Neck stiffness/pain
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| Neck stiffness/pain |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pain and stiffness in the neck can be caused by a number of factors, but mainly by inflammation, infection or trauma. Inflammation of the neck and spinal cord can be indicated by an inability to touch the chin to the chest.
Differential diagnosis of causes of neck stiffness and pain
In alphabetical order. [1] [2]
- Dystonic reaction
- Infection
- Inflammation
- Trauma
- Torticollis
- Tumors
Diagnosis
- Physical examination
History and Symptoms
Other
- Lumbar puncture for CSF analysis
Laboratory Findings
- Labs include
- BUN/Creatinine
- CBC
- Electrolytes
- Calcium
- Glucose
- ESR
- Blood cultures if infection is suspected
MRI and CT
- Head CT without contrast can indicate bleeding
- Neck CT can indicate soft tissue disease
- MRI for epidural hematoma / abscess
Other Imaging Findings
- Cervical spine radiographs if trauma or neck infection are indicated.
Treatment
- Trauma
- soft collar immobilization
- halo brace immobilization
Acute Pharmacotherapies
- Torticollis/soft tissue injuries
- Bacterial meningitis requires ceftriaxone & vancomycin
- Viral meningitis treated supportively requires NSAIDs and IV fluids
- Abscess requires drainage and antibiotics
- Inflammatory arthropathies
Indications for Surgery
- Subarachnoid hemmorhage requires surgery