How Long Does a Stiff Neck Last – And when should you stop waiting it out?
Neck stiffness usually comes about in one of two ways.
You wake up in the morning with a stiff and painful neck, making it hard to move your head and neck.
Neck stiffness slowly builds and you feel like you carry some level of stiffness all the time.
Regardless of how it starts, neck stiffness is not fun to deal with. It is annoying at best and debilitating at worst, leaving you feeling useless for anything else besides trying to survive.
Any kind of pain, stiffness, or tension in the head and neck region makes it especially challenging to concentrate, think, focus, and interact with people. It’s like the closer the pain is to your head, the more your brain revolts against your attempts to be a functional human.
Let’s be honest. No one has time for that.
That’s why we are going to explain to you everything you need to know regarding long does a stiff neck last, why it happens, and what to do about it.
Here’s what we are going to talk about in this blog post:
What causes a stiff neck
How long does a stiff neck last
When waiting it out is reasonable (and how to help it loosen up)
Why a stiff neck may not resolve on its own
Signs it is time to stop waiting it out
How physical therapy can help
What causes a stiff neck
There are several causes of neck stiffness, and whether you woke up with it suddenly or it’s been building over time, the underlying causes are similar.
From our clinical experience, the most common causes of neck stiffness are:
Postural stressors
Spending lots of time in a forward head posture throughout the day puts extra demand on the muscles of the neck and upper back.
Heads are heavy and weigh about 10-12 pounds. For every inch forward your head comes, your neck muscles have to work two to four times harder just to hold your head up.
Here’s what the numbers look like.
Head upright = 12 pounds of force needed by muscles to keep head upright
Head 2 inches forward = 32 pounds of force needed by muscles to keep head upright
Head 4 inches forward = 42 pounds of force needed by muscles to keep head upright
Let’s say your head is just 2 inches forward for 6 hours per day while working, reading, or scrolling on your phone. That is 6 hours in which your neck and upper back muscles are exerting 32 pounds of force, when they only want to be exerting 12 pounds of force. That’s about 3x more work.
This chronic increase in workload is what contributes to tension being held in the neck. Imagine if you had to clean your house 3x more than what you usually do. You wouldn’t be too happy would you?
Same thing with your neck muscles.
Mental and emotional stressors
Muscle and fascia are two body tissues that hold mental/emotional stress and trauma. (Fascia is a type of connective tissue that surrounds literally everything in your body.) The most emotional parts of the body are the head, neck, and jaw as well as the hips, low back, and pelvic floor. And these two body regions are very connected with each other biomechanically.
If you have a good bit of stress that you are currently carrying, or have been carrying for a while, the neck is one place the body stores it.
This is why chronic, unprocessed stress is a huge driver of neck stiffness.
Poor pillow support
Quality pillow support is very important for neck health, especially for side sleepers. We see it quite often that when our clients get a pillow that properly supports them, their neck pain and stiffness improves drastically.
For side sleepers, it is very important that your pillow offers the right amount of support so that your neck is in a neutral position throughout the night. If you have too much or too little support, then your neck is in a sidebent position for 6-8 hours while you sleep. You also want to make sure that your shoulder is NOT resting on the pillow and that the pillow comes up to the side of the neck to support it.
For back sleepers, you want a medium to thin pillow. Definitely don’t use a super thick pillow, as this will bring your head and neck up too high, putting you in an awkward position. Be sure that your shoulders are off the pillow and the pillow adequately supports your neck.
For stomach sleepers- sorry to break it to you but this is not a great position to sleep in. Having your neck in so much rotation throughout the night can contribute to neck stiffness in the morning. If you have tried to break the stomach sleeping habit and are having a hard time with it, try placing a pillow under your chest. This will open up space for your neck to be in a more neutral position.
The question we get asked all the time is “What pillow is best?” While everyone has their own preferences, we love the Groove pillow for side and back sleepers, and many of our clients love it too! Check it out and use code P-EMPOWER for 10% off your order.
Neck driven breathing
How you breathe is super important for neck health. With compensations over time (including poor posture, stress, sucking your stomach in, or movement compensations) the body starts relying more on the neck muscles for breathing instead of the diaphragm.
The diaphragm is a big dome shaped muscle that sits at the bottom of the ribcage. Its number one job is to make you breathe all day, every day. It is very efficient at doing this. Check out this video that shows the diaphragm in action during breathing.
Neck muscles are a secondary breathing muscle, designed to help out when taking deep breaths or heavy breathing after physical exertion.
However, due to compensations, the neck muscles can take a more frequent and active role in breathing. Similar to the forward head posture scenario, this extra work over time leads to cranky muscles and a stiff neck.
Core weakness
The diaphragm’s number two job is core stabilization. If the diaphragm isn’t working properly for breathing, then it isn’t working properly for core stabilization either.
Having solid strength and stability in the core is very important to be able to lift and carry heavy objects, reach for things, and move throughout your day.
If the core isn’t doing its job to stabilize you, the body will find that stability elsewhere. The next place the body usually looks is the neck. The neck then starts to act like a core instead of a neck.
The core is meant to produce stiffness and stabilization. The neck is meant to be loose and free so you can look in all directions around you.
When the neck tries to stabilize, it becomes stiff. This pattern over time drives neck tension.
You will know this process is happening if your neck is the first thing to get sore and tired when doing core exercises or your neck doesn’t feel great the next day after doing a core workout.
How long does a stiff neck last
The short answer to this question is that a stiff neck will last as long as you keep doing things to cause it (aka the things we just talked about). Then once you stop doing those things, you need to set new habits so the neck stiffness doesn’t keep coming back.
For a deeper answer to how long does a stiff neck last, let’s break down the timeline based on the two stiff neck scenarios we initially talked about:
You wake up in the morning with a stiff and painful neck.
This is what we call an acute case of neck stiffness (acute means it just recently happened).
Lots of us have experienced this. You wake up and feel an intense, pinchy pain in your neck whenever you try to move or lift your head off the pillow. If you’ve experienced this, you know it sucks.
This is usually due to neck muscles that are in spasm plus neck joints that are “stuck” and unable to move because of the muscle spasming.
Depending on how intense it is and how proactive you are at addressing it, this pain usually lasts for 3-7 days. It usually gets a little better each day until it's gone.
Neck stiffness that slowly builds and you feel like you carry some level of stiffness all the time.
This is what we call a chronic case of neck stiffness (chronic means it’s been there for quite a bit of time).
Lots of us experience this too. While it can be less dramatic than the acute neck stiffness we just talked about, it can be just as annoying or debilitating.
This type of neck stiffness usually builds throughout the day, tends to be worse during periods of higher stress, or after lots of heavy lifting or a hard workout (especially an arm workout or overhead lifting). It often lasts for months or even years. The clients we see with chronic neck stiffness usually have been dealing with it for years.
For more information on this, check out our blog post on Neck Pain That Gets Worse Throughout The Day and Why You Get a Tension Headache After Working Out and How To Prevent It.
When waiting it out is reasonable (and how to help it loosen up)
You can self-treat acute neck stiffness and sometimes wait it out. We definitely recommend implementing these strategies and not just going about your day, praying it’s gone the next morning.
Here’s what you can do to help your stiff neck:
Heat
Heat is a great way to increase blood flow to tight and spasmed muscles. Blood flow = healing and also helps tight muscles and joints loosen up so they can move better with less pain.
Apply a heating pad, moist heat, or stand in a hot shower for 10-15 minutes. Do any combination of these heat modalities 2-5 times per day.
Neck mobility drills
We need to get your neck moving! Motion is lotion. Movement is medicine.
Directly targeting the spasmed muscles and “stuck” joints will help them loosen up and get back to an optimal way of moving.
Two of our favorite neck mobility drills are the neck rotation SNAG and chin tuck. Click on each of those exercise names for a video on how to perform them.
As you do these drills, do not push into worsening pain. Keep the range of motion as small as you need to at first. This will provide safety to your nervous system, which will actually allow things to calm down. More is NOT better. Pushing into worsening pain will actually perpetuate the tightness because your nervous system will perceive a threat and try to protect you even more.
Get your blood pumping
Again, motion is lotion and movement is medicine! We need to get blood pumping throughout the body to drive more blood flow to the neck. Also, moving your body is a scientifically proven way to reduce overall pain levels (this is called exercise-induced analgesia).
The best way to get your blood pumping is to get your heart rate up. Find a way to do this that doesn’t bother your neck.
Great ways to do this include:
Going on a walk
Going up and down your stairs
Marching in place
Riding an upright bike (a forward leaning bike may not feel great for your neck)
Hiking at a park
Marching in place
Bonus points if what you do gets you outside! Nature and sunshine are therapeutic.
Check your pillow support
Like we talked about before, proper pillow support is super important! Make sure your pillow is supporting you well and consider upgrading your pillow.
Reminder about the Groove pillow, which is our favorite for great neck support! Use code P-EMPOWER for 10% off your order.
In the case of a chronic stiff neck, you’ve been waiting it out for a long time now. It’s safe to say this isn’t going away on its own and it’s time to get professional help.
You need to identify the underlying causes of your neck stiffness and actively address them so that you can feel better long term.
Absolutely implement the strategies listed above. They can definitely help take the edge off! But none of those things will fix you long term. The problem runs deeper than just a tight or spasmed muscle.
Why a stiff neck may not resolve on its own
Your stiff neck may not resolve on its own if there are deeper reasons as to why your neck is stiff.
Let’s say you’re experiencing acute neck pain- you wake up in the morning and your neck is incredibly stiff. If you’ve been trying the strategies we just talked about and it either isn’t getting better or is improving very slowly, you probably have chronic neck stiffness on board as an underlying factor.
When you carry tension in your neck, you’re much more likely to wake up with acute neck pain and stiffness.
The sneaky thing about this is that you may not notice you have chronic neck stiffness. This is because if it’s been around for a long time or is slowly building, this state feels normal to you.
Clients tell us, “My neck was totally fine until it wasn’t!” But when we assess their necks, we can tell that it has been stiff for quite a while before the current flare happened.
In this case, you need some help getting your neck to loosen up.
Signs it is time to stop waiting it out
Here are signs it’s time to stop waiting it out:
You’ve had acute neck tightness for more than one week
You have chronic neck tightness
You’re developing headaches
You have numbness or tingling in the neck, shoulders, or arms
You’re noticing jaw pain, tension, clenching, or grinding
You’re feeling stuck and frustrated
Neck pain and stiffness is usually a pattern as opposed to an isolated, one-time problem. Things like posture, stress, breathing, and core strength all play a role. Having a professional guide you in how to fix these underlying factors will expedite your healing and drastically reduce frustration.
Let us speak some truth to you- it’s time to stop waiting it out. You’ve either given self-treatment a good go or you’ve been ignoring the problem for too long. It’s time to do something different.
There is a better way to live.
How physical therapy can help
Physical therapists are expertly trained to identify the underlying issues contributing to your stiff neck and help you fix them. High-quality physical therapists who also address the mind-body connection will help you navigate the mental and emotional stressors contributing to your stiff neck.
A thorough evaluation will first identify what the primary drivers of your neck stiffness are. Once that is identified, a customized plan including a combination of hand-on techniques, mobility drills, stress processing strategies, posture optimization, and muscle strengthening will help you get to a place where you’re not dealing with neck stiffness on the regular.
Hands-on techniques can include dry needling, cupping, trigger point release, myofascial release, “scraping”, and/or joint mobilizations. You can learn more about our body work techniques here.
It is important to note that to feel different long term, you need to do something different. The hands-on techniques are wonderful at bringing pain and tension levels down. But the magic happens when you pair that with mobility drills, muscle strengthening, productive stress processing, and habit change.
Remember- neck stiffness is common, but it is not something you have to “just live with.” Healing is possible, even if your neck has been stiff and painful for a while. You don’t need to wait until it gets worse or feel totally broken to get support.
Where to find physical therapy for neck stiffness
Have you tried the strategies we discussed and want more individualized support?
If you are located in or near Westerville, Ohio and want to know exactly how long does a stiff neck last, we can help you with physical therapy to finally gain clarity and feel better.
You can get started right away by learning more about our physical therapy services or getting in contact with us.
If you have additional questions, we would love to talk with you, hear your story, answer all your questions, and see how we could help.
You can call or text us at (614) 423-9731 or schedule a free discovery call. You can also learn more about Empower Physio and Wellness + our team or check out other services we offer.