Neck stiffness : causes and initial workup

Neck stiffness is a common complaint encountered across various populations and age groups, often paralleling the presentation and assessment of neck pain. Similar to neck pain, neck stiffness can result from a variety of etiologies, ranging from benign muscle strain to more serious conditions requiring prompt medical attention.

Neck pain, a closely related symptom, is prevalent globally. According to the Global Burden of Disease study, the global point prevalence of neck pain is 4.9%, with an estimated 1-year incidence ranging from 10.4% to 21.3%. Studies have shown that neck pain's prevalence tends to be higher in females, higher-income countries, and urban areas compared to rural regions. For example, a recent population-based study in Singapore reported a 6-month prevalence of neck pain at 23.0%.

Neck pain ranks as the fourth leading cause of disability worldwide and is associated with various comorbidities, including headache, back pain, arthralgias, and depression. Although serious causes of neck pain and stiffness are rare, primary care physicians must be adept at recognizing when these symptoms might indicate a serious underlying pathology. Timely evaluation and specialist referral are crucial in such cases to prevent adverse outcomes.