Neck Tension – Causes, Symptoms & Treatment

Neck tension

Sitting for a long time at the computer, a strenuous car journey, an uncomfortable bed: neck tension has many causes, usually occurs unexpectedly and can be very annoying. The pain in the neck can radiate to the shoulders and the back of the head. Sometimes a neck tension quickly disappears on its own, sometimes the pain is more persistent and a visit to the doctor is necessary.

What is neck strain?

Limited mobility and aching muscles are the basic symptoms of neck tension. The free movement of the head in all directions is no longer possible, sometimes even the mobility of the chest and shoulders is impaired. Rotational movements of the upper body are not possible or only possible to a limited extent and are associated with neck pain .

The doctor refers to the pain in the neck as cervical syndrome or as cervical spine syndrome (cervical spine syndrome). All forms of neck pain are summarized under this term. Depending on the duration, an acute (up to three weeks), a subacute (up to twelve weeks) and a chronic (longer than twelve weeks) course is distinguished.

The longer the pain lasts, the more likely it is that the affected structures will be damaged, the existing symptoms will become chronic, or there will be consequential damage.


In most cases, the tension has built up over a longer period of time and is announced by symptoms such as headaches , burning eyes or tiredness . The earlier the treatment of neck tension begins, the faster the symptoms will disappear. There can also be an unpleasant tingling in the neck, a dull, pulling pain, migraine-like headaches or numbness in the fingers .

The manifestations of neck tension are just as varied as their causes. Spasms in the neck muscles and the associated nerve irritation can occur without a clear cause or in connection with another illness, often a cold . Unilateral stress in combination with a lack of exercise , uncomfortable sleeping or sitting positions as well as stress and drafts are also seen as causes. Overloading, heavy carrying or lifting, jerky movements or drafts can also be the cause.

But sometimes the reason is deeper: Experts cite signs of wear and tear on the extremely mobile and very vulnerable cervical vertebrae and their intervertebral discs as a rare cause of neck tension. Previous illnesses, whether known or not, are also triggers for spasms in the neck and neck muscles. The neck can also stiffen in connection with meningitis , rheumatic or neurological diseases, inflammation of the vertebrae, misalignment of the spine or vascular diseases.

Other triggers can be osteoporosis , infectious diseases such as listeriosis or a salmonella infection , but also bone tumors and lymphomas. If neck tension occurs after an accident, it is often a case of whiplash . Caution is advised here: It could also be a broken vertebra that needs immediate medical attention. A congenital malposition such as torticollis is rarely the cause of the pain.

Symptoms, Ailments & Signs

In addition to muscle tension in the neck, back of the head and shoulders, other symptoms can also occur. The mobility of the head and cervical spine can be restricted, and pain in the shoulders and shoulder joints is frequently mentioned.

Nausea to the point of vomiting , headaches to migraines and the associated visual disturbances often occur in connection with neck problems. But ringing in the ears , shortness of breath , dizziness and tiredness are also symptoms associated with cramped throat and neck muscles. Weakness in the legs occurs only occasionally. Many of the complaints are attributed to the increased pressure of the muscles on the nerve tracts. Excessive muscle tone is perceived as more uncomfortable the longer it lasts.

If an accident or a sudden event is the cause of the muscle hardening, if the pain occurs suddenly or if you are briefly unconscious , it is advisable to consult a doctor immediately. The following applies in all cases: The restriction of mobility entails an increased risk of accidents. In the case of such complaints, doctors advise against activities that require a great deal of mobility in the cervical spine. Car trips should be avoided. Carrying and lifting heavy objects or one-sided strain on the neck and neck muscles can increase the symptoms and damage the cervical spine.


If the tension persists for a long time and does not go away on its own, other problems often arise. The impairment of the nerves can lead to numbness in the neck and shoulders , but also in the fingers and hands. Even a feeling of weakness in the legs can be caused by neck tension.

When should you go to the doctor?

If symptoms are added that cannot be immediately assigned to the tension, caution is called for. Significant weight loss , for example, can indicate a more serious cause. Even if there is a radical deterioration in the condition, an immediate visit to the doctor is indicated.

Neck tension can also occur with a disease of the coronary arteries such as a myocardial infarction ( heart attack ) or angina pectoris . Strong mental strain and persistent stress can lead to a stiff neck even without orthopedic findings. If signs of paralysis appear in the arms or hands, a doctor should be consulted.


The physical examination by the doctor clarifies whether there are malfunctions in the musculoskeletal system, joints , tendons or ligaments . Muscle overload is also checked, as is a strain or a possible herniated disc . It is determined how flexible the cervical spine is or whether nerves are pinched. The extent of bad posture, the quality of the muscles and possible external causes such as accidents or jerky movements are included in the diagnosis.

Other diagnostic options can also be used to clarify the cause of the disease. A blood count excludes infectious diseases and Lyme disease, imaging methods such as an X-ray , computed tomography (CT) or magnetic resonance imaging ( MRI ) provide reliable information about orthopedic causes.

A herniated disc would show up here as well as a pathological change in bones or intervertebral discs. Once the causes of the disease have been clarified, treatment of the symptoms can begin. In consultation with the patient, the doctor will show the appropriate methods to alleviate symptoms and permanently eradicate the cause of the impairment.

Treatment & Therapy

Heat usually relieves the discomfort of tense neck and neck muscles. Blood circulation-promoting ointments with camphor or peppermint oil are also proven first-aid measures. If the disease persists, self-treatment is not recommended. At the latest after a few days with the pain in the neck or if the symptoms worsen, a doctor should be consulted.

If the disease is very severe, such as paralysis of the arms, or if there is a known pre-existing condition (e.g. osteoporosis or rheumatism), a doctor should be consulted. The doctor will define the scope of the examination by means of a targeted anamnesis and initiate the treatment. The question of the duration of the existing pain is just as much part of the initial anamnesis as the reconstruction of the course of the disease, the determination of the severity of the pain and the question of other existing diseases.

Which measures the doctor suggests depends on the extent of the impairment and the pain felt by the patient. In the case of severe complaints, we recommend relieving the cervical spine with the help of a special foam collar or an ergonomically shaped neck pillow. Complementary measures such as acupuncture or naturopathic procedures must be considered in each individual case. Surgery may only be necessary in rare cases and after all other measures have been exhausted.

First, the acute symptoms are treated. Tensions usually respond well to therapeutic measures: massages , heat applications such as fango packs or red light are often used. In most cases, the doctor treating you combines manual treatment with physiotherapeutic units. This should loosen the muscles, loosen stuck fascia and reduce stress.

The tape technique with special kinesiological adhesive tapes that are applied to the skin can also provide relief. The bands act like a permanent massage and gently stretch. Depending on how the patient feels, the doctor prescribes painkillers (e.g. paracetamol ) and non-steroidal rheumatic drugs (e.g. ibuprofen , diclofenac ) to relieve the pain quickly.

Targeted injections of numbing drugs such as lidocaine into the myofascial trigger points, where the tense muscle bundles converge, may be used. The injections have proven to be very effective, especially in combination with stretching exercises. Light exercise such as walks, gentle gymnastics, targeted stretching exercises or relaxed swimming support relaxation and, if used correctly, provide relief even with acute symptoms.

Doctors often recommend the additional use of heating pads, sauna sessions and hot baths. Manipulation of the cervical spine with chiropractic handles should be viewed with caution: this type of treatment should always be done very gently, and rough jerking or tearing should be avoided at all costs. This type of treatment may only be performed by certified doctors.

Outlook & Forecast

The prognosis of neck strain is favorable. Most of those affected experience disturbances in everyday movement. The strain on the organism is not optimal and therefore triggers tension in the neck area. If the muscular system is supported by balancing or therapeutic movements, in most cases the symptoms will be alleviated within a short time. In addition, those affected can independently contribute to improving their health by regularly performing sporting activities.

If one-sided physical stress or poor posture is avoided, the symptoms can also be alleviated. In the case of long-lasting or deep-seated tension, heat baths or massages can also help. These lead to a relaxation of the muscle fibers and relieve the existing tension accordingly. A change in the movement sequences is absolutely necessary for long-term freedom from symptoms. Otherwise, the recurrence rate for neck tension is very high.

If the tension is triggered by disorders of the skeletal system, physiotherapeutic exercises are necessary for a long-term improvement in general health. These should also be used independently by the patient outside of therapy hours in order to take preventive measures. If it is not possible for the person concerned to carry out compensating movement exercises due to an existing serious underlying disease, the symptoms will only be alleviated once the underlying disease has subsided or has been cured.


For a permanent improvement of the condition, the doctor will prioritize the relaxation of the muscle tissue and the loosening of stuck muscle fascia in order to lower the basic tone of the muscles. Regular exercise and a good mental state are just as important to avoid creating new problems. Unilateral stress and monotonous movements should be avoided.

Stress hormones such as cortisol , adrenaline and noradrenaline promote the symptoms: stress reduction, mobility and suppleness are therefore in the foreground as a preventive measure. Easy running, swimming or other endurance sports improve blood circulation and supply the muscles with blood and oxygen. This strengthens the immune system and prevents infectious diseases that can also cause neck tension. Physiotherapy is recommended for very severe symptoms and is often prescribed by the doctor in connection with passive heat applications.


Follow-up care after neck strain is very important. It is the same as prevention, since the aim is to prevent the unpleasant symptoms from flaring up again. It is ideal if the person concerned is aware of how the neck tension came about.

If the cause is an unhealthy posture, for example at work, ergonomic design is an important part of aftercare. Breaks during work are also important to be able to relax the neck again. This applies in particular to everyone who sits in a bent position at a desk or PC. If you make a lot of calls and have the habit of holding the phone between your head and shoulder, you would do well to configure a suitable headset during aftercare.

If the neck tension is the cause of an unfavorable positioning of the cervical spine in bed, the mattress and pillow should be reconsidered. Orthopaedists, physiotherapists and often the correspondingly qualified specialist staff in the specialist bed shop can help here.

If the neck tension has been treated with physiotherapy, the patient has usually also learned exercises that should be continued at home. This is also an integral part of aftercare for this disease. If drafts were the cause of the neck tension, this should be consistently avoided. This is especially true with wet hair after a shower.

You can do that yourself

With the help of back gymnastics, not only the neck, but the entire systemically connected muscles on the back, neck and front of the body as well as on the shoulders and arms are worked on: Strengthening, mobility, mobilization and stretching are the top priorities here.

Gentle yoga gets tense muscles back into shape, but it also reduces stress with meditative elements and promotes oxygen supply with breathing techniques. Relaxation techniques such as progressive muscle relaxation provide improved awareness of the body and one’s own stress level. Many of these courses are subsidized by health insurance companies.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.