I don’t know how people walk around everyday with a neck that barely moves (Stiff neck). Patients tell me they have had it for a long time and it is part of their body issues that they just get used to working around and compensating.

They normally can’t recount any history of an injury, but say it’s ‘chronic’. And it’s not necessarily older people who have the problem.

On physical examination, I find in many cases that the cervical spine joints (the joints that help the neck move), can move individually when the person is lying down. However, once the patient is upright, the movement in all directions is reduced, sometimes to such an extreme that they must turn their entire body to ‘back their car out.’ I even had a person buy a new car with the ‘rear view camera’
instead of dealing with the problem.

There are many muscles that act as stabilizers to the neck that run from each spinal segment to the shoulder area including the collar bone (clavicle) and the shoulder blade (scapula). When the neck is in a forward position that normally comes with age, habituation with working on a computer, and poor general overall posture, gravity tries to force the head off the shoulders. So, the neck muscles on either side of the neck as well as behind must work very hard to keep the head on top of the shoulders. This will include every time one looks at their phone and messages or works on the phone or using the computer in poor positions. So the neck muscles trying to stabilize the head are the scalenes, levator scapulae, SCM and upper trapezius as you can see from the illustration below.

Stiff neck

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I compare it to the analogy of a mast on a boat that is held up by the wires called ‘stays’ at the front and back and ‘shrouds’ on the sides. Depending on the tack you are on, if the boat is on a broad reach or running, so the wind is coming from behind, the stays and the shrouds (particularly the back one) will tighten to make sure that the mast stays upright. If we now look at the neck, you can understand by the above mentioned muscles tighten up to hold up the head. Intertwined in some of these muscles is the start of the brachial plexus which is the major nerve supply to the arms. So it is no wonder that in some cases one can present with arm/hand symptoms such as weakness and tingling.

Stiff neck

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The other factor that one must take into account here is that most of these patients try to fit more into a day than is possible. A lot of them are upper chest breathers and leave their diaphragm totally unknown to help in the breathing process. Proper functioning of the diaphragm is important as you can see that it is attached to the entire rib cage. This part of the puzzle is important so that the rib cage moves better and help the functioning of the neck. Patients must be more conscious of using the diaphragm; a process that takes a great deal of time and effort to retrain.

Stiff neck

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So there are a lot of factors that are instrumental in getting this range of motion back in the neck for a permanent timeframe. It is important that the person understand that this is a process of undoing and relearning which will take some time. However, it is extremely important to work on this so that more normal motion returns to the neck. This will prevent a lot of Stiff neck problems that inevitably transpire over time. So the keys are patience and practice.