercise. By means of slight compensatory movements and a heat supply to the affected area, a clear alleviation of the symptoms or a freedom from symptoms can be achieved without medical treatment. If autonomous sports activities are carried out, which do not cause overstraining and in which the muscles in the neck are loosened gently, an improvement of the health condition is often achieved. Often, a self-initiated massage, the mobility of the shoulders, the neck and the neck can be effected.

If, despite all efforts, the symptoms remain undiminished or increase in intensity, a visit to the doctor should be made. In case of headache, a deformation of the skeleton, a prolonged restraint of the body or a permanent oblique posture by the person concerned, a doctor should be consulted.

If it comes to complaints when chewing, a breath shortage or changes in the appearance of the skin, a doctor should be consulted. Medical assistance should be sought as soon as the complaints have spread or the daily requirements due to the impairments can no longer be met. Repeated nausea and recurrent vomiting are other signs that require medical attention.

Treatment & Therapy

The treatment of meningism depends on the cause. Meningism, the cause of which is an inflammatory disease of the meninges, is treated with antibiotics and often antiviral drugs. Intensive medical care is often required here, as serious complications such as epilepsy can occur during this disease.

If the neck stiffness is caused by a hemorrhage in the brain, then it is absolutely necessary to clarify exactly where the hemorrhage in the brain is. Here, the neurosurgeons need to act very quickly, as the bleeding can cause damage to the brain that is no longer reversible. Furthermore, bleeding in the brain can lead to breathing problems and death of the patient within a very short time.

Especially with bacterial infections, such as purulent angina, the symptoms of antibiotics improve quite quickly, and the stiffness of the neck disappears.

Neck stiffness, which is caused by diseases of the cervical spine, needs to be clarified, which structures of the cervical spine are damaged. Depending on the outcome of this examination, a targeted therapy in the form of medication and physiotherapy then takes place. Severe disc herniations, which can also be associated with neck stiffness, often require surgery.

Outlook & Forecast

Meningism is caused by a potentially life-threatening condition. The prognosis therefore depends primarily on what causes the disease and how quickly the affected people are treated properly. Especially if the disease is of bacterial origin, it must be treated quickly with antibiotics. If left untreated, it almost always ends fatally. With timely treatment, however, there is a good chance that the patients will recover completely.

However, the chances of a full recovery depend on the type of pathogen and the general state of health of the person affected. Accordingly, a prognosis is sometimes less favorable for seniors and for infants. Your immune system is usually not as efficient as healthy adults. A virus-induced disease is significantly less life-threatening.

Nevertheless, the prognosis of the respective virus as well as the general physical condition also depends here. Especially the first days are critical. If the patient survived this but well, the chance of recovery is usually good. The disease usually heals within several weeks without any consequential damage.

In rare cases, the disease can cause prolonged neurological damage. These may be paralysis, hearing impairment or mental or behavioral impairment. Complications and long-term damage usually occur when the disease also jumps to the brain.


A direct prevention of Meningism is not possible. Certain vaccinations reduce the risk of getting a tick bite or meningitis.

Cervical spine damage can be avoided by a variety of activities, gymnastics and a lot of exercise. To prevent vascular changes in the brain, which can potentially lead to life-threatening bleeding in the brain, it is important to avoid high-fat foods, nicotine and obesity. Furthermore, make sure that the blood pressure is not increased.

Regular preventive examinations make it very rare to detect changes in the vessels so that meningism can be avoided in individual cases as a result of early treatment.


The extent to which follow-up care becomes necessary depends on the outcome of the first-line therapy. As a rule, if there is a timely treatment, there are no consequential damages. Therefore, there is no reason for close follow-up as you know from cancer treatments. Recurrence can not develop from the underlying disease. To prevent a recurrence of the neck stiffness, only a few measures are suitable.

As part of the aftercare, a doctor can reduce the risk of a new disease from certain vaccinations. Other forms of prevention, on the other hand, are the responsibility of the patient. So a healthy lifestyle with lots of exercise, a balanced diet and no substance consumption is the best way of preventive aftercare.

Aftercare takes care of other goals, if consequential damages remain from the initial treatment. Then it's about supporting everyday life and minimizing disadvantages. Also, no new complications should occur. The extent and type of follow-up depends on the individual complaints.

So aids can be prescribed for hearing damage. Behavioral problems can be treated in the context of psychotherapy. Neurological damage and paralysis can even lead to lifelong need for help. Most patients with persistent impairments are also treated with medication.

You can do that yourself

To alleviate the discomfort and avoid danger can be contributed to neck stiffness by their own behavior. It is also important to ensure that a natural head restraint due to the disease can be dangerous and must therefore be avoided. This also applies to intensive sports activities, especially gymnastic exercises.

Helpful is a rather restrained reaction to painful neck tension with heat or cold and light massage. Also advantageous is a workplace design according to ergonomic considerations. The right choice of chair and table should be in the foreground when doing office work. Regular breaks with a little exercise serve to reinforce existing complaints not by prolonged, unchanged sitting postures. When driving, it is important to remember that a sudden head and neck bump on the attached neck support could be painful and dangerous. A properly set, well padded neck support is therefore recommended.

Unnecessary stress in everyday life for the neck and spine area should be avoided. This includes incorrect posture, stress and drafts. With the selection of the right mattress and the pillow a sleep free of complaints as far as possible can be promoted. If the neck stiffness is accompanied by a chronic pain, a patient attitude is needed. Relaxation techniques can help to better mentally manage the disease.

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