Stiff neck (meningism) – causes, symptoms & therapy

Meningism is not a disease in its own right. The stiff neck indicates the existence of another disease and can therefore be understood primarily as a symptom. This is another reason why it is important to have the symptoms clarified medically.

Affected people have severe pain , especially when turning their neck. In acute cases, it is also no longer possible to move the head appropriately. Patients are often no longer able to tilt their chin towards their chest. Meningism must be clearly differentiated from shoulder pain and neck pain. This is particularly important for subsequent therapy. This is the only way to apply measures that actively combat the pain.

causes

The cause of meningism is often found in irritation and disease of the meninges. Bleeding in the brain , insect bites and infections are also possible . The medical term “menginism” already indicates increased complaints in the region of the brain. The technical term was derived from “Meningen”. These are the meninges.Rapid action is required, particularly in the case of cerebral hemorrhage. Ticks play a key role in insect bites . Otherwise, meningism due to abscessed sinusitis and tonsillitis cannot be ruled out. In addition, migraine attacks can trigger neck problems. In general, the movement restrictions are a reaction to the pain for which one of the causes mentioned is responsible. If patients with stiff neck fall into a coma , the tension disappears again.

symptoms and course

Typical symptoms of stiff neck (meningism):

• headache

• shoulder pain

• neck pain

• muscle tension

• sensitivity to light

• Fever

• nausea

Meningism initially manifests itself in particular as headaches and restricted freedom of movement. In addition to the head, the neck region also hurts and there is tension. Depending on the cause behind the symptoms, more specific symptoms also occur. These include, for example, fever, sensitivity to light, nausea, dizziness, disturbances of consciousness or visual disturbances. The symptoms have the potential to lead to unconsciousness. In the case of injuries to the cervical spine, for example, abnormal sensations and a loss of strength in the arms occur at the same time.

The course of meningism depends crucially on the underlying cause. If symptoms within the brain, such as bleeding or inflammation , have triggered the symptom, a serious course must be expected. Major complications can occur. In order to save the patient’s life, it must be treated intensively and stabilized at an early stage. Otherwise it cannot be ruled out that the disease will lead to the death of the person concerned.

When to the doctor?

A stiff neck can have many causes and most are non-threatening. However, if this symptom occurs together with certain others, those affected should seek medical help as soon as possible.

Warning signs are a sudden onset of neck stiffness and accompanying nausea, light and noise sensitivity and headaches. Typically, the pain is worse when the head is bent forward or this movement is impossible. Such a combination of symptoms is called meningism or meningeal syndrome.

Since meningism is almost exclusively caused by dangerous diseases such as meningitis , those affected should go to the emergency room quickly. However, neck stiffness is often absent, especially in infants, so that meningitis must be considered even if photophobia occurs alone. Conversely, a stiff neck is not a sure sign of a dangerous illness. Sensitive people react to drafts with neck pain, for example. Tension in the upper spine is also very common and does not necessarily require a doctor’s visit.

If in doubt, it is still advisable to play it safe and seek medical help if the neck stiffness is unclear. This is especially true if other symptoms of meningitis are present at the same time.

Diagnose

The decisive factor in the diagnosis is the detailed discussion with the patient , in which those affected describe the exact symptoms. In addition to headaches and neck problems, all other symptoms must be mentioned. These allow the doctor to consider an initial suspicion. This must then be confirmed by the physical examination. Various measures are available here. It is important to take a picture of the brain, for example with an MRI . If there is bleeding or inflammation, it is possible for the doctor to recognize this using such a measure.

treatment and therapy

If those affected are no longer able to answer the doctor’s questions themselves, third parties should help. An accurate diagnosis is important in order to initiate the appropriate therapy. This ultimately depends on the underlying cause. If inflammation is responsible for the symptoms, antibiotics and antiviral drugs are usually used first . This is the case, for example, with inflammation of the meninges.

During such treatment, patients must remain under intensive care because the risk of further complications cannot be ruled out. In order to be able to treat these quickly if they occur, it is important that patients remain in the hospital. Bleeding in the brain is an even more dangerous situation. It must be found out as quickly as possible where exactly the bleeding is in order to stop it. Otherwise there is a risk of permanent damage or even death.

Once the brain has been damaged, it cannot be reversed. In the case of complaints in the cervical spine, the damage must first be identified. This can then often be treated with physiotherapeutic measures and pain-relieving medication . If there is a herniated disc , it is possible that the conservative measures may not work. In such a case, the affected person must be operated on.

prevention

A stiff neck can only be prevented to a certain extent. There are vaccinations that reduce the risk by containing the risk of meningitis. Otherwise, regular physical activity is important. The neck muscles can be specifically trained through gymnastics and certain exercises.A cerebral hemorrhage is usually caused by vascular changes. These can be reduced by leading a healthy lifestyle with few animal products and fat . Instead, you should make sure you consume enough fruit and vegetables. Avoiding obesity , nicotine and high blood pressure can also be helpful .